Regular Research ArticlesA Three-Country Randomized Controlled Trial of a Psychosocial Intervention for Caregivers Combined With Pharmacological Treatment for Patients With Alzheimer Disease: Effects on Caregiver Depression
Section snippets
Study Subjects
To be eligible, patients were required to meet National Institute of Neurological and Communicative Disorders and Stroke–AD and Related Disorders Association and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for probable AD22, 23; have a Global Deterioration Scale (GDS)24 score of 4 to 5, indicating mild to moderate dementia at enrollment; have no contra-indication to donepezil; be stable with other medications; be in good general physical health; be able to
Demographic Characteristics of Subjects, Subject Accrual, and Follow-Up
Demographic details for patient and caregivers are provided in Table 1. Nearly all patients had mild to moderately severe dementia (GDS 4 or 5). (We inadvertently included two patients in the treatment group and one in the control group with GDS 6 ratings and three patients in the control group with GDS 3 ratings.) Subjects did not differ significantly in caregiver gender or age, patient age or severity of patient dementia between countries, or treatment groups.
Table 2 shows the number of
DISCUSSION
In this study, the first to examine the combined effects of a caregiver intervention and pharmacotherapy, we demonstrated that five sessions of counseling based on the NYU model40 reduced depression scores in spouses of persons with AD taking donepezil. This benefit was significant in analyses that controlled statistically for caregiver gender and country and was not accounted for by antidepressant use.
Although the difference in change in depressive symptoms between the two groups was small, it
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Psychological interventions for symptoms of depression among informal caregivers of older adult populations: A systematic review and meta-analysis of randomized controlled trials
2023, Journal of Affective DisordersCitation Excerpt :Interventions including ‘passive’ psychoeducation (e.g. information via leaflets, e-mails or websites) or education about depression or intervention content were not deemed multicomponent (Donker et al., 2009; Pinquart and Sörensen, 2006). The intervention was delivered one-to-one in nine studies (Au, 2015; Au et al., 2014, 2015; Charlesworth et al., 2008a, b; Farrand et al., 2020; Garand et al., 2014; LeLaurin et al., 2021; Pan and Chen, 2019; Pillemer and Suitor, 2002), in groups (i.e. together with other caregivers) in three (Losada et al., 2011; Vázquez et al., 2016; Vázquez González et al., 2013), and delivery was mixed with both one-to-one and in groups in three studies (Bruvik et al., 2013; Mittelman et al., 2008; Werner et al., 2020). In one study the intervention was partly dyadic, i.e. including some elements where caregivers and their care recipient received the intervention together (Bruvik et al., 2013).
Models and Interventions for Informal Caregiving in Later Life
2022, Comprehensive Clinical Psychology, Second EditionOnline Training and Support Programs Designed to Improve Mental Health and Reduce Burden Among Caregivers of People With Dementia: A Systematic Review
2018, Journal of the American Medical Directors AssociationEvaluation of the Reitman Centre CARERS program for supporting dementia family caregivers: A pre-post intervention study
2022, International Psychogeriatrics
The authors thank the caregivers and patients for their participation, the NYU-ADC counselors in New York, Sean Page and Jane Winter in Manchester, and Angi Lesmina, Karen Berman, and Lynn Seifman in Sydney, Australia.
This work was supported by an unrestricted grant from Pfizer, Inc. Additional resources were provided by the NYU Alzheimer's Disease Center P30 AG08051.
ClinicalTrials.gov registration number NCT00467766.