A randomized, controlled, clinical trial of activity therapy for apathy in patients with dementia residing in long-term care.
BACKGROUND
Apathy is a common symptom in patients with dementia and has adverse consequences for patients and caregivers. Most treatments for apathy, particularly non-pharmacologic interventions, have not been evaluated in controlled trials.


OBJECTIVE
This study evaluated the efficacy of a kit-based activity intervention, compared to a time and attention control (one-on-one meetings with an activity therapist) in reducing apathy and improving quality of life in 37 patients with dementia.


METHODS
The design was a randomized, controlled, partially masked clinical trial. All outcome measures were administered at baseline and follow-up. The primary outcome measure was the apathy score of the Neuropsychiatric Inventory (NPI). Other outcome measures were the NPI total score, the Alzheimer Disease Related Quality of Life scale(ADQRL), and the Copper Ridge Activity Index (CRAI).


RESULTS
There was a significant reduction in NPI apathy scores in both treatment groups. The only significant difference between the two treatment groups was a modest advantage for the control intervention on the CRAI cueing subscale (p = 0.027), but not on the other CRAI subscales. There was also a greater within group improvement in quality of life ratings in the control intervention (p=0.03).


CONCLUSIONS
Despite the substantial improvement in apathy scores during the course of the study, there was no clear advantage to the reminiscence-based intervention over the time and attention, one-on-one control intervention. More research is needed to develop specific behavioral interventions for apathy in patients with dementia.
Politis
Antonios M
AM
The Johns Hopkins University, Baltimore, MD 21287, USA.
Vozzella
Stephen
S
Mayer
Lawrence S
LS
Onyike
Chiadi U
CU
Baker
Alva S
AS
Lyketsos
Constantine G
CG
D000342:Affective Symptoms / Q000209:etiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D008297:Male; D011939:Mental Recall; D009483:Neuropsychological Tests; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome