Reducing the functional impact on people with dementia requires active intervention programs that facilitate timely diagnoses and multidisciplinary active interventions that address and direct the conditions that lead to further disability, as well as train and support their relatives in providing them with adequate care. Through this pilot study, the investigator would like to identify diagnostic tools and therapeutic alternatives for dementia that prioritize functionality and can be introduced into the health system of Perú.
In Peru, older adults with dementia are diagnosed late or remain undiagnosed throughout their illness, a situation that leads to increased comorbidities and accelerated loss of independence. Untrained family members often become the primary caregivers, further adding to the caregiver stress.
The investigator seeks to introduce the first ambulatory program for older Peruvians with neurocognitive impairment centered on providing personalized train and support to family caregivers for optimize the care patients, with the ultimate goal of maintaining patient functional independence. The Multidisciplinary, Multidomain, Ambulatory, Personalized Intervention Program (MMAPP), will be housed within the main Air Force Hospital in Lima, Peru, and will leverage the experience of its geriatric multidisciplinary team. The MMAPP will include assessment tools to identify key conditions that favor the loos of functional independence such as comorbidities, geriatric syndromes, social environment, caregiver distress, which will be addressed via personalized care plan. The MMAPP will be developed within an experimental, prospective randomized trial, that uses the Agile Implementation Methodology, which will allow us to develop the program making evaluations at different time points to do modifications when necessary.
If successful, the MMAPP aside from optimizing the functional independence of older Peruvians with neurocognitive impairment, it will achieve other health benefits such as adequate control of comorbidities, geriatric syndromes, psycho-behavioral symptoms, improve the home care environment and decreased caregiver burden, which will translate to improved overall quality of life. The introduction of the MMAPP represents the first step of a larger and visionary plan to provide comprehensive, personalized care to improve quality of life for elder with neurocognitive impairment across the Peruvian public health system.