Low and middle income countries (LMIC) such as Vietnam are undergoing a dramatic demographic transition that will result in a substantial increase in the number of older adults, including those afflicted with Alzheimer's disease and related dementias, over the next several decades. Alzheimer's disease is among the most costly and disabling conditions to afflict older adults and places considerable stress on families. Strengthening LMIC capacity to support family caregivers of persons with dementia through low-cost and sustainable non- pharmacological approaches, such as education and skill-building to deal with difficult behaviors, is vital to avoid costly and ineffective alternatives such as psychotropic medications or institutionalization and to reduce caregiver burden and depression. While evidence-based models of non-pharmacological treatments exist in high income countries (HIC), these interventions have not been translated and adapted for use in Vietnam and other LMIC. This application directly addresses this important gap in our knowledge. The proposed project will strengthen collaboration between experienced investigators in the US and senior investigators at the National Geriatric Hospital, a leading institution for national geriatric policy, training and research in Vietnam. Dementia-related services and programs are virtually non-existent in Vietnam, a LMIC that is experiencing a rapid increase in its older adult population. This application arose from a request by leaders at the National Geriatric Hospital and Vietnam National Assembly for technical expertise and assistance in developing community based services for dementia caregivers. In the first year of this project, we propose to adapt the REACH-VA model for use in Vietnam. To adapt the model we will use a systematic approach to elicit input from key stakeholders and to attend to cultural factor and local resources. In the second year, we propose to test the feasibility and acceptability of the adapted model and to use the results to further refine the model. Throughout both years of the project, we will conduct activities to strengthen and build capacity in Vietnam to adapt and evaluate community-based dementia care interventions. At the end of the project, we will also disseminate project results and promote networking with other interested groups in Vietnam. This application will generate preliminary data and promote capacity-building to prepare for a larger R01 application to test the effectiveness of the culturally adapted model's effectiveness in Vietnam. Knowledge generated will also inform the broader field by serving as a model for adaptation of evidence-based interventions for dementia and other neurodegenerative brain diseases in LMIC.
Worldwide, the majority of persons with Alzheimer's disease and related dementias reside Vietnam and other low and middle income countries (LMIC) compared with high income countries, a trend that will be magnified in decades to come. While evidence-based models of non-pharmacological treatments exist in high income countries, these interventions have not been translated and adapted for use in Vietnam and many other LMIC. This R-21 application addresses these gaps by building capacity of investigators in Vietnam to adapt and evaluate an evidence-based model for community family caregiver dementia support.
| Nguyen, Tuan Anh; Nguyen, Huong; Pham, Thang et al. (2018) A cluster randomized controlled trial to test the feasibility and preliminary effectiveness of a family dementia caregiver intervention in Vietnam: The REACH VN study protocol. Medicine (Baltimore) 97:e12553 |
