PrAISED 2
Research type
Research Study
Full title
Promoting Activity, Independence and Stability in Early Dementia and Mild Cognitive Impairment 2
IRAS ID
236099
Contact name
Rowan Harwood
Contact email
Sponsor organisation
Nottingham University Hospitals
ISRCTN Number
15320670
Duration of Study in the UK
3 years, 6 months, 11 days
Research summary
Research Summary:
People with memory problems can struggle with everyday activities and may stop doing things they want to do. They are more prone to accidents and have a higher risk of falling. Occupational therapists can advise how to do daily activities more easily and safely. Physiotherapists can teach exercises which increase activity and improve balance, and may help maintain memory.
There is little research on how to make these interventions work for with people with memory problems. In this research we will compare an activity and exercise programme developed for people with memory problems to standard falls prevention assessment and advice. The intervention will be delivered over 1 year in participants’ own homes, and will be tailored to individual interests, abilities and need for supervision. We will encourage participants to exercise by themselves or with family members between visits, and once the programme ends. We are testing the feasibility of delivering and researching this intervention in a feasibility study (due to end March 2018). The intervention has been found to be acceptable to participants.
Participants will be people with early dementia or memory problems, recruited from memory clinics or the ‘Join Dementia Research’ register. We will also recruit a family member. Researchers will visit to collect information at baseline and 12 months. We will measure ability in activities of daily living, activity, quality of life, memory and health service use. Participants will complete monthly falls diaries over 15 months
We will conduct interviews and, video record some therapy sessions, to help understand how the programme works in practice ('process evaluation').Summary of Results:
Dementia causes a deterioration in a person’s memory and thinking abilities which results in problems doing everyday activities such as housework, going out or getting dressed. The Promoting Activity, Independence, and Stability in Early Dementia (PrAISED) programme aimed to test whether a physical exercise and activity intervention could improve the ability of older people with mild dementia to do these activities.
To develop the PrAISED intervention, we brought together the research evidence with the opinions of people with experience of dementia and rehabilitation including people with dementia. We also developed dementia specific motivational strategies. We confirmed through a small-scale study that we could deliver PrAISED; people would take part and complete the study and we could collect the information to test PrAISED in a large study.
We tested PrAISED by recruiting, from five English counties, 365 older people with mild dementia and a family member. We randomly allocated people to receive PrAISED or brief falls prevention assessment and advice. Those allocated to PrAISED received up to 50 supervised physical exercise and activity sessions, delivered by trained therapists and rehabilitation support workers, tailored to their goals, preferences, and abilities. They were encouraged to do the exercises on their own. For everyone in the study, we measured at the start and at 12-months, their ability to do everyday activities independently, quality-of-life, other aspects of their health and their NHS and social care use.
We found that those receiving PrAISED did no better on any of our measurements than those who received the falls assessment and advice. The study was disrupted by the Covid-19 pandemic with recruitment and face-to-face delivery of PrAISED temporarily paused. However, we could not see any benefits for those people who completed PrAISED before the pandemic.
We conclude that after a diagnosis of dementia it might be more appropriate to help the individual to manage problems associate with inevitable decline rather than to try to change the course of the disease or to maintain their abilities.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
18/YH/0059
Date of REC Opinion
1 Mar 2018
REC opinion
Favourable Opinion