Reducing Disability in
Alzheimer’s Disease
(RDAD): (Download
Word Version)
An Evidence-Based Intervention for Alzheimer’s
and Dementia Care
The Reducing Disability in Alzheimer’s Disease (RDAD)
program provides exercise training for people with Alzheimer’s
disease who live at home and simultaneous training for their
family caregivers about how to manage behavioral symptoms. The
program is intended to reduce behavioral symptoms and depression
and improve the person’s physical functioning. A training
manual is available.
Behavioral symptoms and fall-related fractures often result
in nursing home placement for people with Alzheimer’s disease.
The RDAD program combines two interventions to address these
problems. Both interventions were developed and previously tested
by a research team at the University of Washington, Department
of Psychosocial and Community Health (Teri et al., 1997; Teri
et al., 1998). By combining the interventions, the research team
hoped to prevent or delay nursing home placement for people with
Alzheimer’s disease.
Teri et al. (2003) tested the RDAD program in randomized, controlled
research involving 153 people with moderate to severe Alzheimer’s
disease. The 77 people in the control group received no special
services. In contrast, the 76 people in the treatment group and
their family caregivers were seen at home in twelve 1-hour sessions
over an 11-week period and three follow-up sessions over the
following three months. The program was delivered by home health
professionals. The behavior management component of the program
included training for family caregivers about dementia, its impact
on patient behavior, and how to identify and modify behavioral
symptoms, modulate their own responses to the symptoms, and identify
pleasant activities for the care recipient. The exercise component
included 30 minutes of aerobic and endurance activities and strength,
balance, and flexibility training for the person with Alzheimer’s
disease.
Research findings published in the Journal of the American
Medical Association, show statistically significant short-
and long-term benefits for people in the treatment group:
- 3 months after the RDAD program ended, people in the treatment
group were exercising more; their physical functioning had
improved, while the physical functioning of people in the control
group had gotten worse; and people in the treatment group had
decreased depression, while those in the control group had
increased depression.
- 2 years after the RDAD program ended, people in the treatment
group still had better physical functioning than those in the
control group. Only 19% of those in the treatment group had
been placed in a nursing home because of behavioral disturbances,
compared with 50% of those in the control group. (The last
finding did not reach statistical significance.)
For more information about RDAD, contact Linda Teri, Ph.D.,
at the University of Washington, lteri@u.washington.edu or
(206) 543-0715. To purchase the training manual, send an email
to jcb@u.washington.edu.
Publications:
Teri L, Logsdon RG, Uomoto J, McCurry SM. (1997) Behavioral
Treatment of Depression in Dementia Patients: a Controlled Clinical
Trial. Journals of Gerontology: Psychological Sciences and
Social Sciences, 52B(4), P159-P166.
Teri L, McCurry SM, Buchner D, Logsdon RG, et al. (1998) Exercise
and Activity Level in Alzheimer’s Disease: a Potential
Treatment Focus. Journal of Rehabilitation Research and Development,
35, 411-419.
Teri L, Gibbons LE, McCurry SM, Logsdon RG, et al. (2003) Exercise
Plus Behavioral Management in Patients With Alzheimer’s Disease:
A Randomized Trail. Journal of the American Medical Association,
290(15), 2015-2022.
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