The NYU-Spouse Caregiver Intervention Study is the longest-running randomized controlled trial of an intervention to improve the mental health and well-being of family members as they struggle with the devastating symptoms of Alzheimer’s disease.

A total of 406 caregivers were enrolled in the study over a 9.5 year period, and were divided into two groups. Half of the caregivers, the control group, received the usual care (provided on an ad hoc basis upon request). The other half, the enhanced treatment group, were given two sessions of individual counselling, four sessions of family counselling, were asked to join a support group that met weekly, and could request additional ad hoc counselling when needed.

The intensive intervention was very brief - only six sessions - and yet that seems to have had a very long-lasting effect. The benefits that started in the counselling sessions led to changes that many families made in the way they interacted afterwards. Caregivers reported that they felt close to more members of their social networks, and were more satisfied with the support they received.

After one year, less than 30% of caregivers in the enhanced treatment group had symptoms of clinical depression, compared to more than 45% of those in the control group. Three years later, caregivers who received the intervention still exhibited fewer symptoms of depression, on average, than those in the control group who received usual care. They were also able to keep their spouses at home with them longer: on average, caregivers in the enhanced treatment group were able to keep their spouses at home with them for 557 days longer than those in the usual care control group.

The use of multiple types of coordinated therapy seems to be one of the most important factors in the effect of this intervention. Another important aspect of the study is that the counselling was tailored to the particular challenges that each of the caregivers and their families were dealing with. Finally, counselling and support were available to the spouse caregivers and their families for as long as they participated in the study.

Mary Mittelman, Dr PH
NYU School of Medicine

For a summary of Dr. Mittleman's presentation watch the following video. A full version of her presentation is available at our Resource Centre.