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Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial)
Ballard C, Brown R, Fossey J, Douglas S, Bradley P, Hancock J, James IA, Juszczak E et al.. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009-09-01
Topic: Amyloid, tau and blood-test diagnosis
Background Good practice guidelines state that a psychological intervention should usually precede pharmacotherapy, but there are no data evaluating the feasibility of psychological interventions used in this way. Methods At the first stage of a randomized blinded placebo-controlled trial, 318 patients with Alzheimer disease (AD) with clinically significant agitated behavior were treated in an open design with a psychological intervention (brief psychosocial therapy [BPST]) for 4 weeks, preceding randomization to pharmacotherapy. The therapy involved social interaction, personalized music, or removal of environmental triggers. Results Overall, 318 patients with AD completed BPST with an improvement of 5.6 points on the total Cohen-Mansfield Agitation Inventory (CMAI; mean [SD], 63.3 [16.0] to 57.7 [18.4], t = 4.8, df = 317, p 95% of patients. More detailed evaluation of outcome was completed for the 198 patients with AD from these centers, who experienced a mean improvement of 6.6 points on the total CMAI (mean [SD], 62.2 [14.3] to 55.6 [15.8], t = 6.5, df = 197, p Conclusion The specific attributable benefits of BPST cannot be determined from an open trial. However, the BPST therapy was feasible and was successfully delivered according to an operationalized manual. The encouraging outcome indicates the need for a randomized controlled trial of BPST.
Key findings
- Methods At the first stage of a randomized blinded placebo-controlled trial, 318 patients with Alzheimer disease (AD) with clinically significant agitated behavior were treated in an open design with a psychological intervention (brief psychosocial therapy [BPST]) for 4 weeks, preceding randomization to pharmacotherapy.
- Results Overall, 318 patients with AD completed BPST with an improvement of 5.6 points on the total Cohen-Mansfield Agitation Inventory (CMAI; mean [SD], 63.3 [16.0] to 57.7 [18.4], t = 4.8, df = 317, p 95% of patients.
Why it matters
In this open-label first stage, 318 patients with Alzheimer's disease and agitated behavior received brief psychosocial therapy and improved on the agitation scale, but the specific benefits of the therapy cannot be determined from an open trial. It is about managing agitation and does not show a treatment, cure, or prevention of Alzheimer's disease.
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Study details
- Study designrandomized controlled trial
- Participants318
- Evidence strengthHigh
How this study scored 65/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry) |
| Journal's citation record | 2 / 4 | American Journal of Geriatric Psychiatry: journal h-index 178 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 318 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 4 / 7 | Cited 86 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.5 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 3 / 6 | Cited 4.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 1 / 4 | Cited 9 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Robert Howard: h-index 95 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 10 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19700946) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 65 / 100 | — |
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Read the original
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APA 7th
Ballard, C., Brown, R., Fossey, J., Douglas, S., Bradley, P., Hancock, J., et al. (2009). Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. https://doi.org/10.1097/jgp.0b013e3181b0f8c0
Vancouver
Ballard C, Brown R, Fossey J, Douglas S, Bradley P, Hancock J, et al. Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial). The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2009. doi:10.1097/jgp.0b013e3181b0f8c0. PMID: 19700946.
BibTeX
@article{ballard2009-19700946,
author = {Ballard, C. and Brown, R. and Fossey, J. and Douglas, S. and Bradley, P. and Hancock, J. and James, I. A. and Juszczak, E. and others},
title = {{Brief psychosocial therapy for the treatment of agitation in Alzheimer disease (the CALM-AD trial)}},
journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
year = {2009},
doi = {10.1097/jgp.0b013e3181b0f8c0},
pmid = {19700946},
url = {https://doi.org/10.1097/jgp.0b013e3181b0f8c0}
}
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