The Effect of Movement-oriented Dementia Care on ADL and QoL of Dementia Patients in Nursing Homes

NCT03001232 | Completed

• 1 other identifier: METc Vumc: 2013.311/A2015.245
• Study Type: interventional
• Target: 66
• Locations: 0 countries
• Sites: N/A

Brief Summary

The purpose of this study is to determine whether movement-oriented dementia care has a positive effect on quality of life and independence in activities of daily living (ADL) in nursing-home residents with dementia. It was hypothesized that movement-oriented dementia care has a positive effect on quality of life and independence in ADL, as well as on mood, behavior, cognition and physical functioning, in comparison to regular care.

Conditions

Dementia

Keywords

Movement-oriented Dementia Care; QoL; ADL; Nursing Home

Outcome Measures

Primary Outcomes (2)

• Change from Baseline in Activities of Daily Living (ADL), measured with the Barthel Index.

  The Barthel Index is a survey consisting of 10 performance items (e.g. toilet use, dressing) rated on an ordinal scale (two-point, three-point or four-point scale), indicating the level of help needed. Scores range from 0 to 20, with higher scores representing a higher level of functional independence.

  baseline and 3, 6, 9 and 12 months after baseline assessment

• Change from Baseline in Quality of Life (QoL), measured with the Qualidem

  The Qualidem is a questionnaire with 40 items of observable behaviour rated on a four-point rating scale, ranging from 1 (never) to 4 (often). There is no total score; scores can only be obtained for the nine subscales. For each subscale, a higher score represented a better quality of life.

  baseline and 3, 6, 9 and 12 months after baseline assessment

Secondary Outcomes (7)

• Change from Baseline in general cognitive functions, measured with the Severe Impairment Battery 8 (SIB-8).

  baseline and 3, 6, 9 and 12 months after baseline assessment.

• Change from Baseline in mood, measured with the Cornell Scale for Depression in Dementia (CSDD).

  baseline and 3, 6, 9 and 12 months after baseline assessment

• Change from Baseline in behaviour, measured with the Apathy Evaluation Scale-10 (AES-10).

  baseline and 3, 6, 9 and 12 months after baseline assessment.

• Change from Baseline in behaviour, measured with the Cohen-Mansfield Agitation Inventory (CMAI).

  baseline and 3, 6, 9 and 12 months after baseline assessment.

• Change from Baseline in aerobic fitness, measured with the two minute walking test (2mWT).

  baseline and 3, 6, 9 and 12 months after baseline assessment

Other Outcomes (1)

• Degree of implementation of MDC at each ward measured with process evaluations.

  3, 6, 9 and 12 months of intervention.

Study Arms (2)

Movement-oriented Dementia Care

EXPERIMENTAL

The experimental group received movement-oriented dementia care for a period of twelve months.Movement-oriented dementia care is a multidisciplinary approach in which all involved disciplines focus on stimulating physical activity and independence as much as possible. This way physical activity is stimulated at all times for the participants.

Behavioral: Movement-oriented Dementia Care

Care as usual

NO INTERVENTION

The control group received care as usual

Interventions

Movement-oriented Dementia Care BEHAVIORAL

The intervention is a new multidisciplinary approach that focuses on optimizing physical activity and independence in daily care and activities. MDC intended to incorporate all persons surrounding the patients. The nursing staff was intensively trained by an expert in MDC, and played a central role in continuously stimulating patients to function as independently as possible. Geriatric physicians and physiotherapists advised the nursing staff about participants' medical and physical limitations to ensure safe stimulation. Consequently, a plan was created for each resident to determine the daily routines they were capable of performing themselves. Caregivers and volunteers were informed about the benefits of an active lifestyle during several open meetings.

Movement-oriented Dementia Care

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Diagnosis of dementia (based on medical charts)
• Living in a psychogeriatric ward of Solis for at least three weeks
• years of age or older

You may not qualify if:

• Very bad vision
• Psychotic symptoms
• A palliative care protocol
• A score on the Mini-Mental State Examination (MMSE) of 25 or higher

Sponsors & Collaborators

• VU University of Amsterdam: lead
• Zorggroep Solis: collaborator

Related Publications (10)

• Ballard C, O'Brien J, James I, Mynt P, Lana M, Potkins D, Reichelt K, Lee L, Swann A, Fossey J. Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs. Int Psychogeriatr. 2001 Mar;13(1):93-106. doi: 10.1017/s1041610201007499.

  PMID: 11352339 BACKGROUND

• Blankevoort CG, van Heuvelen MJ, Boersma F, Luning H, de Jong J, Scherder EJ. Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia. Dement Geriatr Cogn Disord. 2010;30(5):392-402. doi: 10.1159/000321357. Epub 2010 Oct 28.

  PMID: 20980758 BACKGROUND

• Edwards N, Gardiner M, Ritchie DM, Baldwin K, Sands L. Effect of exercise on negative affect in residents in special care units with moderate to severe dementia. Alzheimer Dis Assoc Disord. 2008 Oct-Dec;22(4):362-8. doi: 10.1097/WAD.0b013e31818ecbbc.

  PMID: 18978600 BACKGROUND

• Burge E, Kuhne N, Berchtold A, Maupetit C, von Gunten A. Impact of physical activity on activity of daily living in moderate to severe dementia: a critical review. Eur Rev Aging Phys Act. 2012 Apr;9(1):27-39. doi: 10.1007/s11556-011-0092-y. Epub 2011 Dec 15.

  PMID: 22639696 BACKGROUND

• Dechamps A, Diolez P, Thiaudiere E, Tulon A, Onifade C, Vuong T, Helmer C, Bourdel-Marchasson I. Effects of exercise programs to prevent decline in health-related quality of life in highly deconditioned institutionalized elderly persons: a randomized controlled trial. Arch Intern Med. 2010 Jan 25;170(2):162-9. doi: 10.1001/archinternmed.2009.489.

  PMID: 20101011 BACKGROUND

• Kemoun G, Thibaud M, Roumagne N, Carette P, Albinet C, Toussaint L, Paccalin M, Dugue B. Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dement Geriatr Cogn Disord. 2010;29(2):109-14. doi: 10.1159/000272435. Epub 2010 Feb 11.

  PMID: 20150731 BACKGROUND

• Morris JN, Fiatarone M, Kiely DK, Belleville-Taylor P, Murphy K, Littlehale S, Ooi WL, O'Neill E, Doyle N. Nursing rehabilitation and exercise strategies in the nursing home. J Gerontol A Biol Sci Med Sci. 1999 Oct;54(10):M494-500. doi: 10.1093/gerona/54.10.m494.

  PMID: 10568531 BACKGROUND

• Wetzels RB, Zuidema SU, de Jonghe JF, Verhey FR, Koopmans RT. Determinants of quality of life in nursing home residents with dementia. Dement Geriatr Cogn Disord. 2010;29(3):189-97. doi: 10.1159/000280437. Epub 2010 Mar 6.

  PMID: 20215750 BACKGROUND

• Galik E, Resnick B, Hammersla M, Brightwater J. Optimizing function and physical activity among nursing home residents with dementia: testing the impact of function-focused care. Gerontologist. 2014 Dec;54(6):930-43. doi: 10.1093/geront/gnt108. Epub 2013 Oct 3.

  PMID: 24092822 BACKGROUND

• Henskens M, Nauta IM, Scherder EJA, Oosterveld FGJ, Vrijkotte S. Implementation and effects of Movement-oriented Restorative Care in a nursing home - a quasi-experimental study. BMC Geriatr. 2017 Oct 23;17(1):243. doi: 10.1186/s12877-017-0642-x.

  PMID: 29058632 DERIVED

MeSH Terms

Conditions

Dementia

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Study Officials

• Marinda Henskens, Msc

  VU University of Amsterdam

  PRINCIPAL INVESTIGATOR

• Erik JA Scherder, Prof. Dr.

  VU University of Amsterdam

  PRINCIPAL INVESTIGATOR

• Susan Vrijkotte, Msc

  Zorggroep Solis

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Msc

Study Record Dates

• First Submitted: December 20, 2016
• First Posted: December 22, 2016
• Study Start: March 1, 2014
• Primary Completion: March 1, 2015
• Study Completion: March 1, 2015
• Last Updated: February 3, 2017

Record last verified: 2017-01

Data Sharing

• IPD Sharing: Will not share