Preventing Aggression in Veterans with Dementia
This study will test a psychosocial intervention to see if it can reduce the risk of aggressive behavior in veterans with dementia by addressing possible causes, including pain, depression, lack of pleasurable activities, caregiver stress, and difficulty in caregiver-veteran communication.
|Minimum Age||Maximum Age||Gender||Healthy Volunteers|
|60 Years||N/A||Both||Accepts Healthy Volunteers|
- Documented diagnosis of mild to moderate dementia
- Receive primary care from the VA
- Community dwelling; live within 45 minutes of the Michael E. DeBakey VA Medical Center, Houston
- Caregiver who is directly involved with the individual at least 8 hours per week, sees him or her at least twice a week, speaks English, and can report clinically significant pain
- History of aggression in the past year, as show by the aggression subscale of the Cohen-Mansfield Agitation Inventory
- Any of the following behaviors during the past year: spitting, cursing/verbal aggression, hitting, kicking, grabbing, pushing, throwing, biting, scratching,hurting self/others, tearing things/destroying property, or making inappropriate verbal or physical sexual advances
Dementia is known primarily for its effects on memory. However, 80 percent of people with dementia also have behavioral disturbances. These behaviors are often not addressed, leading to increased use of nursing homes, higher incidence of injury (to both individuals and caregivers), and the use of tranquilizing medications. Pain is present in about half of people with dementia and is associated with significant negative outcomes, including aggression, increased health care use, inactivity, and isolation.
In this study, investigators will determine whether an active intervention, Preventing Aggression in Veterans with Dementia (PAVeD), can reduce these negative outcomes compared with veterans who do not receive the intervention. PAVeD is a family caregiver-focused, home-based intervention that uses educational and behavioral approaches to help reduce the risk of aggressive behavior in people with dementia. Its objective is to address known causes of aggression such as pain and distress (including mood problems), lack of pleasurable activities, and difficulty in caregiver-veteran communication.
In the PAVeD Intervention, the caregiver will receive six to eight 45-minute visits during 3 months to learn about pain and memory problems. The person with dementia will also be able to learn from these visits. Other participants will receive information in the mail about memory problems and pain; the caregiver will receive eight short telephone calls to check on how the person with dementia is doing. Primary care providers will be notified about any significant behavioral problems or pain.
Michael E. DeBakey VA Medical Center, Houston, TX
Department of Veterans Affairs
|Mark E. Kunik, MD MPH||Principal Investigator||Michael E. DeBakey VA Medical Center|
Preventing Aggression in Veterans With Dementia