Cognitive Intervention For Delirium in Dementia

Study Overview
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Brief Summary
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The purpose of this study is to test the effectiveness of cognitively stimulating activities for resolving delirium in people with dementia.

Detailed Description
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The primary aim in this RCT is to test the efficacy of Recreational Stimulation for Elders as a Vehicle to resolve DSD (RESERVE- DSD). The investigators will randomize 256 subjects, newly admitted to post acute care, to intervention (RESERVE-DSD) or control (usual care). Intervention subjects will receive 30-minute sessions of tailored cognitively stimulating recreational activities for up to 30 days. The investigators hypothesize that subjects who receive RESERVE-DSD will have: decreased severity and duration of delirium; greater gains in attention, orientation, memory, abstract thinking, and executive functioning; and greater gains in physical function compared to subjects with DSD who receive usual care. The investigators will also evaluate potential moderators of intervention efficacy (lifetime of complex mental activities and APOE status). The secondary aim is to describe the costs associated with RESERVE-DSD.

Official Title
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Reserve For Delirium Superimposed On Dementia (DSD)

Conditions
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Delirium, Dementia

Intervention / Treatment
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* Behavioral: Cognitive Stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: presence of delirium mild to moderate cognitive impairments 65 years of age or older English speaking community-dwelling legally authorized representative available Exclusion Criteria: severe vision or hearing problems diagnosis of major depression Parkinson's with Lewy Body disease Huntington's disease normal pressure hydrocephalus seizure disorder subdural hematoma head trauma known structural brain abnormalities acute CVA/stroke acute psychiatric condition life expectancy < 6 months

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual care<br>Participants receive standard clinical care | |
| Experimental: Treatment<br>Behavioral: cognitive stimulation | Behavioral: Cognitive Stimulation<br>* Thirty minutes of cognitive stimulation delivered daily for thirty minutes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Confusion Assessment Method |  | Averaged over 30 days or until discharge, whichever comes first | 
| Delirium Rating Scale |  | Averaged over 30 days or until discharge, whichever comes first | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attention |  | Averaged over 30 days or until discharge, whichever comes first | 
| Memory |  | Averaged over 30 days or until discharge, whichever comes first | 
| Abstract Thinking |  | Averaged over 30 days or until discharge, whichever comes first | 
| Orientation |  | Averaged over 30 days or until discharge, whichever comes first | 
| Executive Function |  | Averaged over 30 days or until discharge, whichever comes first | 
| Physical Function |  | Averaged over 30 days or until discharge, whichever comes first | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Delirium, Dementia, Non-pharmacological Intervention, Post-acute care