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Phase 3 Completed N=203 Randomized Single-blind Health Services Research

Preventing Aggression in Veterans With Dementia

Source: ClinicalTrials.gov NCT01325714 ↗
Enrolled (actual)
203
Serious AEs
9.4%
Results posted
May 2016
Primary outcomePrimary: Number of Participants With Aggression as Determined by the Cohen-Mansfield Agitation Inventory (Aggression Subscale) — 8; 14; 9; 17 participants — p=0.13
◆ Published Evidence
Established
28citations · ~2 / year
Managing pain to prevent aggression in people with dementia: a nonpharmacologic intervention.
American journal of Alzheimer's disease and other dementias · 2012 · Open access · High-confidence link

Summary

This study tests whether education about memory and pain might help to prevent aggression in persons with dementia who have pain. The overall goal of this intervention is to reduce the risk of aggressive behavior by improving several areas of patient life that are known causes of aggression: pain, depression, lack of pleasurable activities, caregiver stress and difficulty in caregiver-patient communication.

Linked Publications (5)

  • Managing pain to prevent aggression in people with dementia: a nonpharmacologic intervention.
    American journal of Alzheimer's disease and other dementias · 2012 · 28 citations · Open access · High-confidence link
  • The Quality of Pain Treatment in Community-Dwelling Persons with Dementia.
    Dementia and geriatric cognitive disorders extra · 2015 · 18 citations · Open access · High-confidence link
  • Correlates of pain intensity in community-dwelling individuals with mild to moderate dementia.
    American journal of Alzheimer's disease and other dementias · 2015 · 8 citations · Open access · High-confidence link
  • Preventing aggression and other secondary features of dementia in elderly persons: Three case studies.
    Bulletin of the Menninger Clinic · 2015 · 2 citations · High-confidence link
  • Patient Versus Informal Caregiver Proxy Reports of Pain Interference in Persons With Dementia.
    Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2021 · 19 citations · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants With Aggression as Determined by the Cohen-Mansfield Agitation Inventory (Aggression Subscale)
8; 14; 9; 17; 17; 14 0.13
SECONDARY
Caregiver-Reported Worst Pain
3.28; 3.03; 2.83; 2.91; 2.77; 2.85 0.46
SECONDARY
Patient-reported Worst Pain.
3.01; 2.84; 2.49; 2.41; 2.35; 2.72 0.23
SECONDARY
Caregiver Reported Overall Pain Over the Last Several Weeks
2.43; 2.06; 1.99; 1.84; 1.96; 1.96 0.23
SECONDARY
Patient-reported Overall Pain Over the Last Several Weeks
2.13; 1.96; 1.71; 1.66; 1.75; 1.92 0.62
SECONDARY
Depression
14.33; 13.97; 13.17; 14.26; 12.81; 14.01 0.42
SECONDARY
Pleasant Events - Short Form - Alzheimer's Disease
23.09; 24.65; 24.01; 24.81; 24.41; 24.06 0.35
SECONDARY
Caregiver Burden
28.94; 28.63; 26.88; 30.37; 27.84; 32.00 0.11
SECONDARY
Caregiver-perceived Mutuality
2.93; 2.99; 3.01; 2.82; 3.02; 2.78 0.01 sig

Eligibility Criteria

Inclusion Criteria

Patients will be eligible to participate in the study if they meet the following criteria:

  • have a documented diagnosis of dementia
  • receive primary care from the VA
  • reside outside a long-term care facility
  • live within 45 minutes of the MEDVAMC
  • have mild-to-moderate dementia
  • have no history of aggression in the past year
  • have no evidence of aggression on the CMAI at baseline (i.e., do not score 2 or higher on both frequency and disruptiveness for any of 13 behaviors listed).
  • have a caregiver who is directly involved with the patient:
  • at least 8 hours per week
  • sees the patient at least twice a week
  • and speaks English
  • report clinically significant pain (either directly or through the caregiver as a proxy)

Exclusion Criteria

Patients will be excluded if they have had history of aggression in the past year

  • The investigators will administer the aggression subscale of the Cohen-Mansfield Agitation Inventory (CMAI)
  • Aggression will be considered present if any of the following items are endorsed as having occurred over the prior year:
  • spitting
  • cursing/verbal aggression
  • hitting
  • kicking
  • grabbing
  • pushing
  • throwing
  • biting
  • scratching
  • hurting self/others
  • tearing things/destroying property
  • making inappropriate verbal sexual advances
  • or making inappropriate physical sexual advances

Participants that scored 2 or higher for both frequency and disruptiveness on any of the 13 behaviors listed on the CMAI at baseline were considered aggressive and were excluded from the study.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01325714) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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