Cross-country Effects of the Tailored Activity Program to Reduce Neuropsychiatric Symptoms and Other Dementia-related Symptoms: Results from Randomized Trials

Background: The Tailored Activity Program (TAP) is a nonpharmacological approach shown to reduce neuropsychiatric symptoms and other dementia-related clinical symptoms in people living with dementia and family caregivers. Method: TAP has been tested in 8 different randomized trials (stage 3 efficacy) in four different countries and is currently used in over 9 countries with varying results. Result: Across 8 trials, TAP was found to have a wide range of benefits including reducing functional dependence and neuropsychiatric symptoms, improving quality of life of both people living with dementia and their caregivers, and enhancing caregiver well-being. Findings from trials also demonstrate differences in outcomes among samples. For example in a USA trial involving 250 families, TAP compared to attention control resulted in differential effects for Black and White families. Statistically and clinically significant reductions in agitation and aggression (frequency and severity scores) were found for Black families in TAP compared to White families in TAP and those in the control group. In contrast, White caregivers receiving TAP reported less depressive symptoms than other groups. Conclusion: Comparing outcomes across trials highlights the role of contextual factors and how country specific needs for dementia care may impact outcomes from nonpharmacological interventions. The comparison also reveals multiple challenges concerning dissemination and implementation of TAP (stage 4 and 5) such as lack of workforce preparation, payment mechanisms, and knowledge and acceptability of nonpharmacological approaches.