Apathy in nursing home residents with dementia: results from a cluster-randomized controlled trial

Y Treusch; T Majic; J Page; H Gutzmann; A Heinz; M A Rapp

doi:10.1016/j.eurpsy.2014.02.004

Apathy in nursing home residents with dementia: results from a cluster-randomized controlled trial

Eur Psychiatry. 2015 Feb;30(2):251-7. doi: 10.1016/j.eurpsy.2014.02.004. Epub 2014 Mar 13.

Authors

Y Treusch¹, T Majic², J Page³, H Gutzmann⁴, A Heinz⁵, M A Rapp⁶

Affiliations

¹ Geriatric Psychiatry Center, Psychiatric University Hospital St. Hedwig, Große Hamburger Str. 5-11, 10115 Berlin, Germany; Institute of Occupational Therapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, 8401 Winterthur, Switzerland; Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany.
² Geriatric Psychiatry Center, Psychiatric University Hospital St. Hedwig, Große Hamburger Str. 5-11, 10115 Berlin, Germany.
³ Institute of Occupational Therapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, 8401 Winterthur, Switzerland.
⁴ Department of Psychiatry, Psychotherapy and Psychosomatics, Krankenhaus Hedwigshoehe, Höhensteig 1, 12526 Berlin, Germany.
⁵ Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: andreas.heinz@charite.de.
⁶ Geriatric Psychiatry Center, Psychiatric University Hospital St. Hedwig, Große Hamburger Str. 5-11, 10115 Berlin, Germany; Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany; Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.

PMID: 24630745
DOI: 10.1016/j.eurpsy.2014.02.004

Abstract

Purpose: Here we evaluate an interdisciplinary occupational and sport therapy intervention for dementia patients suffering from apathy.

Subjects and methods: A prospective, controlled, rater-blinded, clinical trial with two follow-ups was conducted as part of a larger cluster-randomized trial in 18 nursing homes in Berlin. n=117 dementia patients with apathy, defined as a score of 40 or more on the apathy evaluation scale (AES) or presence of apathy on the Neuropsychiatric Inventory (NPI), were randomly assigned to intervention or control group. The intervention included 10 months of brief activities, provided once a week. The primary outcome measure was the total score on the AES scale measured directly after the intervention period and again after 12 months.

Results: We found significant group differences with respect to apathy during the 10 month intervention period (F2,82=7.79, P<0.01), which reflected an increase in apathy in the control group, but not in the intervention group. Within one year after the intervention was ceased, the treatment group worsened and no longer differed significantly from the control group (P=0.55).

Conclusions: Our intervention was effective for the therapy of apathy in dementia, when applied, but not one year after cessation of therapy.

Keywords: Apathy; Dementia; Non-pharmacological intervention; Occupational therapy; Sport therapy.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Affective Symptoms / etiology
Affective Symptoms / therapy*
Aged
Aged, 80 and over
Apathy*
Berlin
Dementia / psychology
Dementia / therapy*
Exercise Therapy / methods
Female
Homes for the Aged*
Humans
Male
Nursing Homes*
Prospective Studies
Psychotherapy / methods*
Treatment Outcome

Associated data

ISRCTN/ISRCTN43578978