Objectives:

Many people with dementia live in their home and require ongoing care, which is often provided by informal family caregivers. Thus, we examined the effectiveness of a multicomponent home-based intervention by evaluating its impact on a) neuropsychiatric symptoms of people with dementia and b) burden and depression of their caregivers.

Methods:

During the first 6 months of this prospective single-center study, we applied a home-based multicomponent intervention in 205 dyads of care-recipients and caregivers. In further analyzes, we included only dyads of caregivers and care-recipients with available data both at baseline and 6-month follow-up (N = 144). All assessments were conducted at home and included sociodemographic features, care-recipients’ clinical data, cognitive status (Mini-Mental State Examination), activities of daily living (Instrumental Activities of Daily Living; Katz Index of Independence in Activities of Daily Living), neuropsychiatric symptoms (Neuropsychiatric Inventory), and caregivers’ burden (Zarit Burden Inventory) and depression (Center for Epidemiological Studies-Depression).

Results:

We found significant decreases in the severity (p_FDR = 0.002) and associated distress (p_FDR = 0.001) of neuropsychiatric symptoms, as well as caregivers’ burden (p_FDR = 0.004) and depressive symptoms (p_FDR = 0.001). As expected, there was significant deterioration in care-recipients’ cognitive status (p_FDR = 0.005) and measures of activities of daily living (p_FDR < 0.005).

Conclusion:

Despite the progressive course of dementia, the home-based multicomponent intervention was effective in decreasing caregivers’ burden and depression and minimizing care-recipients’ neuropsychiatric symptoms’ severity and associated distress after 6 months. Our study highlights the establishment of home-based care units as an advantageous solution, specifically for family members seen to have a “taken-for-granted” role in dementia caring.

中文翻译：

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一项针对痴呆症患者和看护者负担和抑郁症患者神经精神症状的多组分家庭干预：一项为期 6 个月的纵向研究

目标：

许多痴呆症患者住在家里，需要持续的护理，这通常由非正式的家庭护理人员提供。因此，我们通过评估其对 a) 痴呆症患者的神经精神症状和 b) 照顾者的负担和抑郁的影响来检验多组分家庭干预的有效性。

方法：

在这项前瞻性单中心研究的前 6 个月中，我们对 205 名看护人和看护人进行了以家庭为基础的多组分干预。在进一步的分析中，我们仅纳入了在基线和 6 个月随访中具有可用数据的护理人员和护理接受者（N = 144）。所有评估均在家中进行，包括社会人口学特征、护理对象的临床数据、认知状态（简易精神状态检查）、日常生活活动（日常生活的工具性活动；日常生活活动独立的卡茨指数）、神经精神症状（Neuropsychiatric Inventory）、照顾者负担（Zarit Burden Inventory）和抑郁症（流行病学研究中心-抑郁症）。

结果：

我们发现神经精神症状的严重程度 (p _FDR = 0.002) 和相关的痛苦 (p _FDR = 0.001) 以及照顾者的负担 (p _FDR = 0.004) 和抑郁症状 (p _FDR = 0.001) 显着降低。_{正如预期的那样，护理接受者的认知状态（p FDR} = 0.005）和日常生活活动的测量值（p _FDR < 0.005）显着恶化。

结论：

尽管痴呆症呈进行性进展，但以家庭为基础的多组分干预在减轻护理人员的负担和抑郁症方面是有效的，并在 6 个月后最大限度地减少了护理人员的神经精神症状的严重程度和相关的痛苦。我们的研究强调建立家庭护理单位是一种有利的解决方案，特别是对于在痴呆症护理中被视为“理所当然”的家庭成员。