> A second group of spouses was assigned to receive the usual support services for families of AD patients at the Center. Unlike those in the enhanced treatment group, these spouses did not receive formal counseling and their family members did not have contact with the counselors. Beyond receiving information about resources, the caregivers in the "usual" care group could, if they chose, participate in support groups and use the crisis counseling. Both groups of spouse-caregivers were followed regularly until 2 years after the death of their husband or wife, or until participation in the study ended.

Symptoms of depression were compared over time between the two groups. When they began the study, the two groups showed comparable levels of depressive symptoms. But after 1 year, 29.8 percent of caregivers in the enhanced treatment group had symptoms of clinical depression compared with 45.1 percent of those in the usual care (control) group. Significant differences in the mean number of symptoms were found through the third year of follow-up. The difference between the two groups gradually diminished over a 5-year follow-up period.

"The sustainability of these effects shows that an individualized program of counseling and continuing support is a potent intervention," Dr. Mittelman says in her paper. "While support and information are essential, if used in isolation they are insufficient for caregivers and their families."

AD is an irreversible disorder of the brain, robbing those who have it of memory, and eventually, overall mental and physical function, leading to death. It is the most common cause of dementia among people over age 65, affecting an estimated 4.5 million Americans.

"While we work to untangle the complex biology of this disease, this important finding may provide a foundation for developing comprehensive support for families and caregivers to help them through these stressful times," says Creighton Phelps, Ph.D.
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Contact: Doug Dollemore
dollemod@nia.nih.gov
301-496-1752
NIH/National Institute on Aging
1-May-2003

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