1066: Evaluating dementia intervention
This project is being carried out under the auspices of the 10/66 Dementia Research Group to discover the prevalence and causes of dementia in different countries, and find evidence-based solutions.
This is one of a number of projects based on 10/66 population based surveys of people aged over 65; these surveys have been carried out in Cuba, Brazil, the Dominican Republic, Venezuela, Mexico, Peru, Argentina, China and India.
The study aims to develop and evaluate a home-based intervention to offer support to caregivers of people with dementia in the Dominican Republic, in China and in India following the population-based survey to report the prevalence of dementia and alzheimer’s disease and their aetiology and impact.
Dementia is a significant and rapidly growing problem in developing countries but few families seek medical help and heath services are not geared towards meeting the needs of people with dementia and their carers.
The 10/66 Group has been working on an intervention designed to educate and train caregivers to better manage people with dementia and this research tests the effectiveness of that intervention. Multi-Purpose Health Workers exist in some form in many developing countries: they generally get to know all the families in a specific catchment area. The intervention trains these workers to better identify cases of dementia and then work with the main caregiver and members of the immediate and extended family, giving advice about how to manage problem behaviours, and information about dementia and Alzheimer’s Disease.
House-to-house surveys were conducted in Santo Domingo and in a rural neighbourhood in the Dominican Republic, in Beijing and in a rural neighbourhood in China and in Chennai and in a rural neighbourhood in India. They have identified and interviewed all those aged 65 and over. They collected information about mental and physical health, use of health services, diet, nutrition, risk factors for vascular disease, living circumstances and social support. A clinical interview identified those people suffering from dementia, and this information has been cross-referenced with the information supplied by health workers who have been trained to identify people with probable dementia in their district.
Those people who are given a diagnosis of dementia have then been given the education and training intervention for their family immediately, or after six months. This allows the research team to compare the experiences of a group of caregivers and people with dementia who received the intervention with a group who didn’t and therefore gauge its success.
The intervention has also been tested in Moscow, where the training intervention was trialled without a population-based survey.
The principal investigator is Professor Martin Prince in the Section of Epidemiology.
Collaborators are: Dr Cleusa Ferri, Professor K.S Jacob, Professor Krishnamoorthy, Dr Daisy Acosta, Dr Yeuqin Huang, and Professor Gravilova.
The study was funded by the World Health Organisation and The Psychiatry Research Trust at the IoP supported work in the Dominican Republic.