Project CARE: a randomized controlled trial of a behavioral intervention group for Alzheimer's disease caregivers.
OBJECTIVE
The neuropsychiatric symptoms associated with Alzheimer's disease are a major contributor to caregiver distress and burden. Despite recent efforts to teach caregivers skills to manage neuropsychiatric symptoms and reduce burden, there continues to be limited evidence that these strategies have helped caregivers of individuals with Alzheimer's disease to effectively manage neuropsychiatric symptoms. We report here on Project CARE, a randomized controlled trial designed to test the effectiveness of a caregiver-based multicomponent behavioral intervention aimed to reduce caregiver distress related to neuropsychiatric symptoms, as well as general caregiver burden, and to decrease neuropsychiatric symptom severity among individuals with Alzheimer's disease.


METHODS
The behavioral intervention involved five weekly sessions designed to teach caregivers specific techniques for managing patient neuropsychiatric symptoms in the home environment. Through the use of a randomized control trial, 80 caregivers were assigned to either the behavioral intervention group or a psychoeducational control group and were assessed both before and after the intervention.


RESULTS
Compared with caregivers in the control group, caregivers in the behavioral intervention group displayed significantly greater reductions in caregiver distress related to neuropsychiatric symptoms (p=.005). Global caregiver burden, however, did not decrease significantly for caregivers in either group (p>.05). Although it was not statistically significant, there was a trend toward greater reductions in care recipients' neuropsychiatric symptom severity in the intervention group (p=.10).


CONCLUSIONS
The current findings suggest that targeted, group-based behavioral interventions are effective for reducing distress related to neuropsychiatric symptoms among caregivers of individuals with Alzheimer's disease and for reducing care recipients' neuropsychiatric symptoms.
Gonyea
Judith G
JG
Boston University, School of Social Work, 264 Bay State Road, Boston, MA 02215, and Department of Psychology, Edith Norse Rogers Veterans Memorial Hospital, Bedford, USA. jgonyea@bu.edu
O'Connor
Maureen K
MK
Boyle
Patricia A
PA
D000544:Alzheimer Disease / Q000451:nursing*; D001521:Behavior Therapy / Q000379:methods*; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D009483:Neuropsychological Tests; D016896:Treatment Outcome