Effectiveness of Strength-based Intervention for Elderly With Dementia Living in the Community

NCT07037550 | Recruiting

• 1 other identifier: STRENGTH-B
• Study Type: interventional
• Target: 272
• Locations: 1 country
• Sites: 1

Brief Summary

In the realm of dementia care, the imperative to intervene at the earliest stages of cognitive decline is paramount. Recognizing this pivotal moment, the development of innovative and effective interventions becomes imperative in delaying dementia progression. Rooted in the Roy Adaptation Model and Zimmer's Theory of Psychological Empowerment, the investigator team has developed the empowerment-based dyadic strength-based intervention, which integrates strength-based and empowerment methodologies. Emphasizing a shift from deficits to capabilities, the strength-based approach fosters awareness of collective strengths within care dyads, facilitating coping mechanisms and resilience in the face of cognitive afflictions.

Conditions

Dementia; Mild Cognitive Impairment; Caregiver; Dementia Alzheimer Type

Keywords

dementia; mild cognitive impairment; caregiver; strength-based intervention; dementia alzheimer type

Outcome Measures

Primary Outcomes (24)

• A battery of cognitive assessments (CAB)

  evaluate the global cognition sore by the Alzheimer's Disease Assessment Scale -Cognitive Subscale (ADAS-Cog), the digit span-forward and backward test for attention and working memory, the list learning delayed recall test for episodic memory, 5-min Montreal Cognitive Assessment and Trail-Making Test for complex attention, executive function and task switching. The higher score indicates poor cognitive function

  baseline (T0)

• A battery of cognitive assessments (CAB)

  evaluate the global cognition sore by the Alzheimer's Disease Assessment Scale -Cognitive Subscale (ADAS-Cog), the digit span-forward and backward test for attention and working memory, the list learning delayed recall test for episodic memory, 5-min Montreal Cognitive Assessment and Trail-Making Test for complex attention, executive function and task switching. The higher score indicates poor cognitive function

  9-weeks immediate posttest (T1)

• A battery of cognitive assessments (CAB)

  evaluate the global cognition sore by the Alzheimer's Disease Assessment Scale -Cognitive Subscale (ADAS-Cog), the digit span-forward and backward test for attention and working memory, the list learning delayed recall test for episodic memory, 5-min Montreal Cognitive Assessment and Trail-Making Test for complex attention, executive function and task switching. The higher score indicates poor cognitive function

  3 months after the posttest (T2)

• Quality of Life-Alzheimer's Disease (QoL-AD)

  evaluate the health-related quality of life (HRQL) covering physical, functional, psychosocial, interpersonal, and environmental status of the patient with dementia, scales 13 to 52, with higher score indicating better HRQL

  baseline (T0)

• Quality of Life-Alzheimer's Disease (QoL-AD)

  evaluate the health-related quality of life (HRQL) covering physical, functional, psychosocial, interpersonal, and environmental status of the patient with dementia, scales 13 to 52, with higher score indicating better HRQL

  9-weeks immediate posttest (T1)

• Quality of Life-Alzheimer's Disease (QoL-AD)

  evaluate the health-related quality of life (HRQL) covering physical, functional, psychosocial, interpersonal, and environmental status of the patient with dementia, scales 13 to 52, with higher score indicating better HRQL

  3 months after the posttest (T2)

• the 10-item Center for Epidemiologic Studies Depression Scale (CES-D)

  evaluate the changes in participant's mood status. The response set is a 4-point Likert scale, scale from 0-30, with a higher score indicating a higher level of depression.

  baseline (T0)

• the 10-item Center for Epidemiologic Studies Depression Scale (CES-D)

  evaluate the changes in participant's mood status. The response set is a 4-point Likert scale, scale from 0-30, with a higher score indicating a higher level of depression.

  9-weeks immediate posttest (T1)

• the 10-item Center for Epidemiologic Studies Depression Scale (CES-D)

  evaluate the changes in participant's mood status. The response set is a 4-point Likert scale, scale from 0-30, with a higher score indicating a higher level of depression.

  3 months after the posttest (T2)

• Dyadic Relationship Scale - Patient version (DRS-patient)

  evaluate the quality of interpersonal relationships in the caregiving dyad, in the care recipient perspective. It measures aspects such as communication, support, and satisfaction within the dyad, providing insight into the dynamics of caregiving relationships in dementia care settings. It scale from 0-30 with a higher score indicating a better dyadic relationship.

  baseline (T0)

• Dyadic Relationship Scale - Patient version (DRS-patient)

  evaluate the quality of interpersonal relationships in the caregiving dyad, in the care recipient perspective. It measures aspects such as communication, support, and satisfaction within the dyad, providing insight into the dynamics of caregiving relationships in dementia care settings. It scale from 0-30 with a higher score indicating a better dyadic relationship.

  9-weeks immediate posttest (T1)

• Dyadic Relationship Scale - Patient version (DRS-patient)

  evaluate the quality of interpersonal relationships in the caregiving dyad, in the care recipient perspective. It measures aspects such as communication, support, and satisfaction within the dyad, providing insight into the dynamics of caregiving relationships in dementia care settings. It scale from 0-30 with a higher score indicating a better dyadic relationship.

  3 months after the posttest (T2)

• Dyadic Relationship Scale - Caregiver version (DRS-caregiver)

  evaluate the quality of interpersonal relationships in the caregiving dyad, in the caregiver perspective. It measures aspects such as communication, support, and satisfaction within the dyad, providing insight into the dynamics of caregiving relationships in dementia care settings. It scale from 0-33 with a higher score indicating a better dyadic relationship.

  baseline (T0)

• Dyadic Relationship Scale - Caregiver version (DRS-caregiver)

  evaluate the quality of interpersonal relationships in the caregiving dyad, in the caregiver perspective. It measures aspects such as communication, support, and satisfaction within the dyad, providing insight into the dynamics of caregiving relationships in dementia care settings. It scale from 0-33 with a higher score indicating a better dyadic relationship.

  9-weeks immediate posttest (T1)

• Dyadic Relationship Scale - Caregiver version (DRS-caregiver)

  evaluate the quality of interpersonal relationships in the caregiving dyad, in the caregiver perspective. It measures aspects such as communication, support, and satisfaction within the dyad, providing insight into the dynamics of caregiving relationships in dementia care settings. It scale from 0-33 with a higher score indicating a better dyadic relationship.

  3 months after the posttest (T2)

• The Revised Scale for Caregiving Self-Efficacy (RSCSE)

  evaluate the perceived self-efficacy in caregiving, to measure the caregivers' perceived self-efficacy in handling the symptoms of the persons with mild cognitive impairment and to control their own emotions. It scale from 0-100 with a higher score indicating a higher caregiving self-efficacy.

  baseline (T0)

• The Revised Scale for Caregiving Self-Efficacy (RSCSE)

  evaluate the perceived self-efficacy in caregiving, to measure the caregivers' perceived self-efficacy in handling the symptoms of the persons with mild cognitive impairment and to control their own emotions. It scale from 0-100 with a higher score indicating a higher caregiving self-efficacy.

  9-weeks immediate posttest (T1)

• The Revised Scale for Caregiving Self-Efficacy (RSCSE)

  evaluate the perceived self-efficacy in caregiving, to measure the caregivers' perceived self-efficacy in handling the symptoms of the persons with mild cognitive impairment and to control their own emotions. It scale from 0-100 with a higher score indicating a higher caregiving self-efficacy.

  3 months after the posttest (T2)

• The Neuro-psychiatric Inventory (NPI)

  evaluate the neuro-psychiatric symptoms of the patient with dementia reported by the caregiver, scales from 12 to 96 with higher scores indicating higher severity

  baseline (T0)

• The Neuro-psychiatric Inventory (NPI)

  evaluate the neuro-psychiatric symptoms of the patient with dementia reported by the caregiver, scales from 12 to 96 with higher scores indicating higher severity

  9-weeks immediate posttest (T1)

• The Neuro-psychiatric Inventory (NPI)

  evaluate the neuro-psychiatric symptoms of the patient with dementia reported by the caregiver, scales from 12 to 96 with higher scores indicating higher severity

  3 months after the posttest (T2)

• the Patient-Reported Mild Behavioral Impairment Scale

  evaluate the behavioral changes associated with cognitive decline for those with mild cognitive impairment, which enables patients to self-report symptoms, aiding in early detection and intervention for mild behavioral impairment, a potential precursor to dementia. It scale from 0-102 with a higher score indicating a higher risk of behavioral changes associated with cognitive decline.

  baseline (T0)

• the Patient-Reported Mild Behavioral Impairment Scale

  evaluate the behavioral changes associated with cognitive decline for those with mild cognitive impairment, which enables patients to self-report symptoms, aiding in early detection and intervention for mild behavioral impairment, a potential precursor to dementia. It scale from 0-102 with a higher score indicating a higher risk of behavioral changes associated with cognitive decline.

  9-weeks immediate posttest (T1)

• the Patient-Reported Mild Behavioral Impairment Scale

  evaluate the behavioral changes associated with cognitive decline for those with mild cognitive impairment, which enables patients to self-report symptoms, aiding in early detection and intervention for mild behavioral impairment, a potential precursor to dementia. It scale from 0-102 with a higher score indicating a higher risk of behavioral changes associated with cognitive decline.

  3 months after the posttest (T2)

Study Arms (2)

Strength-based intervention

EXPERIMENTAL

The Strength-based intervention incorporates 8-week Ambassador-led strength-based intervention including: a strength-based assessment to the patient-participant and caregiver done by the Social Worker, Ambassador-assisted preparation of the strength-based biography, four Ambassador-led workshops, the workshop will be delivered in group of 6-8 participants by at least 2 Ambassadors, and one Social Worker-led zoom video conference delivered to the caregivers.

Behavioral: Strength-based intervention

Usual care

NO INTERVENTION

No intervention, continue with usual care

Interventions

Strength-based intervention BEHAVIORAL

The Strength-based intervention incorporates 8-week Ambassador-led strength-based intervention including: 1. a strength-based assessment to the patient-participant and caregiver done by the Social Worker, 2. Ambassador-assisted preparation of the strength-based biography, 3. four Ambassador-led workshops, the workshop will be delivered in group of 6-8 participants by at least 2 Ambassadors, and 4. one Social Worker-led zoom video conference delivered to the caregivers.

Strength-based intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age over 18
• a confirmed diagnosis of mild dementia as indicated by the cut-off score of Montreal Cognitive Assessment-5-min at 13-18 for dementia and \>18-21 for mild cognitive impairment
• self-reported cognitive complaints
• have the ability to engage in the communication with the research assistant
• able to identify a family caregiver
• consent to participate

You may not qualify if:

• person who has communication problems with the research team

Sponsors & Collaborators

• The University of Hong Kong: lead

Study Sites (1)

The University of Hong Kong

Hong Kong, 0000, Hong Kong

RECRUITING

Related Publications (9)

• Haskan Avcı, Ö. (2014). Development of the Dyadic Relationship Scale. Eurasian Journal of Educational Research, 56, 89-108 DOI: http://dx.doi.org/10.14689/ejer.2014.56.6

  BACKGROUND

• Yu DS, Li PW, Zhang F, Cheng ST, Ng TK, Judge KS. The effects of a dyadic strength-based empowerment program on the health outcomes of people with mild cognitive impairment and their family caregivers: a randomized controlled trial. Clin Interv Aging. 2019 Oct 4;14:1705-1717. doi: 10.2147/CIA.S213006. eCollection 2019.

  PMID: 31686796 BACKGROUND

• Yeung PY, Wong LLL, Chan CC, Yung CY, Leung LMJ, Tam YY, Tang LN, Li HS, Lau ML. Montreal Cognitive Assessment - Single Cutoff Achieves Screening Purpose. Neuropsychiatr Dis Treat. 2020 Nov 6;16:2681-2687. doi: 10.2147/NDT.S269243. eCollection 2020.

  PMID: 33192067 BACKGROUND

• Smith SC, Lamping DL, Banerjee S, Harwood R, Foley B, Smith P, Cook JC, Murray J, Prince M, Levin E, Mann A, Knapp M. Measurement of health-related quality of life for people with dementia: development of a new instrument (DEMQOL) and an evaluation of current methodology. Health Technol Assess. 2005 Mar;9(10):1-93, iii-iv. doi: 10.3310/hta9100.

  PMID: 15774233 BACKGROUND

• Ismail Z, Aguera-Ortiz L, Brodaty H, Cieslak A, Cummings J, Fischer CE, Gauthier S, Geda YE, Herrmann N, Kanji J, Lanctot KL, Miller DS, Mortby ME, Onyike CU, Rosenberg PB, Smith EE, Smith GS, Sultzer DL, Lyketsos C; NPS Professional Interest Area of the International Society of to Advance Alzheimer's Research and Treatment (NPS-PIA of ISTAART). The Mild Behavioral Impairment Checklist (MBI-C): A Rating Scale for Neuropsychiatric Symptoms in Pre-Dementia Populations. J Alzheimers Dis. 2017;56(3):929-938. doi: 10.3233/JAD-160979.

  PMID: 28059789 BACKGROUND

• Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994 Dec;44(12):2308-14. doi: 10.1212/wnl.44.12.2308.

  PMID: 7991117 BACKGROUND

• Chu LW, Chiu KC, Hui SL, Yu GK, Tsui WJ, Lee PW. The reliability and validity of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog) among the elderly Chinese in Hong Kong. Ann Acad Med Singap. 2000 Jul;29(4):474-85.

  PMID: 11056778 BACKGROUND

• Boey KW. Cross-validation of a short form of the CES-D in Chinese elderly. Int J Geriatr Psychiatry. 1999 Aug;14(8):608-17. doi: 10.1002/(sici)1099-1166(199908)14:83.0.co;2-z.

  PMID: 10489651 BACKGROUND

• Steffen AM, Gallagher-Thompson D, Arenella KM, Au A, Cheng ST, Crespo M, Cristancho-Lacroix V, Lopez J, Losada-Baltar A, Marquez-Gonzalez M, Nogales-Gonzalez C, Romero-Moreno R. Validating the Revised Scale for Caregiving Self-Efficacy: A Cross-National Review. Gerontologist. 2019 Jul 16;59(4):e325-e342. doi: 10.1093/geront/gny004.

  PMID: 29546334 BACKGROUND

MeSH Terms

Conditions

Dementia; Cognitive Dysfunction; Alzheimer Disease

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders; Cognition Disorders; Tauopathies; Neurodegenerative Diseases

Central Study Contacts

Sau Fung Doris Yu, PhD

CONTACT

+852 3917 6319; dyu1@hku.hk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Another Research Assistant with no information of the random group allocation will execute the posttest assessment
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The Strength-based intervention incorporates 8-week Ambassador-led strength-based intervention including: 1. a strength-based assessment to the patient-participant and caregiver done by the Social Worker, 2. Ambassador-assisted preparation of the strength-based biography, 3. four Ambassador-led workshops, the workshop will be delivered in group of 6-8 participants by at least 2 Ambassadors, and 4. one Social Worker-led zoom video conference delivered to the caregivers.

Study Record Dates

• First Submitted: June 17, 2025
• First Posted: June 25, 2025
• Study Start: July 1, 2024
• Primary Completion: January 31, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: June 25, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

HK (1)