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Targeting Functional Decline in Alzheimer Disease: A Randomized Trial
Callahan CM, Boustani MA, Schmid AA, LaMantia MA, Austrom MG, Miller DK, Gao S, Ferguson DY et al.. Annals of internal medicine, 2016-11-22
Topic: Amyloid, tau and blood-test diagnosis
Background Alzheimer disease results in progressive functional decline, leading to loss of independence. Objective To determine whether collaborative care plus 2 years of home-based occupational therapy delays functional decline. Design Randomized, controlled clinical trial. (ClinicalTrials.gov: NCT01314950). Setting Urban public health system. Patients 180 community-dwelling participants with Alzheimer disease and their informal caregivers. Intervention All participants received collaborative care for dementia. Patients in the intervention group also received in-home occupational therapy delivered in 24 sessions over 2 years. Measurements The primary outcome measure was the Alzheimer's Disease Cooperative Study Group Activities of Daily Living Scale (ADCS ADL); performance-based measures included the Short Physical Performance Battery (SPPB) and Short Portable Sarcopenia Measure (SPSM). Results At baseline, clinical characteristics did not differ significantly between groups; the mean Mini-Mental State Examination score for both groups was 19 (SD, 7). The intervention group received a median of 18 home visits from the study occupational therapists. In both groups, ADCS ADL scores declined over 24 months. At the primary end point of 24 months, ADCS ADL scores did not differ between groups (mean difference, 2.34 [95% CI, -5.27 to 9.96]). We also could not definitively demonstrate between-group differences in mean SPPB or SPSM values. Limitation The results of this trial are indeterminate and do not rule out potential clinically important effects of the intervention. Conclusion The authors could not definitively demonstrate whether the addition of 2 years of in-home occupational therapy to a collaborative care management model slowed the rate of functional decline among persons with Alzheimer disease. This trial underscores the burden undertaken by caregivers as they provide care for family members with Alzheimer disease and the difficulty in slowing functional decline. Primary funding source National Institute on Aging.
Key findings
- Background Alzheimer disease results in progressive functional decline, leading to loss of independence.
- Results At baseline, clinical characteristics did not differ significantly between groups; the mean Mini-Mental State Examination score for both groups was 19 (SD, 7).
- Limitation The results of this trial are indeterminate and do not rule out potential clinically important effects of the intervention.
Why it matters
In this trial of 180 people with Alzheimer disease, adding two years of home-based occupational therapy to collaborative care did not produce different scores on a measure of daily living activities at 24 months compared with collaborative care alone. The authors state the results are indeterminate and do not rule out potentially important effects of the intervention.
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Study details
- Evidence strengthHigh
How this study scored 63/100
Published in a leading specialty journal, and it is a randomised controlled trial. Scored zero for sample size and effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of internal medicine) |
| Journal's citation record | 4 / 4 | Annals of Internal Medicine: journal h-index 648 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized 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 | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| 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 (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 4 / 7 | Cited 40 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.6 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 3 / 6 | Cited 3.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Hugh C. Hendrie: h-index 76 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Indiana University: institution h-index 926 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 27893087) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 63 / 100 | — |
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Read the original
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Callahan, C. M., Boustani, M. A., Schmid, A. A., LaMantia, M. A., Austrom, M. G., Miller, D. K., et al. (2017). Targeting Functional Decline in Alzheimer Disease: A Randomized Trial. Annals of internal medicine. https://doi.org/10.7326/m16-0830
Vancouver
Callahan CM, Boustani MA, Schmid AA, LaMantia MA, Austrom MG, Miller DK, et al. Targeting Functional Decline in Alzheimer Disease: A Randomized Trial. Annals of internal medicine. 2017. doi:10.7326/m16-0830. PMID: 27893087.
BibTeX
@article{callahan2017-27893087,
author = {Callahan, C. M. and Boustani, M. A. and Schmid, A. A. and LaMantia, M. A. and Austrom, M. G. and Miller, D. K. and Gao, S. and Ferguson, D. Y. and others},
title = {{Targeting Functional Decline in Alzheimer Disease: A Randomized Trial}},
journal = {Annals of internal medicine},
year = {2017},
doi = {10.7326/m16-0830},
pmid = {27893087},
url = {https://doi.org/10.7326/m16-0830}
}
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