title: Effectiveness of an Internet intervention for family caregivers of people with dementia: results of a randomized controlled trial.
abstract: BACKGROUND
  The World Health Organization stresses the importance of accessible and (cost)effective caregiver support, given the expected increase in the number of people with dementia and the detrimental impact on the mental health of family caregivers.
  
  
  METHODS
  This study assessed the effectiveness of the Internet intervention 'Mastery over Dementia'. In a RCT, 251 caregivers, of whom six were lost at baseline, were randomly assigned to two groups. Caregivers in the experimental group (N = 149) were compared to caregivers who received a minimal intervention consisting of e-bulletins (N = 96). Outcomes were symptoms of depression (Center for Epidemiologic Studies Depression Scale: CES-D) and anxiety (Hospital Anxiety and Depression Scale: HADS-A). All data were collected via the Internet, and an intention-to-treat analysis was carried out.
  
  
  RESULTS
  Almost all caregivers were spouses or children (in-law). They were predominantly female and lived with the care recipient in the same household. Age of the caregivers varied from 26 to 87 years. Level of education varied from primary school to university, with almost half of them holding a bachelor's degree or higher. Regression analyses showed that caregivers in the experimental group showed significantly lower symptoms of depression (p = .034) and anxiety (p = .007) post intervention after adjustment for baseline differences in the primary outcome scores and the functional status of the patients with dementia. Effect sizes were moderate for symptoms of anxiety (.48) and small for depressive symptoms (.26).
  
  
  CONCLUSIONS
  The Internet course 'Mastery over Dementia' offers an effective treatment for family caregivers of people with dementia reducing symptoms of depression and anxiety. The results of this study justify further development of Internet interventions for family caregivers of people with dementia and suggest that such interventions are promising for keeping support for family caregivers accessible and affordable. The findings are even more promising because future generations of family caregivers will be more familiar with the Internet.
  
  
  BACKGROUND
  Dutch Trial Register NTR-2051 www.trialregister.nl/trialreg/admin/rctview.asp?TC=2051.
authors: Dutch Alzheimer's Society, Department Scientific Research, Amersfoort, The Netherlands.
authors: Marco M
authors: MM
authors: Blom
authors: The Pennsylvania State University, Department of Human Development and Family Studies, University Park, Pennsylvania, United States of America; Gerontology Institute, University College of Health Science, Jönköping, Sweden.
authors: Steven H
authors: SH
authors: Zarit
authors: Dutch Alzheimer's Society, Department Scientific Research, Amersfoort, The Netherlands.
authors: Rob B M
authors: RB
authors: Groot Zwaaftink
authors: VU University, Department of Clinical Psychology, EMGO+, Amsterdam, The Netherlands.
authors: Pim
authors: P
authors: Cuijpers
authors: VU University, Department of Clinical Psychology, EMGO+, Amsterdam, The Netherlands; Netherlands Institute of Mental Health and Addiction (Trimbos-institute), Program on Aging, Utrecht, The Netherlands; University of Queensland, School of Psychology, Brisbane, Australia.
authors: Anne Margriet
authors: AM
authors: Pot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000517:prevention & control; D017028:Caregivers / Q000193:education* / Q000523:psychology*; D003704:Dementia; D003863:Depression / Q000517:prevention & control; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged