OBJECTIVE: To evaluate the effectiveness of a combination of cholinesterase inhibitor therapy for patients with Alzheimer disease (AD) and psychosocial intervention, for their spouse caregivers compared with drug treatment alone in three countries simultaneously. DESIGN: Randomized controlled trial. Structured questionnaires were administered at baseline and at regular follow-up intervals for 24 months by independent raters blind to group assignment. SETTING: Outpatient research clinics in New York City, U.S., Manchester, U.K. and Sydney, Australia. PARTICIPANTS: Volunteer sample of 158 spouse caregivers of community dwelling patients with AD. INTERVENTIONS: Five sessions of individual and family counseling within 3 months of enrollment and continuous availability of ad hoc telephone counseling were provided for half the caregivers. Donepezil was prescribed for all patients. MAIN OUTCOME MEASURE: Depressive symptoms of spouse caregivers measured at intake and follow-up assessments for 24 months using Beck Depression Inventory (revised). RESULTS:Depression scores of caregivers who received counseling decreased over time, whereas the depression scores for caregivers who did not receive counseling increased. The benefit of the psychosocial intervention was significant after controlling for site, gender and country was not accounted for by antidepressant use and increased over 2 years even though the individual and family counseling sessions occurred in the first 3 months. CONCLUSION: Effective counseling and support interventions can reduce symptoms of depression in caregivers when patients are taking donepezil. Harmonized multinational psychosocial interventions are feasible. Combined drug and supportive care approaches to the management of people with AD should be a priority.
RCT Entities:
OBJECTIVE: To evaluate the effectiveness of a combination of cholinesterase inhibitor therapy for patients with Alzheimer disease (AD) and psychosocial intervention, for their spouse caregivers compared with drug treatment alone in three countries simultaneously. DESIGN: Randomized controlled trial. Structured questionnaires were administered at baseline and at regular follow-up intervals for 24 months by independent raters blind to group assignment. SETTING:Outpatient research clinics in New York City, U.S., Manchester, U.K. and Sydney, Australia. PARTICIPANTS: Volunteer sample of 158 spouse caregivers of community dwelling patients with AD. INTERVENTIONS: Five sessions of individual and family counseling within 3 months of enrollment and continuous availability of ad hoc telephone counseling were provided for half the caregivers. Donepezil was prescribed for all patients. MAIN OUTCOME MEASURE: Depressive symptoms of spouse caregivers measured at intake and follow-up assessments for 24 months using Beck Depression Inventory (revised). RESULTS:Depression scores of caregivers who received counseling decreased over time, whereas the depression scores for caregivers who did not receive counseling increased. The benefit of the psychosocial intervention was significant after controlling for site, gender and country was not accounted for by antidepressant use and increased over 2 years even though the individual and family counseling sessions occurred in the first 3 months. CONCLUSION: Effective counseling and support interventions can reduce symptoms of depression in caregivers when patients are taking donepezil. Harmonized multinational psychosocial interventions are feasible. Combined drug and supportive care approaches to the management of people with AD should be a priority.
Authors: A Burns; M Rossor; J Hecker; S Gauthier; H Petit; H J Möller; S L Rogers; L T Friedhoff Journal: Dement Geriatr Cogn Disord Date: 1999 May-Jun Impact factor: 2.959
Authors: A Lukas; R Kilian; B Hay; R Muche; C A F von Arnim; M Otto; M Riepe; M Jamour; M D Denkinger; T Nikolaus Journal: Z Gerontol Geriatr Date: 2012-06 Impact factor: 1.281
Authors: Quincy M Samus; Deirdre Johnston; Betty S Black; Edward Hess; Christopher Lyman; Amrita Vavilikolanu; Jane Pollutra; Jeannie-Marie Leoutsakos; Laura N Gitlin; Peter V Rabins; Constantine G Lyketsos Journal: Am J Geriatr Psychiatry Date: 2014-01-04 Impact factor: 4.105
Authors: Jeremy A Tanner; Betty S Black; Deirdre Johnston; Edward Hess; Jeannie-Marie Leoutsakos; Laura N Gitlin; Peter V Rabins; Constantine G Lyketsos; Quincy M Samus Journal: Am J Geriatr Psychiatry Date: 2014-08-13 Impact factor: 4.105
Authors: Adam E Singer; Joy R Goebel; Yan S Kim; Sydney M Dy; Sangeeta C Ahluwalia; Megan Clifford; Elizabeth Dzeng; Claire E O'Hanlon; Aneesa Motala; Anne M Walling; Jaime Goldberg; Daniella Meeker; Claudia Ochotorena; Roberta Shanman; Mike Cui; Karl A Lorenz Journal: J Palliat Med Date: 2016-08-17 Impact factor: 2.947
Authors: Crystal V Flynn Longmire; Lea T Drye; Constantine E Frangakis; Barbara K Martin; Curtis L Meinert; Jacobo E Mintzer; Cynthia A Munro; Anton P Porsteinsson; Peter V Rabins; Paul B Rosenberg; Lon S Schneider; Daniel Weintraub; Constantine G Lyketsos Journal: Am J Geriatr Psychiatry Date: 2014-01 Impact factor: 4.105