Jennifer Rose V. Molano, MD reviewing Callahan CM et al. Ann Intern Med 2016 Nov 22.

In-home therapy did not improve functional activity in patients with mild-to-moderate Alzheimer disease in a 2-year study.

Maintaining functional ability is an important goal for many patients and families living with Alzheimer disease (AD). This randomized, controlled trial included 180 community-dwelling patients with possible or probable AD. All patients received collaborative care co-managed by memory-care and primary-care practices. Those in the intervention group also received up to 24 in-home occupational therapy sessions spread over 2 years, individually tailored to the needs of the patient and caregiver. The goal of the intervention was to optimize the patient's self-care functional abilities. Caregivers assessed patients' activities of daily living by questionnaire every 6 months. The investigators also determined patients' lower-extremity physical performance and muscle function.

The participants in the study had a mean age of 80 years and mild-to-moderate cognitive impairment. At baseline, the participants had existing impairments in activities of daily living, behavioral issues, and, frequently, comorbid conditions such as diabetes and cardiovascular disease. Those in the intervention group received a median of 18 in-home therapy sessions. Both groups showed a decline in activities of daily living at 24 months, with no significant differences between the two groups due to a wide confidence interval showing both the potential for improvement and decline with intervention. Patient performance measures also showed no differences between groups over time.

CITATION(S):

Callahan CM et al. Targeting functional decline in Alzheimer disease: A randomized trial. Ann Intern Med 2016 Nov 22; [e-pub]. 

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