Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial.
BACKGROUND
Caring for a family member with dementia is extremely stressful, contributes to psychiatric and physical illness among caregivers, and increases the risk for caregiver death. Finding better ways to support family caregivers is a major public health challenge.


OBJECTIVE
To test the effects of a structured multicomponent intervention on quality of life and clinical depression in caregivers and on rates of institutional placement of care recipients in 3 diverse racial or ethnic groups.


METHODS
Randomized, controlled trial.


METHODS
In-home caregivers in 5 U.S. cities.


METHODS
212 Hispanic or Latino, 219 white or Caucasian, and 211 black or African-American caregivers and their care recipients with Alzheimer disease or related disorders.


METHODS
Caregivers within each racial or ethnic group were randomly assigned to an intervention or to a control group. The intervention addressed caregiver depression, burden, self-care, and social support and care recipient problem behaviors through 12 in-home and telephone sessions over 6 months. Caregivers in the control group received 2 brief "check-in" telephone calls during the 6-month intervention.


METHODS
The primary outcome was a quality-of-life indicator comprising measures of 6-month caregiver depression, burden, self-care, and social support and care recipient problem behaviors. Secondary outcomes were caregiver clinical depression and institutional placement of the care recipient at 6 months.


RESULTS
Hispanic or Latino and white or Caucasian caregivers in the intervention group experienced significantly greater improvement in quality of life than those in the control group (P < 0.001 and P = 0.037, respectively). Black or African-American spouse caregivers also improved significantly more (P = 0.003). Prevalence of clinical depression was lower among caregivers in the intervention group (12.6% vs. 22.7%; P = 0.001). There were no statistically significant differences in institutionalization at 6 months.


CONCLUSIONS
The study used only a single 6-month follow-up assessment, combined heterogeneous cultures and ethnicities into a single group, and excluded some ethnic groups.


CONCLUSIONS
A structured multicomponent intervention adapted to individual risk profiles can increase the quality of life of ethnically diverse dementia caregivers. ClinicalTrials.gov identifier: NCT00177489.
Belle
Steven H
SH
University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA.
Burgio
Louis
L
Burns
Robert
R
Coon
David
D
Czaja
Sara J
SJ
Gallagher-Thompson
Dolores
D
Gitlin
Laura N
LN
Klinger
Julie
J
Koepke
Kathy Mann
KM
Lee
Chin Chin
CC
Martindale-Adams
Jennifer
J
Nichols
Linda
L
Schulz
Richard
R
Stahl
Sidney
S
Stevens
Alan
A
Winter
Laraine
L
Zhang
Song
S
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012648:Self Care / Q000523:psychology; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D014481:United States