Cognitive-Behavioral Treatment for Mild Alzheimer's Patients and Their Caregivers (CBTAC)
Cognitive-Behavioral Treatment for Patients With Mild Alzheimer's Dementia: A Randomized Controlled Trial
研究概览
地位
条件
详细说明
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).
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Zurich、瑞士、8032
- Psychiatric University Hospital, Clinic for Geriatric Medicine
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Cognitive Behavioral Therapy (CBT)
Comprehensive, CBT-based, multi-component treatment.
Comprehensive CBT intervention in addition to standard treatment
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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).
其他名称:
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有源比较器:Treatment as usual (TAU)
Standard Treatment (medical and psychosocial)
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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.
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
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Change from baseline in Geriatric Depression Scale (GDS)
大体时间:Pre-treatment, posttreatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, posttreatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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Change from baseline in Neuropsychiatric Inventory (NPI)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Change from baseline in Bayer-Activities of Daily Living (B-ADL)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Change from baseline in Stress Coping Inventory (SCI)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Change from baseline in Apathy Evaluation Scale (AES)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Center for Epidemiologic Studies Depression Scale (CES-D)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Trait scale of the State Trait Anxiety Inventory (STAI)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Anger-in and anger-out scales of the State Trait Anger Expression Inventory (STAXI)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Short-Form Health Survey (SF-12)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Zarit Burden Interview (ZBI)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Caregiver: Change from baseline in Stress Coping Inventory (SCI)
大体时间:Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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Pre-treatment, post-treatment (expected average of 9 months after protreatment), 6- and 12-months follow-up
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合作者和调查者
调查人员
- 首席研究员:Simon Forstmeier, Ph.D.、University of Zurich
- 学习椅:Andreas Maercker, M.D.,Ph.D.、University of Zurich
- 学习椅:Egemen Savaskan, M.D.、Psychiatric University Hospital, Zurich
- 学习椅:Tanja Roth, Ph.D.、Psychiatric University Hospital, Zurich
出版物和有用的链接
一般刊物
- Forstmeier S, Maercker A. Problems of aging. Psychotherapy in older age [German]. Göttingen, Germany: Hogrefe. 2008.
- Forstmeier S, Maercker A. Psychotherapie im Alter. Psychotherapeutenjournal 4: 340-352, 2007
- Forstmeier S, Maercker A, Savaskan E, Roth T. Cognitive behavioural treatment for mild Alzheimer's patients and their caregivers (CBTAC): study protocol for a randomized controlled trial. Trials. 2015 Nov 17;16:526. doi: 10.1186/s13063-015-1043-0.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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