New research comparing different approaches to dementia care for people with Alzheimer’s disease and other found no significant differences in patient behavioral symptoms or caregiver strain, whether delivered through a health system, provided by a community-based organization, or as usual care over 18 months.
Comparing Dementia Care Approaches: No Significant Differences in Behavioral Outcomes
Dementia Care Study, also known as D-CARE, also found that caregiver self-efficacy. A measurement of caregivers’ confidence in managing dementia-related challenges and accessing support. This improved in both the health-system and community-based care approaches and was rated higher than in those receiving usual care. Higher self-efficacy was observed within 6 months of care delivery and remained consistent throughout the study.
The Largest Dementia Care Study to Date
“The D-CARE trial is the largest evaluation, to date, of different approaches to providing dementia care,” said Dr. David Reuben, Archstone Professor of Geriatrics at the David Geffen School of Medicine at UCLA and principal investigator of the study. “Caregivers play an essential role in the lives of individuals with dementia, and their ability to manage stress and feel confident in their caregiving roles is crucial. Higher self-efficacy may lead to obtaining more resources and keeping persons with dementia in their homes.”
The study will be published on Jan. 29 in the peer-reviewed Journal of the American Medical Association (JAMA).
Funded by the Patient-Centered Outcomes Research Institute and the National Institute on Aging. The D-CARE study aimed to compare the effectiveness of two established its approaches to each other and to usual care. It comprised 2,176 persons with it and their caregivers and was conducted from June 2019 to August 2023.
Study Design and Key Findings
The study was led by investigators at the University of California, Los Angeles. With data management and statistics performed by the Yale Data Coordinating Center. And this was conducted at four clinical sites: Atrium Health Wake Forest Baptist, Baylor Scott & White Health, the University of Texas Medical Branch, and Geisinger Health. Investigators at the Benjamin Rose Institute on Aging, University of Oklahoma Health Sciences Center, Cedars-Sinai Medical Center, and RAND supported the study. Participants were randomly assigned to one of three groups: healthcare system-based care. Delivered by Dementia Care Specialists (based on the UCLA Alzheimer’s and Dementia Care Program), community-based organization-based care delivered by Care Consultants (utilizing Benjamin Rose Institute on Aging Care Consultation Program), or usual care.
“The study’s results underscore the complexities of it and the challenges in comparing dementia care models in a real-world setting, particularly during the COVID-19 pandemic,” Reuben said. “Moreover, some benefits of the models may not have been fully captured in the trial’s chosen primary and secondary outcomes.” The effects of the interventions on healthcare utilization are still pending.
Reference: Materials provided by University of California – Los Angeles Health Sciences. Note: Content may be edited for style and length.
