Abstract

Background: Dementia, characterised by cognitive decline and behavioural and psychological symptoms of dementia (BPSD), significantly affects management and prognosis. BPSD encompasses emotional, perceptual and behavioural disturbances in older adults. This study evaluates the impact of a Thai culturally-based mutual support group (T-MSG) online programme on activities of daily living (ADL), the Neuropsychiatric Inventory (NPI) and quality of life (QOL) among older adults with BPSD. Methods: A randomised controlled trial was conducted from September 2021 to March 2022. The study involved 186 older adults with BPSD and their 186 family caregivers from four psychiatric hospitals in Thailand. Participants were randomly assigned to two groups: the experimental group (n = 99), which received T-MSG along with standard care, and the control group (n = 87), which received only standard care. Outcomes were measured at baseline, week 4 and week 12 using the Barthel ADL Index, NPI-Q Thai and QOL-D Scale. Group comparisons showed significant effects for ADL and QOL scores (analysed by repeated measures ANOVA) and NPI scores (analysed by non-parametric tests). Results: The experimental group showed significant improvements in average ADL and QOL scores at both the 4- and 12-week intervals compared to baseline (p < 0.001). Additionally, the experimental group had notably higher average ADL and QOL scores than the control group at both follow-up points (p < 0.001). Although the T-MSG did not significantly reduce NPI scores within the experimental group over time, the experimental group consistently exhibited significantly lower mean NPI scores compared to the control group. Conclusions: The T-MSG programme improved functional abilities (ADL), QOL and reduced neuropsychiatric symptoms (NPI) in older adults with BPSD. This culturally tailored intervention provides a viable nursing approach for enhancing functional ability, QOL, neuropsychiatric symptoms and daily functioning in Thai older adults with dementia.