INTRODUCTIONCollaborative dementia care models with care navigation, including the Care Ecosystem, improve outcomes for persons living with dementia (PLWDs) and their caregivers. The effects of continuous care over long periods have not been studied.METHODSIn this randomized clinical trial with 456 PLWD–caregiver dyads with high caregiver burden, we evaluated the cumulative 5‐year treatment effect on PLWD quality of life, health care utilization, caregiver depression, self‐efficacy, and burden.RESULTSFive‐year participation was associated with higher quality of life, lower caregiver depression, and higher caregiver self‐efficacy (all p’s < 0.05) with a trend for lower burden (p = 0.07). Treatment effects were most robust during the first 2 years. The effects on emergency department visits and hospitalizations were not significant.DISCUSSIONThe benefits of collaborative dementia care on PLWD quality of life and caregiver well‐being are sustained for 5 years, and the dyads may experience the greatest benefit during the first 2 years.Highlights Collaborative dementia care with care navigation was evaluated over 5 years using a randomized clinical trial. The care was associated with better quality of life for the person with dementia and well‐being for the caregiver. The most robust treatment effects were in the first 2 years.

中文翻译：

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协作痴呆护理对生活质量和照护者福祉的长期影响


引言具有护理导航的协作式痴呆护理模式，包括护理生态系统，可改善痴呆患者 （PLWD） 及其护理人员的结果。尚未研究长期持续护理的影响。方法在这项随机临床试验中，有 456 名具有高护理人员负担的 PLWD-照顾者二元组，我们评估了 5 年累积治疗对 PLWD 生活质量、医疗保健利用、照顾者抑郁、自我效能和负担的影响。结果一年的参与与较高的生活质量、较低的照顾者抑郁和较高的照顾者自我效能感 （所有 p 的 < 0.05） 相关，并且有降低负担的趋势 （p = 0.07）。前 2 年的治疗效果最为强劲。对急诊科就诊和住院治疗的影响不显著。讨论协作痴呆护理对 PLWD 生活质量和护理人员福祉的益处持续 5 年，二人组在前 2 年可能会获得最大的益处。亮点 使用随机临床试验对协作痴呆护理与护理导航进行了 5 年以上的评估。这种护理与痴呆患者更好的生活质量和护理人员的幸福感有关。最强大的治疗效果是在前 2 年。