{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T10:36:27Z","timestamp":1791714987323,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,28]],"date-time":"2017-11-28T00:00:00Z","timestamp":1511827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Veterans Administration Health Services Research and Development Service","award":["VA-IIR 11-119"],"award-info":[{"award-number":["VA-IIR 11-119"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>\n                      Dementia\u2010related behavioral symptoms and functional dependence result in poor quality of life for persons with dementia and their caregivers. The goal was to determine whether a home\u2010based activity program (Tailored Activity Program;\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      ) would reduce behavioral symptoms and functional dependence of veterans with dementia and caregiver burden.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      Single\u2010blind (interviewer), parallel, randomized, controlled trial (Clinicaltrials.gov:\n                      <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n                      01357564).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Veteran's homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Veterans with dementia and their family caregivers (N = 160 dyads).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>\n                      Dyads in\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      underwent 8 sessions with occupational therapists to customize activities to the interests and abilities of the veterans and educate their caregivers about dementia and use of customized activity. Caregivers assigned to attention control received up to 8 telephone\u2010based dementia education sessions with a research team member.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Primary outcomes included number of behaviors and frequency of their occurrence multiplied by severity of occurrence; secondary outcomes were functional dependence, pain, emotional well\u2010being, caregiver burden (time spent caregiving, upset with behaviors) and affect at 4 (primary endpoint) and 8 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 160 dyads (n = 76\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      ; n = 84 control), 111 completed 4\u2010month interviews (n = 51\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      ; n = 60 control), and 103 completed 8\u2010month interviews (n = 50\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      ; n = 53 control). At 4 months, compared to controls, the\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      group showed reductions in number (difference in mean change from baseline = \u22120.68, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      = \u22121.23 to \u22120.13) and frequency by severity (\u221224.3, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      = \u221245.6 to \u22123.1) of behavioral symptoms, number of activities needing assistance with (\u22120.80, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      = \u22121.41 to \u22120.20), functional dependence level (4.09, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      = 1.06, 7.13), and pain (\u22121.18, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      = \u22122.10 to \u22120.26). Caregivers of veterans in\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      reported less behavior\u2010related distress. Benefits did not extend to 8 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      had positive immediate effects and no adverse events. Because\n                      <jats:styled-content style=\"fixed-case\">TAP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>\n                      reduces behavioral symptoms, slows functional dependence, and alleviates pain and caregiver distress, it is a viable treatment option for families.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15194","type":"journal-article","created":{"date-parts":[[2017,11,29]],"date-time":"2017-11-29T10:43:36Z","timestamp":1511952216000},"page":"339-345","source":"Crossref","is-referenced-by-count":105,"title":["Targeting Behavioral Symptoms and Functional Decline in Dementia: A Randomized Clinical Trial"],"prefix":"10.1111","volume":"66","author":[{"given":"Laura N.","family":"Gitlin","sequence":"first","affiliation":[{"name":"Center for Innovative Care in Aging School of Nursing Johns Hopkins University Baltimore 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