title: Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: a randomized controlled trial.
abstract: OBJECTIVE
  Interventions directed at the mental health of family dementia caregivers may have limited impact when focused on caregivers who have provided care for years and report high burden levels. We sought to evaluate the mental health effects of problem-solving therapy (PST), designed for caregivers of individuals with a recent diagnosis of Mild Cognitive Impairment (MCI) or early dementia.
  
  
  METHODS
  Seventy-three (43 MCI and 30 early dementia) family caregivers were randomly assigned to receive PST or a comparison condition (nutritional education). Depression, anxiety, and problem-solving orientation were assessed at baseline and at 1, 3, 6, and 12 months post intervention.
  
  
  RESULTS
  In general, the PST caregiver intervention was feasible and acceptable to family caregivers of older adults with a new cognitive diagnosis. Relative to nutritional education, PST led to significantly reduced depression symptoms, particularly among early dementia caregivers. PST also lowered caregivers' anxiety levels, and led to lessening of negative problem orientation.
  
  
  CONCLUSIONS
  Enhanced problem-solving skills, learned early after a loved one's cognitive diagnosis (especially dementia), results in positive mental health outcomes among new family caregivers.
authors.affiliation: Health & Community Systems Department, The University of Pittsburgh School of Nursing, Pittsburgh, PA. Electronic address: ligst4@pitt.edu.
authors.forename: Linda
authors.initials: L
authors.lastname: Garand
authors.affiliation: Health & Community Systems Department, The University of Pittsburgh School of Nursing, Pittsburgh, PA.
authors.forename: Donna E
authors.initials: DE
authors.lastname: Rinaldo
authors.affiliation: Health & Community Systems Department, The University of Pittsburgh School of Nursing, Pittsburgh, PA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Alberth
authors.affiliation: Health & Community Systems Department, The University of Pittsburgh School of Nursing, Pittsburgh, PA.
authors.forename: Jill
authors.initials: J
authors.lastname: Delany
authors.affiliation: Health & Community Systems Department, The University of Pittsburgh School of Nursing, Pittsburgh, PA.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Beasock
authors.affiliation: Departments of Neurology and Psychiatry, and Alzheimer Disease Research Center, The University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Lopez
authors.affiliation: Department of Psychiatry, Advanced Center for Interventions and Services Research in Late Life Depression Prevention and Treatment, The University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.affiliation: Departments of Psychiatry, Biostatistics, Epidemiology, Psychology and Clinical and Translational Science, The University of Pittsburgh Schools of Medicine and Public Health, Pittsburgh, PA.
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000451:nursing*; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011613:Psychotherapy; D016896:Treatment Outcome
keywords: Problem-solving therapy; early dementia; early family dementia caregiving; mild cognitive impairment