A therapeutic approach at home can slow down their loss of autonomy and reduce behavioral disorders, according to a French study.
Although much remains to be done, France has made efforts to improve the care of patients with dementia. First thanks to a national plan for Alzheimer’s disease in 2008, then with the 2014-2019 Neurodegenerative Disease Plan that followed. Some new care systems have been put in place, such as Specialized Alzheimer’s Teams (ESA) offering a new approach to Alzheimer’s patients, the “ occupational therapy ”.
This therapy consists of stimulating certain activities of sick people or of maintaining their autonomy in a safe and effective manner while taking into account their lifestyle and their environment. Based on the intervention of occupational therapists, psychomotor therapists and gerontological care assistants, care takes place at home on medical prescription. Although it had been shown to be effective in a few clinical trials, it had not been shown under routine care conditions and deserved to be investigated. It is now done by French researchers from Inserm (1).
Improved quality of life
These new results have just been published in the Journal of Alzheimer’s Disease. The study was conducted on 421 patients with dementia who were referred to ESA by their attending physician or a specialist physician. The researchers were interested in their clinical evolution between the beginning and the end of the treatment lasting 3 months, then 3 months after the end of the intervention. This observational study conducted in real life conditions demonstrated that patients with dementia reported clinical benefits during the period of the intervention, say the researchers in a press release.
These scientists report that “the behavioral disorders of patients, the time spent by caregivers taking care of their loved one and the emotional load associated with this care, had significantly decreased over the 3 months of intervention and was stable after this period ”. “The quality of life of patients was improved,” they logically conclude.
For early stage patients
In addition, the cognitive performances of the patients remained stable during the 6 months of the study. Functional autonomy was also maintained during the 3 months of intervention, but it was significantly reduced thereafter. And in the study group, the most recently diagnosed patients had the most benefit in terms of functional decline. “These findings suggest that occupational therapy should primarily concern patients in the early stages of Alzheimer’s disease in order to optimize its possible clinical benefits,” the team specifies.
For the authors of this work, these results also open a new field of research concerning occupational therapy in France. Indeed, this intervention was conceptualized as a short-term home intervention, but the long-term benefits and consequences of discontinuing care remain unknown. With this in mind, the Inserm team of researchers will conduct a trial to compare the effectiveness of occupational therapy over an additional period of 4 months compared to the usual care as recommended.
(1) INSERM, Unit 1219 “ Institute of Public Health, Epidemiology and Development ”, Center INSERM U1219-Epidemiologie-Biostatistique, Bordeaux, France University Bordeaux, Bordeaux, France Department of Neurology, Department of Clinical Neurosciences, CHU Pellegrin, Bordeaux, France INSERM, Clinical Investigation Center – Clinical Epidemiology 1401, Bordeaux, France.
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