title: [Beneficial effect of a cognitive behavioral and multidisciplinary program in Alzheimer Disease on spouse caregiver anxiety: French study ELMMA].
abstract: BACKGROUND
  Over the last decade, several programs have been developed for caregivers of Alzheimer disease patients. In France however, studies exploring their effects are still scarce. We conducted a study to compare two different interventions: a structured multidisciplinary program versus a classical intervention designed for Alzheimer disease patients and their spouses.
  
  
  METHODS
  Sixteen couples (Alzheimer's disease patient and spouse) residing in our administrative district participated in this monocentric study. For at least two years, these couples participated in a multidisciplinary program (n=8 couples) or received usual care (n=8 couples). The multidisciplinary program involved biannual consultations with a neurologist, a neuropsychologist and a psychologist, in addition to an annual meeting, stratified on the patient's MMSE score, for spouses). Usual care involved biannual consultations with the neurologist. The multidisciplinary program included a psychological intervention based on cognitive behavioral theories and centered on psycho-education, problem solving, adaptation strategies and on prevention of depression and anxiety. The spouses and the patients evaluated the 2-year follow-up during clinical interviews, completed by questionnaires. Sociodemographic data were noted for the patients and their spouses. Levels of depression and anxiety (Mini International Neuropsychiatric Inventory, Montgomery and Asberg Depression Scale, State-Trait Anxiety Inventory), perceived stress (Perceived Stress Scale) and care burden (Zarit Burden Inventory) were evaluated in spouses. Levels of cognitive impairment (Mini Mental State Examination), autonomy (Instrumental Activities of Daily Living), psychological state (Montgomery and Asberg Depression Scale, Covi Anxiety Scale), and behavioral symptoms frequency (Neuropsychiatric Inventory) were assessed in patients.
  
  
  RESULTS
  The main significant result showed that the spouses' state of anxiety was lower among participants in the multidisciplinary program, compared with the classical neurological intervention. It also was found that the spouses and the patients who participated in this multidisciplinary program were less depressed.
  
  
  CONCLUSIONS
  This study shows that a multidisciplinary structured intervention, with only two annual consultations and one annual meeting for spouses, can contribute to decrease significantly the spouses' state of anxiety. Further studies including a larger number of subjects should be conducted to confirm these findings.
authors.affiliation: Laboratoire de psychopathologie et processus de santé EA 4057, université Paris Descartes, Paris, France. vnegovanska@gmail.com
authors.forename: V
authors.initials: V
authors.lastname: Negovanska
authors.forename: T
authors.initials: T
authors.lastname: Hergueta
authors.forename: E
authors.initials: E
authors.lastname: Guichart-Gomez
authors.forename: B
authors.initials: B
authors.lastname: Dubois
authors.forename: M
authors.initials: M
authors.lastname: Sarazin
authors.forename: C
authors.initials: C
authors.lastname: Bungener
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D001007:Anxiety / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010348:Patient Care Team; D011619:Psychotropic Drugs / Q000627:therapeutic use
chemical_list: D011619:Psychotropic Drugs