{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:04:52Z","timestamp":1780391092510,"version":"3.54.1"},"reference-count":32,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Health ministry of France","award":["PREPS-16-116"],"award-info":[{"award-number":["PREPS-16-116"]}]},{"DOI":"10.13039\/501100017007","name":"Regional Health Agency","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100017007","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is increasing interest in non-pharmacological approaches to address the needs of patients with Alzheimer's disease and other dementia. However, previous research highlighted the need to adapt interventions to the healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness for community-dwelling patients with mild-to-moderate dementia in France, of maintaining occupational therapy (OT) over a longer period compared with standard OT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a pragmatic, single-blinded randomized controlled trial (RCT) design (ClinicalTrials.gov NCT03435705). A total of 238 community-dwelling adults with dementia were recruited from OT services and randomly assigned to receive either standard OT (12\u201315 home-based sessions over a 3\u20134-month period) or OT maintained for an additional 4 months. The primary outcome was behavioral symptoms measured with the Neuropsychiatric Inventory (NPI) at 8 months. The secondary outcomes included participants\u2019 functional performance, depressive symptoms, quality of life, institutionalization, caregivers\u2019 burden and sense of competence. Primary analysis followed intention-to-treat. Linear model was used to compare changes in NPI scores between groups at 8 months, with imputation for missing values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 211 participants (88.6%) were assessed for the primary outcome at 8 months. Participants benefiting from OT maintenance showed no significant improvement in behavioral symptoms compared to controls (adjusted mean difference = \u22123.8, 95% confidence interval: \u221210.3; 2.7). Maintenance of OT had no effect on secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our pragmatic RCT did not support changing the current policy regarding the coverage of the French model of OT. Nevertheless, the non-significant improvement in behavioral symptoms calls for further long-term trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261442233","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T13:55:00Z","timestamp":1776434100000},"page":"1362-1372","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maintenance of occupational therapy for individuals with dementia: Findings from a pragmatic randomized controlled trial"],"prefix":"10.1177","volume":"111","author":[{"given":"Cl\u00e9ment","family":"Pimouguet","sequence":"first","affiliation":[{"name":"Alliance maladies rares, Paris, France"},{"name":"Bordeaux Population Health Research Center, University of Bordeaux, INSERM, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Kret","sequence":"additional","affiliation":[{"name":"Public Health Department, Clinical Epidemiology Unit (USMR), Bordeaux University Hospital, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5435-5064","authenticated-orcid":false,"given":"Florence","family":"Francis-Oliviero","sequence":"additional","affiliation":[{"name":"Public Health Department, Clinical Epidemiology Unit (USMR), Bordeaux University Hospital, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2848-6287","authenticated-orcid":false,"given":"M\u00e9lanie","family":"Le Goff","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health Research Center, University of Bordeaux, INSERM, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-7250","authenticated-orcid":false,"given":"J\u00e9r\u00f4me","family":"Wittwer","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health Research Center, University of Bordeaux, INSERM, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Dartigues","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health Research Center, University of Bordeaux, INSERM, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5169-7421","authenticated-orcid":false,"given":"Catherine","family":"Helmer","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health Research Center, University of Bordeaux, INSERM, Bordeaux, France"},{"name":"Clinical and Epidemiological Research Unit, INSERM, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.4607"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212948"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.13239"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/218980"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026308"},{"key":"e_1_3_3_7_2","article-title":"Personally tailored activities for improving psychosocial outcomes for people with dementia in community settings","volume":"8","author":"Mohler R","year":"2020","unstructured":"Mohler R, Renom A, Renom H, et al. Personally tailored activities for improving psychosocial outcomes for people with dementia in community settings. 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Inventaire apathie : \u00e9valuation de l'apathie chez les sujets pr\u00e9sentant une maladie d'Alzheimer ou un trouble cognitif l\u00e9ger. Rev G\u00e9riatr 2003; 28: 473\u2013480.","journal-title":"Rev G\u00e9riatr"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.134.4.382"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/26.3.260"},{"key":"e_1_3_3_25_2","first-page":"227","article-title":"The measurement of sense of competence in caregivers of patients with dementia","volume":"51","author":"Vernooij-Dassen M","year":"2003","unstructured":"Vernooij-Dassen M, Kurz X, Scuvee-Moreau J, et al. The measurement of sense of competence in caregivers of patients with dementia. 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