Efficacy of an Italian psychosocial intervention for caregivers of Alzheimer’s patients

Objectives. To determine the impact of a psychosocial intervention for caregivers of Alzheimer disease (AD) patients: a) on caregivers’ burden, mood, health, social support, service use, and relationships with others; b) on patients’ troublesome behaviours. Methods. 145 home-dwelling dyads (AD patients and their primary caregivers) were enrolled in this randomized controlled study. 75 caregivers (CG, Control Group) received the care/treatment usually given at our center. The remainders (IG, Intervention Group) underwent 6 sessions of individual/family counselling over 4 months, based on the strategies developed both in the REACH program (Wisniewski et al., 2003) and at the NYU-ADRC (Mittelman et al., 1999). Both groups were reassessed at 6 and 12 months. Between and within group analyses were performed using t-test, Repeated-Measures ANOVA, and ANCOVA. Results. The two groups were comparable at baseline for age, sex, education and patients' disease severity, but not for severity of depressive symptoms. Compared to CG, IG had better health (p = 0.03) and lower Hamilton Depression Rating Scale scores at 6 months, even after controlling for depression severity at baseline (p = 0.03). However, between group differences disappeared at 12 months. Within the IG, health and relationships with others improved from baseline to month 6, while emotional distress, depressive symptoms and social support, as well as patients’ troublesome behaviours, significantly improved from baseline to month 12. Conversely, within the CG, service use increased from baseline to month 12 (p<0.05). Conclusions. These data support the long-term efficacy of a psychosocial intervention for caregivers of AD patients.