Dr. C. Bakker
Radboud University Medical Center
GRIP on neuropsychiatric symptoms in young-onset dementia: The BEYOND-II study
Alzheimer's disease & other dementias
This is the first project to develop and implement a multi-component care program for the management of neuropsychiatric symptoms (NPS) in young-onset dementia (YOD) nursing home (NH) residents and determine its effectiveness.
The Behaviour and Evolution of Young-onset Dementia (BEYOND)-II study is an intervention study consisting of the following five consecutive workpackages:
(1) The design of a care program for the management of NPS in People with young-onset dementia (PwYOD) residing in special care units in NHs, based on an existing care program for the management of NPS in late onset dementia, The Grip on challenging behaviour program. The care program will be adapted and tailored using recent YOD literature and key-findings of the Young-onset Dementia (NEEDYD)-study and the BEYOND-I study (Mulders) as well as using clinical experience. The care program will be reviewed by a panel of caregivers of PwYOD residing in NHs and an expert panel of the Dutch YOD Knowledge Centre (DKC).
(2) The development of an enhanced implementation strategy for the care program. The implementation strategy will include an intervention to increase extrinsic motivation of NH management and professionals. Also, to improve the implementation and the use of the care program the program will be digitalized and e-learning modules for the nursing staff will be developed.
(3) An evaluation of the effectiveness of the care program using a stepped wedge design. Ten YOD SCUs with 20 residents each, in three clusters with 4 measurements will be included in the study. The outcome will be NPS as assessed with the Cohen Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory-NH version (NPI-NH). The CMAI will be used in primary effect analyses.
(4) A process evaluation comprising the evaluation of the internal and external validity as well as barriers and facilitators in the implementation process of the care program. Furthermore, a cost-consequence analysis of the care program will be performed.
(5) The development of a blueprint for the design of a home based care program for the management of NPS in YOD.
Results will be disseminated to YOD care organisations, political stakeholders, vocational/specialist training of elderly care physicians, psychologists and nurses and through scientific papers in national and international journals.