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Health and nutrition promotion program for patients with dementia (NutriAlz): cluster randomized trial

Authors

Salva, A., Andrieu, S., Fernandez, E., Schiffrin, E. J., Moulin, J., Decarli, B., Rojano-i-Luque, X., Guigoz, Y., Vellas, B.

Journal

The Journal Of Nutrition, Health & Aging, Volume: 15, No.: 10, Pages.: 822-830

Year of Publication

2011

Abstract

Objective: To assess the effectiveness of health and nutrition program (NutriAlz) versus usual care on functional level in elderly people with dementia living at home, as well as on clinical practice related to nutrition and on the caregiver’s burden.; Design: Cluster randomized multi-centre study with one-year follow-up.; Setting: 11 Alzheimer outpatients and day care centres (Barcelona, Spain).; Participants: Nine hundred and forty six home-living Alzheimer patients with identified caregiver were consecutively recruited (intervention group: 6 centres, 448 patients vs control group: 5 centres, 498 patients).; Intervention: The intervention was a teaching and training intervention on health and nutrition program, NutriAlz, directed both to physician and main caregiver, as well as persons affected by Alzheimer’s disease or other dementias, including a standardised protocol for feeding and nutrition.; Main Outcome Measures: The main outcome measure was the reduction in the loss of autonomy (Activities of daily living (ADL/IADL) scales) assessed at 6 and 12 months. Secondary outcomes measures were Improvement in nutritional status (Mini Nutritional Assessment (MNA), BMI, and weight changes), and caregiver burden (Zarit scale).; Results: The one-year assessment was completed for 293 patients (65.4%) in the intervention group and 363 patients (72.9%) in the control group (usual care). The annual rate of ADL change was -0.83 vs -0.62 (p=0.984), and the caregiver’s subjective burden 0.59 vs 2.36 (p=0.681) in intervention and control group, respectively. MNA, however, showed an improvement (+0.46 vs -0.66, p=0.028), suggesting an effective nutritional behaviour.; Conclusion: The NutriAlz program had no effect on functional decline in Alzheimer disease patients living at home over one year, but reduced the risk for malnutrition, as recommendations concerning diet and exercise were provided.;

Keywords

activities of daily living, aged, aged, 80 and over, alzheimer disease, and, body mass index, body weight, caregivers, carers, complications, day care, diet, epidemiology, female, geriatric assessment, healht, health education, humans, male, malnutrition, methods, nutrition, nutrition assessment, nutritional, nutritional status, outcome assessment (health care), outpatients, prevention & control, program evaluation, programme, spain, standard of care, status, to, training

Countries of Study

Spain

Types of Dementia

Dementia (general / unspecified)

Types of Study

Cluster RCT

Type of Outcomes

ADLs/IADLs, Carer Burden (instruments measuring burden), Other, Physical Health

Settings

Day Care

Type of Interventions

Non-pharmacological Treatment, Treatment/prevention of co-morbidities or additional risks, Workforce oriented interventions

Non-Pharmaceutical Interventions

Other

Carer Focussed Interventions

Training programmes / workshops including behavioural training

Co-Morbidities

Other

Workforce Interventions

Professional Training / Continuing Professional Development