जर्नल ऑफ़ क्लिनिकल केस रिपोर्ट्स

Online Programme “Symparastasi”: Psychoeducation and Multicomponent Exercise Programme to the Caregivers of Patients with MCI and Mild Dementia: An Original RCT

Abstract

Tatiana Danai Dimitriou and Evangelia Zacharia

Objective: Symparastasi online programme was created because of the quarantines due to covid-19. The professional care centers were closed. After the quarantines there was a need of professional care for patients who live away from the big city centers. Symparastasi programme aimed to educate the informal dementia caregivers in order for them to be able to perform some non-pharmacological interventions to their patients effectively and safely. The programme offered psychoeducation and multicomponent training programme for the caregivers of patients with Mild Cognitive Impairment (MCI) and mild dementia. The aim of the programme was to examine which group had the best results in 3 domains: a) maintain or enhance cognitive abilities, b) Decrease Behavioural and Psychological Symptoms (BPSD) and c) improve the quality of life of patient and caregivers.

Methods/Design: This is randomized controlled trial with 426 participants of both genders. The participants were randomly assigned into 3 groups of 142 patients each. Group A received only the multicomponent training programme, group B received only the psychoeducation and group C received both interventions. The programme was online and the caregivers should have access to the internet. There were 11 multicomponent training videos with progressive difficulty of the exercises, and 11 psychoeducation videos that were referring to topics regard dementia, its progress, its prognosis, prevention, BPSD, non-pharmacological interventions etc. The 12th session was a private session of each patient and caregiver in order to ask questions and be supported emotionally. The measurements used were: the Timed Up and Go test (TUG), Berg Balance Scale (BBS) and 30second Sit to Stand Test for the physical tests. For the cognitive abilities used: Mini Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination-Revised (ACE-R). For the neuropsychiatric problems used: Neuropsychiatric Inventory (NPI). For the caregivers the study used the following scales: State Trait Anxiety Inventory (STAI-S) in order to record the anxiety levels, Beck Depression Inventory (BDI) for the depression and NPI and Zarit Burden Interview (ZBI) in order to record caregivers’ burden. The programme lasted for 24 weeks and there was three recordings of the results: at the beginning of the programme (T1), after 6 months of performing the interventions (T2), and 3 months after the end of the programme (T3), as a follow up.

Results: All groups had positive results in the three domains, but group C had the best results. In terms of cognitive abilities the interventions did not enhance the cognitive skills but tried to maintain the good results for a period of time. BPSD were reduced statistically significant and the caregivers’ burden and anxiety and depression levels were also decreased. Some results maintained over time.

Conclusion: The combination of psychoeducation and multicomponent training programme has positive results in maintaining the cognitive abilities, decrease BPSD and improve the general quality of life of both patients and caregivers in patients with MCI and mild dementia.