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Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial.

ABSTRACT: BACKGROUND:Caring for a family member with dementia is extremely stressful, contributes to psychiatric and physical illness among caregivers, and increases the risk for caregiver death. Finding better ways to support family caregivers is a major public health challenge. OBJECTIVE:To test the effects of a structured multicomponent intervention on quality of life and clinical depression in caregivers and on rates of institutional placement of care recipients in 3 diverse racial or ethnic groups. DESIGN:Randomized, controlled trial. SETTING:In-home caregivers in 5 U.S. cities. PARTICIPANTS:212 Hispanic or Latino, 219 white or Caucasian, and 211 black or African-American caregivers and their care recipients with Alzheimer disease or related disorders. INTERVENTION:Caregivers within each racial or ethnic group were randomly assigned to an intervention or to a control group. The intervention addressed caregiver depression, burden, self-care, and social support and care recipient problem behaviors through 12 in-home and telephone sessions over 6 months. Caregivers in the control group received 2 brief "check-in" telephone calls during the 6-month intervention. MEASUREMENTS:The primary outcome was a quality-of-life indicator comprising measures of 6-month caregiver depression, burden, self-care, and social support and care recipient problem behaviors. Secondary outcomes were caregiver clinical depression and institutional placement of the care recipient at 6 months. RESULTS:Hispanic or Latino and white or Caucasian caregivers in the intervention group experienced significantly greater improvement in quality of life than those in the control group (P < 0.001 and P = 0.037, respectively). Black or African-American spouse caregivers also improved significantly more (P = 0.003). Prevalence of clinical depression was lower among caregivers in the intervention group (12.6% vs. 22.7%; P = 0.001). There were no statistically significant differences in institutionalization at 6 months. LIMITATIONS:The study used only a single 6-month follow-up assessment, combined heterogeneous cultures and ethnicities into a single group, and excluded some ethnic groups. CONCLUSIONS:A structured multicomponent intervention adapted to individual risk profiles can increase the quality of life of ethnically diverse dementia caregivers. ClinicalTrials.gov identifier: NCT00177489.

SUBMITTER: Belle SH

PROVIDER: S-EPMC2585490 | biostudies-literature | 2006 Nov

REPOSITORIES: biostudies-literature

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Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial.

Belle Steven H SH Burgio Louis L Burns Robert R Coon David D Czaja Sara J SJ Gallagher-Thompson Dolores D Gitlin Laura N LN Klinger Julie J Koepke Kathy Mann KM Lee Chin Chin CC Martindale-Adams Jennifer J Nichols Linda L Schulz Richard R Stahl Sidney S Stevens Alan A Winter Laraine L Zhang Song S

Annals of internal medicine 20061101 10

<h4>Background</h4>Caring for a family member with dementia is extremely stressful, contributes to psychiatric and physical illness among caregivers, and increases the risk for caregiver death. Finding better ways to support family caregivers is a major public health challenge.<h4>Objective</h4>To test the effects of a structured multicomponent intervention on quality of life and clinical depression in caregivers and on rates of institutional placement of care recipients in 3 diverse racial or e ...[more]

PMID: 17116917

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Project description:Background/objectivesGiven the lack of effective pharmacologic strategies to prevent, slow, or reverse dementia progression, maximizing quality of life (QOL) is a major priority for persons living with dementia. Despite well-documented racial/ethnic disparities in dementia incidence and prevalence, it is unknown whether there are racial/ethnic disparities in QOL among persons with dementia. The objective of this study was to determine if there are racial/ethnic differences in poor health-related quality of life (HRQOL) among persons with and without dementia in a nationally-representative cohort.DesignRepeated measures cross-sectional analysis of a prospective cohort study.SettingUnited States nationally-representative National Health and Aging Trends Study (2011-2018).ParticipantsNon-nursing home-dwelling Black, Latino, and white adults age 65+ (n = 10,886).MeasurementsWe estimated racial/ethnic differences in five dichotomous indicators of poor HRQOL (depressive and anxiety symptoms, self-rated health, pain, and physical functional limitations), stratified by dementia status (probable, possible, none). We used generalized estimating equations to estimate prevalence ratios (PRs) and differences, and marginal standardization to estimate prevalence.ResultsGenerally, Blacks and Latinos reported higher prevalence of poor HRQOL compared with whites. The largest differences were observed for self-rated health, and Latino-white differences were slightly larger compared to Black-white differences. PRs were larger among those with no dementia. For example, the Black versus white PRs for poor self-rated health were 1.93 (95% confidence interval (CI) = 1.82-2.04) among the no dementia group and 1.21 (95% CI = 1.12-1.31) among the probable dementia group; Latino versus white PRs for these comparisons were 2.39 (2.21-2.59) and 1.48 (1.35-1.62), respectively. Prevalence differences also showed racial/ethnic differences, but these were similar across dementia statuses.ConclusionsWe observed racial/ethnic disparities in poor HRQOL, showing greater unmet clinical needs among Black and Latino versus white older adults. Relative disparities were smaller in those with dementia, but absolute magnitudes of disparities were similar by dementia status.

Project description:BackgroundCertain racial/ethnic minority groups have a higher risk of developing dementia, yet studies have demonstrated that they often have limited knowledge and understanding of this disease. An increasing number of educational and advocacy programs have been developed to promote dementia knowledge. We aimed at assessing current evidence and quality regarding educational interventions for promoting dementia knowledge.MethodsWe searched for intervention studies published in English that focused on educational interventions for promoting dementia knowledge among racial/ethnic minority groups. We identified 25 relevant studies through PubMed, PsycINFO, CINAHL, and Scopus, using tailored search terms. We screened titles and abstracts, reviewed full texts, synthesized relevant evidence, and evaluated the studies' quality based on the Mixed Methods Appraisal Tool. Relevant intervention studies took place in communities, hospitals or clinics, and schools, and online.ResultsMost studies were conducted in the United States (n = 21), followed by the UK (n = 3). Over half of the studies included Asian/Pacific Islander groups (n = 14), followed by Black groups (n = 12) and Hispanic groups (n = 11). The intervention delivery mode varied across studies-from workshops hosted in a faith community to talk shows on YouTube. Target populations included middle-aged and older adults, caregivers and family members, health students and professionals, and elementary school students. Common content included symptoms and signs of dementia, protective and risk factors, and local resources. The assessment of study outcomes varied across studies. Improvement in dementia knowledge and attitudes towards dementia was reported in many studies. Among the included studies, intervention satisfaction was high. The overall quality of the interventions was low.ConclusionFormally evaluated educational interventions promoting dementia knowledge are at an early stage. Existing published interventions showed adequate acceptability and promise in promoting better understanding and awareness of dementia in minority groups. More well-designed randomized controlled trials are needed.

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Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial.

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Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial.

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