Total views : 212

Effects of a Functional Routine Enabling Program on Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease and on Caregiver Burden


  • Department Occupational Therapy, Dong-Nam Health University, 50 Cheoncheon-ro 74-gil, Jangan-gu, Suwon-si - 16328, Gyeonggi-do, Korea
  • Department Occupational Therapy, Yeoju Institute of Technology, 338 Sejong-ro - 12652, Gyeonggi-do, Korea
  • Department Occupational Therapy, Jungwon University, 85 Munmu-ro, Geosan-eup, Geosan-gun - 367700, Chungcheongbuk-do, Korea
  • Department Occupational Therapy, Hanseo University, 46 Hanseo1-ro, Hami-Myun, Seosan-si - 31962, Chungcheongnam-do, Korea
  • Department of Neuropsychiatry, Gyeonggi Provincial Hospital for the Elderly, 17 Sangha-dong, Cheoin-gu, Yongin-si - 446-512, Gyeonggi-do, Korea


Objectives: This study applied to a client-oriented FRE program to dementia patients in a community to analyze the effects of the program in reducing the patients’ BPSD and caregiver burden. Methods/Statistical Analysis: A home-visit activity program centered on environmental factors and evidence was implemented for dementia patients and their caregivers twice a week (once in a home visit, once by checking via a call). 72dementia patients and 53 caregivers participated in this study. Findings: Statistically significant changes were found in the frequency of depression and memory-related questions and the responses of caregivers to the Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry of Alzheimer’s Disease assessment packet, Dementia care assessment packet-Instrumental activity of daily living, Neuropsychiatric Inventory, Revised-Memory and Behavior Problem Checklist, and the total score of the Zarit Burden Interview. In addition, the frequency of overall problem behaviors and depression had the largest effects on the total score of caregiver burden. Improvements/Applications: The FRE program was confirmed to be effective for reducing BPSD in dementia patients and, thereby, caregiver burden.


Alzheimer’s Disease, Caregiver Burden, Community, Habituation, Roles.

Full Text:

 |  (PDF views: 178)


  • Springate BA, Tremont G. Dimensions of caregiver burden in dementia: Impact of demographic, mood, and care recipient variables. American Journal of Geriatric Psychiatry. 2014; 22(3):294-300.
  • Reed C, Belger M, DellAgnello G, Wimo A, Argimon JM, Bruno G. Caregiver burden in Alzheimer’s disease: Differential associations in adults-child and spousal caregivers in the GERAS observational study. Dementia and Geriatric Cognitive Disorders Extra. 2014; 4(1):51-4.
  • Lyketsos CG, Colenda CC, Beck C, Black K, Doraiswamy MP, Kalunian DY. Position statement of the American Association for Geriatric Psychiatry regarding principles of care for patients with dementia resulting from Alzheimer disease. American Journal of Geriatric Psychiatry. 2016; 14(9):808.
  • Kales HC, Gitlin LN, Lyketsos CG. Management of neuropsychiatric symptoms of dementia in clinical settings: Recommendations from a multidisciplinary expert panel. Journal of the American Geriatric Society. 2014; 62(4):762-9.
  • Brooker DJ, Woolley RJ, Lee D. Enriching opportunities for people living with dementia in nursing homes: An evaluation of a multi-level activity-based model of care. Aging & Mental Health. 2007; 11(4):361-70.
  • Jutkowitz E, Gitlin LN, Pizzi LT. Evaluating willingness-to-pay thresholds for dementia care giving interventions: Application to the tailored activity program. International Society for Pharmaco Economics and Outcomes Research. 2010; 13(6):720-5.
  • Kielhofner GA. Williams & Wilkins: US: A Model of Human Occupation: Theory and Application, 4th (edn). 1995; p. 608.
  • Opara JA. Activities of daily living and quality of life in Alzheimer disease. Journal of Medicine and Life. 2012; 5(2):162-7.
  • Lee JH, Lee KU, Lee DY, Kim KW, Jhoo JH, Kim JH. Development of the Korean version of the consortium to establish a registry for Alzheimer’s disease assessment packet (CERAD-K): Clinical and neuropsychological assessment batteries. The Journal of Gerontology: Psychological Sciences. 2002; 5b(1):47-53.
  • McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology. 1984; 34(7):939-44.
  • Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale of the staging of dementia. The British Journal of Psychiatry. 1982; 140(6):566-72.
  • Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975; 12(3):189-98.
  • Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. Journal of Clinical Epidemiology. 1989; 42(8):703-9.
  • Kim KW, Woo JI, Yoon JC, Lee DY, Lee JH, Jhoo JH. Seoul: The Korean Association for Dementia: Dementia Care Assessment Packet (DCAP). 2002.
  • Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3):179-86.
  • Cummings JL, Mega M, Gray K. Rosenberg-Thomson S, Carusi DA, Gornbein J. The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology. 1994; 44(12):2308-14.
  • Choi SH, Na DL, Kwon HM, Yoon SJ, Jeong JH, Ha CK. The Korean version of the neuropsychiatric inventory: A scoring tool for neuropsychiatric disturbance in dementia patients. Journal of Korean Medical Science. 2000; 15(6):609-15.
  • Teri L, Truax Pl, Logsdon R, Uomoto J, Zarit S, Vitaliano PP. Assessment of behavioral problems in dementia: The reversed memory and behavior problems checklist. Psychology and Aging.1992; 7(4):622-31.
  • Lee HS, Kim DK, Ko JK, Ku HM, Kwon EJ, Kim JH. Measurement of stress in the caregivers of dementia patients: Reliability and validity of the revised-memory and behavior problem checklist and the burden interview. Korean Journal of Clinical Psychology. 2004; 3(1):1029-50.
  • Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist. 1980; 20(6):649-55.
  • Cohen-Mansfield J. Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia. The American Journal of Geriatric Psychiatry. 2001; 9(4):361-81.
  • Wood W, Quinn JM, Kashy DA. Habits in Everyday Life: Thought, emotion, and action. Journal of Personality & Social Psychology. 2002; 83(6):1281-97.
  • Kielhofner G. US: Williams and Wilkins: A Model of Human Occupation: Theory and Application. 2nd (edn). 2002.
  • Giltlin LN, Kales HC, Lyketsos CG. Nonpharmacologic management of behavioral symptoms in dementia. Journal of American Medical Association. 2012; 308(19):2020-9.
  • Park KY, Park SY, Jeong WM, Park SH, Hwang YJ, Young JC. An Analysis of Clinical Features in Individuals with Alzheimer’s Dementia Living in the Community using the Allen Cognitive Levels. Indian Journal of Science and Technology. 2016; 9(25):1-7.
  • Huang SS, Lee MC, Liao YC, Wang WF, Lai TJ. Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderly. Archives of Gerontology & Geriatrics. 2012; 55(1):55-9.
  • Weiler PG, Chiriboga DA, Black SA. Comparison of mental status tests: Implications for Alzheimer’s patients and their caregivers. The Journal of Gerontology. 1994; 49(1):S44–S51.
  • Cho YH, Ra JS. Correlation between Preventive Health Behavior and Family Burden in Family Caregivers for the Elderly with Dementia. Indian Journal of Science and Technology. 2015; 8(26):1-8.
  • Giltlin LN, Corcoran M, Winter L, Boyce A, Hauck WW. A Randomized, controlled trial of a home environmental intervention: Effect on efficacy and upset in caregivers and daily function of persons with dementia. The Gerontologist. 2001; 41(1):4-14.


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.