Individual therapeutic-cognitive intervention of the psychological and behavioural symptoms of patients with dementia (PRESTA study)

Abstract

IntroductionThe behavioral and psychological symptoms of dementia (BPSD) frequently appear associated with patients with dementia, aggravating their cognitive and behavioral status, which generates anguish for their main caregivers. Non-pharmacological therapies are a method to approach BPSD. AimTo analyze the effectiveness of a behavioral educational intervention and support to the family caregiver on the reduction of its overload, and if this reduction has a positive impact on BPSD of the patient with dementia. MethodsA randomized, controlled, double-blind trial was conducted with patients with dementia and their principal caregivers (PC). The PC were randomized to the intervention group (IG) or control (CG). The intervention consisted an individual cognitive-behavioral education performed by outpatient nursing, with periodic telephone contacts, during 3 months. CG received treatment as usual. Cognitive function was assessed using the cognitive scale Mini-Mental State Exploration (MMSE), Neuropsychiatric inventory (NPI-10) and depressive Geriatric Depression Scale (GDS). And caregiver reported burden through (Zarit Caregiver Burden Inventory). The Quantitative and qualitative data of SPCD’s were collected at baseline and after the intervention. ResultsThe mean total age of patients was 78.96 (± 6.64) years and 50% were men. And in PC (n = 28) of 58.64 (± 11.69) years, and 92.9% were women. The IG (n = 13) showed better score than the CG (n = 15) in the MMSE p < 0,001 and the GDS p < 0,001, although without changes in the NPI-10 (p = 0,419), between the start visit and at 3 months, indicating improvement cognitive and depressive after the intervention. The PC also obtained statistically significant scores in the Zarit (p = 0,010). SPCD’s improved significantly in GI: repetition p < 0,001, depression (p = 0,013), apathy and indifference (p = 0,003), sleep and diurnal rhythm disorders (p = 0,006) and eating disorders (p = 0,019) at 3 months. Clinicaltrials.gov Identifier: NCT03732521. ConclusionsThe non-pharmacological therapy of individual therapeutic-cognitive intervention directed to caregivers and carried out by nursing personnel expert in its management, has a favorable impact in the control and reduction of the SPCD of patients with dementia.