TY - JOUR
TI - A randomized, controlled, clinical trial of activity therapy for apathy
in patients with dementia residing in long-term care
AU - Politis, AM
AU - Vozzella, S
AU - Mayer, LS
AU - Onyike, CU
AU - Baker, AS
AU - and Lyketsos, CG
JO - International Journal of Geriatric Psychiatry
PY - 2004
VL - 19
TODO - 11
SP - 1087-1094
PB - Wiley
SN - 0885-6230, 1099-1166
TODO - 10.1002/gps.1215
TODO - apathy; Alzheimer’s disease; quality of life; reminiscence therapy;
dementia; nursing home; long term care
TODO - Background Apathy is a common symptom inpatients with dementia and has
adverse consequences for patients and care-givers. Most treatments for
apathy, particularly non-pharmacologic interventions, have not been
evaluated in controlled trials.
Objectives This study evaluated the efficacy of a kit-based activity
intervention, compared to a time and attention control (one-on-one
meetings with an activity therapist) in reducing apathy and improving
quality of life in 37 patients with dementia.
Methods The design was a randomized, controlled, partially masked
clinical trial. All outcome measures were administered at baseline and
follow-up. The primary outcome measure was the apathy score of the
Neuropsychiatric Inventory (NPI). Other outcome measures were the NPI
total score, the Alzheimer Disease Related Quality of Life scale(ADQRL),
and the Copper Ridge Activity Index (CRAI).
Results There was a significant reduction in NPI apathy scores in both
treatment groups. The only significant difference between the two
treatment groups was a modest advantage for the control intervention on
the CRAI cueing subscale (p = 0.027), but not on the other CRAI
subscales. There was also a greater within group improvement in quality
of life ratings in the control intervention (p = 0.03).
Conclusions Despite the substantial improvement in apathy scores during
the course of the study, there was no clear advantage to the
reminiscence-based intervention over the time and attention, one-on-one
control intervention. More research is needed to develop specific
behavioral interventions for apathy in patients with dementia. Copyright
(C) 2004 John Wiley Sons, Ltd.
ER -