Possin Katherine L, Dulaney Sarah, Sideman Alissa B, Wood Andrew J, Allen I Elaine, Bonasera Stephen J, Merrilees Jennifer J, Lee Kirby, Chiong Winston, Braley Tamara L, Hooper Sarah, Kanzawa Mia, Gearhart Rosalie, Medsger Helen, Harrison Krista L, Hunt Lauren J, Kiekhofer Rachel E, Chow Christopher, Miller Bruce L, Guterman Elan L
Weill Institute for Neurosciences, University of California, San Francisco, California, USA.
The Global Brain Health Institute, University of California, San Francisco, California, USA.
Alzheimers Dement. 2025 Jan;21(1):e14370. doi: 10.1002/alz.14370. Epub 2024 Nov 19.
Collaborative dementia care models with care navigation, including the Care Ecosystem, improve outcomes for persons living with dementia (PLWDs) and their caregivers. The effects of continuous care over long periods have not been studied.
In this randomized clinical trial with 456 PLWD-caregiver dyads with high caregiver burden, we evaluated the cumulative 5-year treatment effect on PLWD quality of life, health care utilization, caregiver depression, self-efficacy, and burden.
Five-year participation was associated with higher quality of life, lower caregiver depression, and higher caregiver self-efficacy (all p's < 0.05) with a trend for lower burden (p = 0.07). Treatment effects were most robust during the first 2 years. The effects on emergency department visits and hospitalizations were not significant.
The benefits of collaborative dementia care on PLWD quality of life and caregiver well-being are sustained for 5 years, and the dyads may experience the greatest benefit during the first 2 years.
Collaborative dementia care with care navigation was evaluated over 5 years using a randomized clinical trial. The care was associated with better quality of life for the person with dementia and well-being for the caregiver. The most robust treatment effects were in the first 2 years.
包括护理生态系统在内的具有护理导航功能的协作性痴呆症护理模式，可改善痴呆症患者（PLWDs）及其护理人员的治疗效果。长期持续护理的效果尚未得到研究。
在这项针对456对护理负担较重的PLWD-护理人员二元组的随机临床试验中，我们评估了为期5年的累积治疗对PLWD生活质量、医疗保健利用率、护理人员抑郁、自我效能感和负担的影响。
参与5年与更高的生活质量、更低的护理人员抑郁以及更高的护理人员自我效能感相关（所有p值<0.05），负担有降低趋势（p = 0.07）。治疗效果在前两年最为显著。对急诊就诊和住院的影响不显著。
协作性痴呆症护理对PLWD生活质量和护理人员幸福感的益处可持续5年，二元组在前两年可能获益最大。
使用随机临床试验对具有护理导航功能的协作性痴呆症护理进行了5年评估。该护理与痴呆症患者更好的生活质量和护理人员的幸福感相关。最显著的治疗效果出现在前两年。
