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.