title: A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: results of the Pleasant Events Program (PEP).
abstract: Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51). Assessments were completed pre- and post-intervention and at 1-year follow-up. Biological assessments included CVD risk markers Interleukin-6 (IL-6) and D-dimer. Psychosocial outcomes included depressive symptoms, positive affect, and negative affect. Participants receiving the PEP intervention had significantly greater reductions in IL-6 (p = .040), depressive symptoms (p = .039), and negative affect (p = .021) from pre- to post-treatment. For IL-6, clinically significant improvement was observed in 20.0% of PEP participants and 6.5% of IS participants. For depressive symptoms, clinically significant improvement was found for 32.7% of PEP vs 11.8% of IS participants. Group differences in change from baseline to 1-year follow-up were non-significant for all outcomes. The PEP program decreased depression and improved a measure of physiological health in older dementia caregivers. Future research should examine the efficacy of PEP for improving other CVD biomarkers and seek to sustain the intervention's effects.
authors.affiliation: Department of Psychiatry, University of California, San Diego, USA; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, USA.
authors.forename: Raeanne C
authors.initials: RC
authors.lastname: Moore
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Chattillion
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ceglowski
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ho
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mills
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ziegler
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
mesh_terms: D000339:Affect; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000517:prevention & control* / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012944:Social Support
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; C036309:fibrin fragment D
keywords: Alzheimer's disease; Cardiovascular disease; Depression; Intervention; Treatment
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