An interdisciplinary rehabilitation program for adults with dementia-A randomized controlled pilot trial evaluating social participation, loneliness and mental health.

The pilot trial enrolled 61 participants with dementia randomized to an intervention group or usual care.

• Participants had a mean age (SD) of 78.7 (±6.6) years.
• Intervention group: n = 31; usual care group: n = 30.
• The rehabilitation program consisted of a 20-week rehabilitation period with two follow-ups after 5 and 14 months.
• An interdisciplinary team performed assessments and interventions based on the individual's goals.
• Assessors blinded to group allocation performed structured assessments at baseline and after 5, 12, 24, and 36 months.

Initially, response rates for assessments in the areas of social participation, loneliness, and mental health were high in participants with dementia.

• Response rates after 12 months decreased, particularly for cognitively demanding questions.
• The greatest decline in response rates was observed for multiple-choice questions in the area of social participation.
• Assessments of loneliness and mental health over three years seemed feasible.
• It seemed cognitively demanding for participants with dementia to answer questions regarding social participation over time.

Overall, there were few statistically significant differences between the intervention and usual care groups in outcomes over 36 months.

• Outcomes assessed included social participation, loneliness, and mental health.
• The trial was a pilot study and not powered to detect statistically significant differences.
• Follow-up period extended to 36 months.
• Some findings were described as 'potentially clinically meaningful in favor of the intervention group.'

The intervention group showed potentially clinically meaningful increases in frequency of active recreation and organized social activities outside the home.

• Increased frequency of active recreation and organized social activities outside the home was reported by both participants with dementia and caregivers or staff.
• Participants in the intervention group also experienced more frequent visits to family and friends.
• A short-term reduction in depressive symptoms was observed in the intervention group.
• These findings were described as 'potentially clinically meaningful in favor of the intervention group' despite limited statistical significance.

Asking informal caregivers or staff about social participation outcomes in addition to participants with dementia was identified as worthwhile to avoid data loss.

• Cognitively demanding questions with multiple-choice options in the area of social participation showed particularly decreased response rates after 12 months.
• The authors recommend also asking informal caregivers or staff to supplement participant self-report.
• This strategy was recommended to avoid data loss over the course of longitudinal assessments.
• Assessments of loneliness and mental health over three years 'seemed feasible.'

The authors concluded it is relevant to proceed to an adequately powered RCT conducted in additional geographical regions.

• The pilot trial was registered at ISRCTN: http://www.isrctn.com/ISRCTN59155421.
• Positive findings noted during assessments and potential effects were cited as justification for a larger trial.
• The authors noted the need for an 'adequately powered RCT' as the pilot was not designed to definitively test efficacy.
• Expansion to 'additional geographical regions' was recommended to improve generalizability.