A randomized controlled trial to examine the effectiveness of case management model for community dwelling older persons with mild dementia in Hong Kong.
OBJECTIVE
To evaluate a case management (CM) model for people with mild dementia, whereby resources within the family and in the community were mobilized and optimally used.


METHODS
Community dwelling psychiatric and geriatrics outpatients with mild dementia were randomized to receive CM by a trained occupational therapist for 4 months (CM group, N = 59) or usual care only (control group, N = 43). Primary outcome indicators included the Zarit Burden Scale (ZBI), General Health Questionnaire (GHQ), and Personal Well-Being Index for Adult (PWI-A) of the family caregivers. Secondary outcome indicators included the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Personal Well-Being Index for Intellectually Disabled (PWI-ID) of the demented subjects as measured at fourth and twelfth months.


RESULTS
CSDDis reduced in the CM group at fourth month, but not at twelfth month. The changes in outcome variables of persons with dementia did not differ between the groups (Mann-Whitney U-test, p > 0.05). At follow-up, CM group used more day care and domestic helpers than control group (chi (2), p > 0.05).


CONCLUSIONS
Case management for Chinese persons with mild dementia outpatients did not show significant effects in reducing caregiver burden, but encouraged family caregivers to seek external support.
Lam
Linda C W
LC
Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong.
Lee
Jenny S W
JS
Chung
Jenny C C
JC
Lau
Anna
A
Woo
Jean
J
Kwok
Timothy C Y
TC
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D019090:Case Management / Q000592:standards*; D003153:Community Health Services / Q000458:organization & administration*; D017281:Cost of Illness; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D003863:Depression / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D006304:Health Status; D006723:Hong Kong; D006801:Humans; D057187:Independent Living; D008297:Male; D009788:Occupational Therapy / Q000592:standards; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires