Cognitive-behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease.
BACKGROUND
Family caregivers of patients with dementia frequently experience psychological stress, depression and disturbed psychophysiological activity, with increased levels of diurnal cortisol secretion.


OBJECTIVE
To compare the effects of a cognitive-behavioural group therapy (CBT) to a psychoeducation group programme (EDUC) on cortisol secretion in caregivers of patients with moderate Alzheimer's disease (AD).


METHODS
Caregivers of AD outpatients were semi-randomly allocated to one of two intervention programmes (CBT or EDUC) consisting of eight weekly sessions. Twenty-six participants completed the study. Before and after intervention, salivary cortisol was collected at four different times of the day. Effects of the interventions were evaluated with self-report psychological scales and questionnaires related to functional abilities and neuropsychiatric symptoms of the AD relative.


RESULTS
Only in the CBT group did salivary cortisol levels significantly decrease after intervention, with a large effect size and high achieved power. Both groups reported a reduction of neuropsychiatric symptoms of their AD relative after intervention.


CONCLUSIONS
Psychoeducation for caregivers may contribute to a reduction of neuropsychiatric symptoms of AD patients while CBT additionally attenuates psychophysiological responses to stressful situations in caregivers, by reducing diurnal cortisol levels. This may lead to a positive impact in the general health of the caregiver, eventually resulting in better care of the AD patient.
a Department of Clinical Neurosciences, Division of Neurology , Geneva University Hospitals , Geneva , Switzerland.
T
T
Aboulafia-Brakha
D
D
Suchecki
F
F
Gouveia-Paulino
R
R
Nitrini
R
R
Ptak
D000368:Aged; D000544:Alzheimer Disease; D015415:Biomarkers; D001938:Brazil; D017028:Caregivers / Q000193:education* / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D017281:Cost of Illness; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000302:isolation & purification* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000503:physiopathology; D011795:Surveys and Questionnaires
D015415:Biomarkers; D006854:Hydrocortisone
Alzheimer; burden; caregiver; cognitive–behavioural therapy; cortisol; dementia; neuropsychiatric symptoms; psychoeducation; stress