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Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial

Clarkson, Paul; Pitts, Rosa; Islam, Saiful; Peconi, Julie; Russell, Ian; Fegan, Greg; Beresford, Rebecca; Entwistle, Charlotte; Gillan, Vincent; Orrell, Martin; Challis, David; Chester, Helen; Hughes, Jane; Kapur, Narinder; Roe, Brenda; Malik, Baber; Robinson, Catherine

Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial Thumbnail


Authors

Paul Clarkson

Rosa Pitts

Saiful Islam

Julie Peconi

Ian Russell

Greg Fegan

Rebecca Beresford

Charlotte Entwistle

Vincent Gillan

MARTIN ORRELL M.ORRELL@NOTTINGHAM.AC.UK
Director - Institute of Mental Health

Helen Chester

Jane Hughes

Narinder Kapur

Brenda Roe

Baber Malik

Catherine Robinson



Abstract

BACKGROUND: Common memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued. OBJECTIVE: To investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a pragmatic, randomised controlled trial. METHODS: Of 469 people with mild-to-moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) Score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; S-MMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ). RESULTS: DSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS Score increased to 14.6 (SD: 10.4) in intervention and 12.6 (SD: 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between-group difference was 0.38 (95% CI: -0.89 to 1.65, p=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes. CONCLUSIONS: This intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers. TRIAL REGISTRATION NUMBER: Current Controlled Trials ISRCTN12591717.

Journal Article Type Article
Acceptance Date Oct 4, 2021
Online Publication Date Oct 19, 2021
Publication Date Sep 1, 2022
Deposit Date Oct 22, 2021
Publicly Available Date Oct 22, 2021
Journal Journal of neurology, neurosurgery, and psychiatry
Print ISSN 0022-3050
Electronic ISSN 1468-330X
Publisher BMJ
Peer Reviewed Peer Reviewed
Volume 93
Issue 9
Pages 1001-1009
DOI https://doi.org/10.1136/jnnp-2021-326748
Keywords Psychiatry and Mental health, Neurology (clinical), Surgery
Public URL https://nottingham-repository.worktribe.com/output/6508690
Publisher URL https://jnnp.bmj.com/content/early/2021/10/19/jnnp-2021-326748

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