Effects of the Tailored Activity Program in Brazil (TAP-BR) for Persons With Dementia: A Randomized Pilot Trial.

OBJECTIVES: The objectives of this study were to evaluate the effects of the Tailored Activity Program-Brazilian version (TAP-BR), on behavioral symptoms and the quality of life (QOL) in persons with dementia, as well as on their caregivers, and on caregiver burden. MATERIALS AND METHODS: A 2-group randomized controlled trial with 30 dyads was conducted: the experimental group (n=15) received TAP-BR over 4 months, and a wait-list control group (n=15) received usual care. Dyads were recruited from the community of Santos City, Brazil. RESULTS: For persons with dementia, 50% were female individuals, the average age was 81.37 (±7.57), and the educational level was 9.97 (±5.32) years. For caregivers, 83.33% were female, the average age was 65.97 (±10.13), and the educational level was 12.10 (±4.44) years. At posttest, in comparison with the wait-list control group, experimental group caregivers reported greater reductions in number (P<0.001; Cohen d=0.93), frequency (P<0.001; Cohen d=1.12), and intensity (P<0.001; Cohen d=0.77) of the behavioral psychological symptoms of dementia, and caregiver distress (P<0.001; Cohen d=0.87). Caregivers also reported improvement in their own QOL (P<0.05; Cohen d=0.57) and that of the person with dementia (P<0.01; Cohen d=0.56); no differences were found in the ratings of QOL by the person with dementia themselves. CONCLUSIONS: The results provide compelling evidence that the TAP-BR is an effective strategy to support dementia caregivers in other cultures (cross-validation).

Validation of the Brazilian version of the quality of life scale for patients with Alzheimer's disease and their caregivers (QOL-AD).

Quality of life (QOL) has been extensively studied in clinical trials and in research on chronic degenerative diseases and dementia. The aim of this study was to assess the reliability and construct validity of the Brazilian version of the QOL scale in Alzheimer's disease (AD; QOL-AD). The QOL-AD was administered to 60 patients with mild or moderate AD and to their caregivers. The construct validation was accomplished through correlations amongst total scores of patients' and caregivers' reports on patients' quality of life (PQOL and C-PQOL, respectively), and data related to cognitive impairment, depressive symptoms, functional performance, behavioral disturbances and a generic instrument of quality of life (WHOQOL-brief), as well as correlation of total score of caregivers' reports on their own quality of life (CQOL) with the measurements cited above, QOL-AD patient reports, and depressive symptoms. The reliability was high for PQOL, C-PQOL, and CQOL versions (Cronbach's alpha = 0.80, 0.83, and 0.86, respectively). We observed significant correlations in the construct validity of all three versions regarding the variables associated with the disease and also with WHOQOL-brief. The scale took, on average, six min for each version. The results indicate reliability and construct validity of the Brazilian version of the QOL-AD in the studied sample.

The influence of neuropsychiatric and functional changes on quality of life in Alzheimer's disease.

To investigate the influence of neuropsychiatric manifestations and functional performance on quality of life (QOL) of AD patients and their caregivers/family members. METHODS: The QOL-AD scale, Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Cornell and Beck Scales for Depression, Physical and Instrumental-Self Maintenance scales (AIDL and ADL) and the Neuropsychiatric Inventory (NPI) were applied to 60 patients with probable AD, mild (n=30) or moderate (n=30) dementia, according to NINCDS-ADRDA and DSM-III-R criteria, respectively, and to their caregivers/family members. The total scores on the three QOL-AD versions were correlated with the measures previously mentioned. RESULTS: The QOL-AD patients' version displayed significant correlations with GDS (-0.76 p<0.01), Cornell (-0.53 p<0.01) and NPI (-0.46 p<0.05) in the mild dementia subgroup. The caregivers' version about patients' QOL correlated with GDS (-0.48 p<0.01), Cornell (-0.57 p<0.01), NPI (-0.46 p<0.01) and AIDL (-0.36 p<0.05), while the caregivers' version about their own QOL was significantly correlated with NPI (-0.43 p<0.01), AIDL (-0.35 p<0.05) and Beck Depression (-0.67 p<0.01). In the moderate dementia subgroup, significant correlations were observed with GDS (-0.45 p<0.05) and Cornell (-0.46 p<0.01). For the caregivers' version about patients' QOL, significant correlations emerged with Cornell (-0.68 p<0.01), NPI (-0.67 p<0.01), AIDL (-0.41 p<0.05), ADL (-0.49, p<0.01) and Beck Depression (-0.33 p<0.05). For the caregivers' version about their own QOL, significant correlations with Beck Depression (-0.54 p<0.01) and ADL (-0.38, p<0.05) were found. CONCLUSION: The symptoms presented in AD affected the QOL in patients and caregivers/family members in both mild and moderate dementia.

Investigar avaliar a influência das manifestações neuropsiquiátricas e do desempenho funcional sobre a qualidade de vida dos pacientes com DA e de seus cuidadores/familiares. MÉTODOS: A escala QdV-DA, Mini-exame do Estado Mental (MEM), Escala de Depressão Geriátrica (GDS), Inventário de Depressão de Beck e a Escala de Cornell para depressão, Escala de atividades de vida diária (ABVD e AIVD) de Lawton e Brody e o Inventário Neuropsiquiátrico (INP) foram administrados em uma amostra de 60 pacientes com DA provável, segundo os critérios do NINCDS-ADRDA , com gravidade de leve (n=30) a moderado (n-30) segundo os critérios do DMS-III-R. e a seus respectivos cuidadores/familiares. A pontuação total, das três versões da escala, foi correlacionada aos instrumentos previamente mencionados. RESULTADOS: A versão de QV dos pacientes no grupo de demência leve apresentou correlações significativas com o GDS (­0,76 p<0,01), Cornell (­0,53 p<0,01) e INP (­0,46 p<0, 05). A versão do cuidador sobre a QV do paciente se correlacionou com: GDS (­0,48 p<0,01), Cornell (­0,57 p<0,01), INP (­0,62 p<0,01) e AIVD (­0,36 p<0,05) enquanto que a versão do cuidador sobre sua própria QV se correlacionou significativamente com NPI (­0,43 p<0,01), AIVD (­0,35 p<0,05) e GDS (­0,67 p<0,01). No grupo de pacientes moderados foram encontradas correlações significativas com GDS (­0,45 p<0,05) e a Escala de Cornell (­0,46 p<0,01). Para versão do cuidador sobre a QV do paciente as correlações significativas foram com: Cornell (-0,68 p<0,01), INP (-0,67 p<0,01), AIVD (-0,41 p<0,05), ABVD (-0,49 p<0,01), e Inventário de Depressão de Beck (-0,33 p<0,05). Para versão do cuidador sobre sua própria QV foram encontradas correlações significativas com: Inventário de Depressão Beck (-0,54 p<0,01) e ABVD (-0,38 p<0,05). CONCLUSÃO: Os sintomas da DA afetam a QV dos pacientes como também dos cuidadores/familiares tanto na fase leve como na fase moderada.