EFFECTIVENESS OF A MULTI-COMPONENT INTERVENTION ON AGITATION AND AGGRESSION IN PEOPLE WITH DEMENTIA AND MILD COGNITIVE IMPAIRMENT IN PAKISTANI SHARED-HOUSING ARRANGEMENTS: A CLUSTER-RANDOMIZED CONTROLLED TRIAL

Abstract

Purpose: This study examined the effectiveness of a multi-component intervention in reducing agitation and aggression in individuals living with dementia or mild cognitive impairment (MCI) in Pakistani shared-housing arrangements.

Design: A cluster-randomized controlled trial was conducted across six shared-housing facilities in Punjab, Pakistan, with 120 participants. The intervention included structured staff training, personalized engagement activities, and environmental modifications. Agitation and aggression were assessed as secondary outcomes using the Cohen-Mansfield Agitation Inventory (CMAI).

Findings: Multilevel mixed-effects models indicated significant reductions in overall agitation and aggression in the intervention group compared to the control group over 12 weeks. Specific subdomains, including verbal aggression and physical restlessness, showed notable improvement.

Practical implications: The findings suggest that culturally adapted, multi-component interventions can effectively reduce behavioral disturbances in Pakistani dementia care settings.

Originality/value: This is the first cluster-RCT evaluating behavioral interventions for dementia in Pakistan’s shared-housing context, extending evidence from high-income countries to LMICs.