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Promoting Activity, Independence and Stability in Early Dementia and Mild Cognitive Impairment (PrAISED2)

20 août 2019 mis à jour par: Nottingham University Hospitals NHS Trust
A clinical trial to test the clinical and cost-effectiveness of a therapy intervention designed to promote activity and independence and reduce falls, amongst people with early dementia or mild cognitive impairment

Aperçu de l'étude

Statut

Inconnue

Les conditions

Intervention / Traitement

Description détaillée

Background and study aims People with memory problems can struggle with everyday activities and may stop doing things they want to do. They are more prone to accidents and have a higher risk of falling. Occupational therapists can advise how to do daily activities more easily and safely. Physiotherapists can teach exercises which increase activity and improve balance, and may help maintain memory. There is little research on how to make these interventions work for with people with memory problems. The aim of this study is to compare an activity and exercise programme developed for people with memory problems to standard falls prevention assessment and advice.

Who can participate? Patients aged 65 or over with early dementia or memory problems, recruited from memory clinics or the 'Join Dementia Research' register

What does the study involve? Participants are randomly allocated to either the control group or the intervention group. The control group receive standard brief falls assessment and advice, and up to two further visits if required. The intervention group receive an assessment, tailored strength and balance exercise programme, activity analysis and risk enablement advice, and assessment for environmental hazards. The intervention is delivered over 1 year in participants' own homes, and is tailored to individual interests, abilities and need for supervision. Participants are encouraged to exercise by themselves or with family members between visits, and once the programme ends. Researchers visit at the start of the study and after 12 months to measure ability in activities of daily living, activity, quality of life, memory and health service use. Participants complete monthly falls diaries over 15 months. The researchers conduct interviews and video record some therapy sessions to help understand how the programme works in practice.

What are the possible benefits and risks of participating? Some participants may benefit from taking part in the intervention, as exercise is generally known to be beneficial to health and well-being, including benefits to heart, blood pressure, diabetes, joints, mood and daily life. These participants may find that they are better able to do their daily activities. All participants and their relatives may enjoy having the researchers coming to visit them in their house. Some people appreciate having the opportunity to contribute to the well-being of others through research.

Type d'étude

Interventionnel

Inscription (Anticipé)

368

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Royaume-Uni
    • Derbyshire
      • Derby, Derbyshire, Royaume-Uni, DE22 3LZ
    • Lincolnshire
      • Lincoln, Lincolnshire, Royaume-Uni, NG34 8GG
        • Recrutement
        • Lincolnshire Partnership NHS Foundation Trust
        • Contact:
        • Contact:
    • Notts
      • Nottingham, Notts, Royaume-Uni, NG3 6AA
    • Somerset
      • Bath, Somerset, Royaume-Uni, BA1 3NG
        • Recrutement
        • RICE - Research Institute for the Care of Older People
        • Contact:
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

65 ans et plus (Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Age 65 or over (no maximum)
  2. Diagnosis of MCI or dementia (of any subtype, except Dementia with Lewy Bodies i.e. Parkinson's Disease Dementia)
  3. Have a carer or friend who knows the participant well (at least one hour a week contact over the phone, internet, or in person), and is willing and able to act as an informant
  4. Able to walk without human help
  5. Able to communicate in English
  6. Able to see, hear and have dexterity sufficiently to perform neuropsychological tests
  7. Have capacity to give consent to participate, and consenting to do so

Exclusion Criteria:

  1. Co-morbidity preventing participation (e.g. severe breathlessness, pain, psychosis, Parkinson's, Dementia with Lewy Bodies, or other severe neurological disease)
  2. Unavailable over the next year (e.g. plans to relocate or go on a long holiday, or has a life expectancy of less than a year)

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Aucune intervention: Control
The control group will receive standard brief falls assessment and advice.
Comparateur actif: Intervention
Therapy intervention.
Comportemental: Intervention
Assessment, tailored strength and balance exercise programme, activity analysis and risk enablement advice, and assessment for environmental hazards. Tailored adherence support and supervision.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Disability Assessment in Dementia (DAD)
Délai: 12 months

Primary outcomes will be disability in Activities of Daily Living (Disability Assessment in Dementia, DAD) measured 12 months after randomisation. This is as recommended in a recent NIHR systematic review [Webster 2017].

scale range is 0% to 100%. Where 0% = minimal functional ability and 100% maximal functional ability. Higher scores represent less disability in ADL and lower scores indicate more dysfunction. There are no subscales.

"The total score is obtained by adding the rating for each question and converting this total score out of 100. The items rated as N/A are not considered for the total score. For example:

A score of 33 on 40 (maximum score) converted out of 100 = 83% A score of 33 on 38 (max. score with 2 N/A) converted out of 100 = 87%

This will result in a final score, a percentage which provides an appreciation of global function in ADL. Higher scores represent less disability in ADL while lower scores indicate more dysfunction."
12 months

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Nottingham Extended ADL Scale
Délai: 12 months
Self-reported Activities of Daily Living (ADL) using the Nottingham Extended ADL Scale [Nouri and Lincoln 1980].
12 months
Falls Rate
Délai: 12 months
Falls rate in months four-15 from randomisation (defined as 'unintentionally coming to rest on the ground or at a lower level, however caused', and ascertained by monthly diary)
12 months
Quality of Life
Délai: 12 months
Quality of life (EQ5D3L and EQ5D5L proxy [EuroQol Group 1990]; DemQol and DemQol proxy, including Demqol-u weights [Smith 2005; Mulhern 2013])
12 months
Mood or 'Affect'
Délai: 12 months
Mood or 'Affect' - Hospital Anxiety and Depression Scale (HADS [Zigmond and Snaith 1983]; Apathy Evaluation Scale - AES [Marin, Biedrzycki and Firinciogullari 1991])
12 months
Physical activity
Délai: 12 months
Longitudinal Aging Study Amsterdam (LASA) physical activity questionnaire [Stel 2004], pedometers
12 months
Cognition
Délai: 12 months
three scales from CANTAB [Cambridge Cognition, 2015]; Montreal Cognitive Assessment - MoCA [Nasreddine 2005], verbal fluency (from MoCA)
12 months
Time to first fall
Délai: 12 months
Time to first fall (from diary)
12 months
Rate of fractures and injurious falls
Délai: 12 months
Rate of fractures and injurious falls (from diary)
12 months
Rate of hospital and care home admissions, and days spent in hospital
Délai: 12 months
Rate of hospital and care home admissions, and days spent in hospital (from diary, hospital administrative records)
12 months
Carer strain
Délai: 12 months
Carer strain (Carergiver Strain Index [Robinson 1983]).
12 months
Carer health-related quality of life
Délai: 12 months
Carer health-related quality of life (EQ5D-5L [EuroQol Group 1990])
12 months
Personality
Délai: 12 months
Personality (Big Five Personality Inventory- short [BFI-10, Rammstedt and John 2007])
12 months

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Nottingham University Hospitals NHS Trust

Collaborateurs

National Institute for Health Research, United Kingdom

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Liens utiles

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 octobre 2018

Achèvement primaire (Anticipé)

31 mars 2021

Achèvement de l'étude (Anticipé)

13 mars 2022

Dates d'inscription aux études

Première soumission

21 mai 2019

Première soumission répondant aux critères de contrôle qualité

20 août 2019

Première publication (Réel)

22 août 2019

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

22 août 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

20 août 2019

Dernière vérification

1 août 2019

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • 17HC006

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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