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Cognitive-Behavioral Treatment for Mild Alzheimer's Patients and Their Caregivers (CBTAC)

1 de novembro de 2017 atualizado por: Simon Forstmeier, University of Zurich

Cognitive-Behavioral Treatment for Patients With Mild Alzheimer's Dementia: A Randomized Controlled Trial

The purpose of this study is to determine whether a comprehensive cognitive-behavioral therapy-based, multi-component treatment programme is effective in the treatment of neuropsychiatric symptoms of patients with mild Alzheimer's dementia.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

Mild Alzheimer's dementia (AD) cases are with 15 millions worldwide the largest fraction of all AD cases. Most patients are cared for by their family at home. Neuropsychiatric symptoms are very common in AD, even as early as in mild AD: About 90% of all mild AD cases experience neuropsychiatric symptoms, most frequently depression, anxiety, and irritability. These symptoms are associated with greater morbidity, reduced quality of life for the patient, increased burden and depression for the caregiver, higher costs of care, and nursing home placement. Thus, interventions aimed at treating these symptoms could have a tremendous effect on pa-tients, caregivers, and society.

This study is a randomized, controlled trial (RCT) evaluating a comprehensive CBT-based, multi-component treatment programme consisting of eight modules (diagnosis and goal-setting; psycho-education; engagement in pleasant activities; cognitive restructuring; life review; training caregiver in behavior management techniques; interventions for the caregiver; couples counseling) and 20 sessions.

This trial aims at significantly reducing depressive and other neuropsychiatric symptoms in the AD patients, and secondary in reducing burden and depressive symptoms of the caregivers. Patients with AD alone or mixed AD and vascular dementia that are in the mild stage and suffer under any neuropsychiatric symptom will be included. The patients and their caregiver will be randomized to either the CBT-based intervention or to the control condition that receives treatment as usual (TAU).

Tipo de estudo

Intervencional

Inscrição (Real)

50

Estágio

  • Fase 2

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

  • Suíça
      • Zurich, Suíça, 8032
        • Psychiatric University Hospital, Clinic for Geriatric Medicine

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

50 anos a 95 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion Criteria:

  • Patients have to meet NINCDS-ADRDA criteria for probable or possible AD (McKhann et al., 1984). Mixed Alzheimer and Vascular dementia cases will also be included.
  • Only AD cases with a mild dementia severity will be included, determined by the Clinical Dementia Rating (CDR) scale (i.e. scores of 0.5 or 1, Morris, 1993) and by the Mini Mental State Examination (MMSE) (i.e. scores of 20 or more, Folstein, Folstein, & McHugh, 1975).
  • The patient must suffer under any non-cognitive symptom that motivates him to accept psy-chotherapeutic help.
  • A caregiver must be available to take part in most of the therapy sessions.

Exclusion Criteria:

  • concomitant alcohol or drug addiction and a history of a malignant disease, severe organ failure, metabolic or hematologic disorders, neurosurgery or neurological condition such as Parkinson's disease, epilepsy, postencephalitic and postconcussional syndrome

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Cognitive Behavioral Therapy (CBT)
Comprehensive, CBT-based, multi-component treatment. Comprehensive CBT intervention in addition to standard treatment
Comportamental: Comprehensive, CBT-based, multi-component treatment
It includes eight modules: diagnosis and goal setting; psychoeducation; engagement in pleasant activities; cognitive restructuring; live review; training caregiver in behavior man-agement techniques; interventions for the caregiver; and couples counselling. It consists of 20 weekly sessions (plus appr. 5 single session with caregiver).
Outros nomes:
  • Intervenção psicossocial
Comparador Ativo: Treatment as usual (TAU)
Standard Treatment (medical and psychosocial)
Comportamental: Treatment as usual
Each patient/caregiver must receive at least three out of six interventions: (1) psychoeducation on dementia and treatment of dementia (oral and written); (2) appropriate medical treatment; (3) social counseling by specialized staff; (4) memory training in group setting; (5) self-help group for the patient; (6) self-help group for the caregiver.
Outros nomes:
  • Tratamento padrão

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Prazo
Change from baseline in Geriatric Depression Scale (GDS)
Prazo: Pre-treatment, posttreatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, posttreatment (expected average of 9 months after protreatment), 6- and 12-months follow-up

Medidas de resultados secundários

Medida de resultado
Prazo
Change from baseline in Neuropsychiatric Inventory (NPI)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Change from baseline in Bayer-Activities of Daily Living (B-ADL)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Change from baseline in Stress Coping Inventory (SCI)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Change from baseline in Apathy Evaluation Scale (AES)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Caregiver: Change from baseline in Center for Epidemiologic Studies Depression Scale (CES-D)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Caregiver: Change from baseline in Trait scale of the State Trait Anxiety Inventory (STAI)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Caregiver: Change from baseline in Anger-in and anger-out scales of the State Trait Anger Expression Inventory (STAXI)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Caregiver: Change from baseline in Short-Form Health Survey (SF-12)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Caregiver: Change from baseline in Zarit Burden Interview (ZBI)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Caregiver: Change from baseline in Stress Coping Inventory (SCI)
Prazo: Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

University of Zurich

Colaboradores

Psychiatric University Hospital, Zurich

Investigadores

  • Investigador principal: Simon Forstmeier, Ph.D., University of Zurich
  • Cadeira de estudo: Andreas Maercker, M.D.,Ph.D., University of Zurich
  • Cadeira de estudo: Egemen Savaskan, M.D., Psychiatric University Hospital, Zurich
  • Cadeira de estudo: Tanja Roth, Ph.D., Psychiatric University Hospital, Zurich

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de fevereiro de 2011

Conclusão Primária (Real)

1 de setembro de 2017

Conclusão do estudo (Real)

1 de setembro de 2017

Datas de inscrição no estudo

Enviado pela primeira vez

3 de janeiro de 2011

Enviado pela primeira vez que atendeu aos critérios de CQ

7 de janeiro de 2011

Primeira postagem (Estimativa)

10 de janeiro de 2011

Atualizações de registro de estudo

Última Atualização Postada (Real)

6 de novembro de 2017

Última atualização enviada que atendeu aos critérios de controle de qualidade

1 de novembro de 2017

Última verificação

1 de novembro de 2017

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • 10-130034/1a

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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