Urban Ekman1,2,3, Mike K Kemani2,4, John Wallert5, Rikard K Wicksell5, Linda Holmström2,5, Tiia Ngandu1,6, Anna Rennie1,7, Ulrika Akenine1,7, Eric Westman1,8, Miia Kivipelto1,7,9,10. 1. Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden. 2. Medical Unit Medical Psychology, Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden. 3. Medical Unit Ageing, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden. 4. Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden. 5. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 6. Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland. 7. Theme Aging, Karolinska University Hospital, Huddinge, Sweden. 8. Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. 9. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 10. Ageing and Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, United Kingdom.
Abstract
BACKGROUND: Individuals with early phase cognitive impairment are frequently affected by existential distress, social avoidance and associated health issues (including symptoms of stress, anxiety, and depression). The demand for efficient psychological support is crucial from both an individual and a societal perspective. We have developed a novel psychological intervention (Psychological Intervention tailored for Patients with Cognitive Impairment, PIPCI) manual for providing a non-medical path to enhanced psychological health in the cognitively impaired population. The current article provides specific information on the randomized controlled trial (RCT)-design and methods. The main hypothesis is that participants receiving PIPCI will increase their psychological flexibility (the ability to notice and accept interfering thoughts, emotions, and bodily sensations without acting on them, when this serves action in line with personal values) compared to participants in the active control (cognitive training) group and the waiting list control group. The secondary hypotheses are that participants receiving PIPCI will improve psychological health (stress measures, quality of life, depression, and general health) compared to participants in the active control group and the waiting list control group. MATERIALS AND METHODS: This three-arm RCT will recruit participants from the cognitive centers at Karolinska University Hospital in Stockholm and randomize approximately 120 individuals in the early phase of cognitive impairment to either an experimental group (psychological intervention once a week for 10 weeks), an active control group (cognitive training once a week for 10 weeks) or a waiting list control group. Intervention outcome will be evaluated with self-report questionnaires on physical and psychological aspects of health, cognitive assessment, biological markers (obtained from blood and saliva) and health care costs. Assessments will be performed at pre- (1 week before the interventions) and post-intervention (1 week after the interventions), as well as at a 6-month follow-up. DISCUSSION: The development of a potentially feasible and effective psychological intervention tailored for early phase cognitive impairment (PIPCI) has the potential to advance the non-pharmacological intervention field. This is especially important given the extensive burden for many affected individuals and their families and the current lack of effective treatments. If the psychological intervention discussed here shows feasibility and efficacy, there is potential for far-reaching healthcare implications for patients with early cognitive impairment at risk of developing dementia. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT04356924. Date of registration: April 22, 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04356924.
BACKGROUND: Individuals with early phase cognitive impairment are frequently affected by existential distress, social avoidance and associated health issues (including symptoms of stress, anxiety, and depression). The demand for efficient psychological support is crucial from both an individual and a societal perspective. We have developed a novel psychological intervention (Psychological Intervention tailored for Patients with Cognitive Impairment, PIPCI) manual for providing a non-medical path to enhanced psychological health in the cognitively impaired population. The current article provides specific information on the randomized controlled trial (RCT)-design and methods. The main hypothesis is that participants receiving PIPCI will increase their psychological flexibility (the ability to notice and accept interfering thoughts, emotions, and bodily sensations without acting on them, when this serves action in line with personal values) compared to participants in the active control (cognitive training) group and the waiting list control group. The secondary hypotheses are that participants receiving PIPCI will improve psychological health (stress measures, quality of life, depression, and general health) compared to participants in the active control group and the waiting list control group. MATERIALS AND METHODS: This three-arm RCT will recruit participants from the cognitive centers at Karolinska University Hospital in Stockholm and randomize approximately 120 individuals in the early phase of cognitive impairment to either an experimental group (psychological intervention once a week for 10 weeks), an active control group (cognitive training once a week for 10 weeks) or a waiting list control group. Intervention outcome will be evaluated with self-report questionnaires on physical and psychological aspects of health, cognitive assessment, biological markers (obtained from blood and saliva) and health care costs. Assessments will be performed at pre- (1 week before the interventions) and post-intervention (1 week after the interventions), as well as at a 6-month follow-up. DISCUSSION: The development of a potentially feasible and effective psychological intervention tailored for early phase cognitive impairment (PIPCI) has the potential to advance the non-pharmacological intervention field. This is especially important given the extensive burden for many affected individuals and their families and the current lack of effective treatments. If the psychological intervention discussed here shows feasibility and efficacy, there is potential for far-reaching healthcare implications for patients with early cognitive impairment at risk of developing dementia. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT04356924. Date of registration: April 22, 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04356924.
Authors: Frank W Bond; Steven C Hayes; Ruth A Baer; Kenneth M Carpenter; Nigel Guenole; Holly K Orcutt; Tom Waltz; Robert D Zettle Journal: Behav Ther Date: 2011-05-25
Authors: D V Sheehan; Y Lecrubier; K H Sheehan; P Amorim; J Janavs; E Weiller; T Hergueta; R Baker; G C Dunbar Journal: J Clin Psychiatry Date: 1998 Impact factor: 4.384
Authors: Frank Jessen; Steffen Wolfsgruber; Birgitt Wiese; Horst Bickel; Edelgard Mösch; Hanna Kaduszkiewicz; Michael Pentzek; Steffi G Riedel-Heller; Tobias Luck; Angela Fuchs; Siegfried Weyerer; Jochen Werle; Hendrik van den Bussche; Martin Scherer; Wolfgang Maier; Michael Wagner Journal: Alzheimers Dement Date: 2013-01-30 Impact factor: 21.566