COGNITIVE STIMULATION TRAINING IN ALZHEIMERS FAMILIES

尽管照顾阿兹海默症患者有很大的负担

Although care of the Alzheimer patient places a substantial buren on families, day care frequently is not a financially feasible option. Previous research has indicated, however, that a home- based program, patterned on day care, has potential for impacting health of the Alzheimer family unit. Therefore, the purpose of this proposed study is to test over time the effect of a family- based intervention of active cognitive stimulation on the functional status of the patient, or the well-being of the caregiver, and on the caregiver-patient interactional status. Sex differences will also be examined. It is assumed that family units (caregiver and patient) will benefit most from active cognitive stimulation training as compared to passive or no stimulation. One hundred twenty-six family units with an Alzheimer spouse under 80 years of age in the mild to moderate stage of Alzheimer's disease will be recruited from the University of California Alzheimer's Disease Research Center and Seniors Only Care Center. Patients will be given neurological, neuropsychological, and medical screening, as well as assessed on cognitive, behavioral and affective measures. Caregivers will be assessed on physical and mental health, life satisfaction, and marital interaction, along with stress, coping, support, and respite time. A pretest-posttest control group design will be used to test the hypotheses of group differences on outcomes. Families will be stratified by sex of patient and randomly assigned to one of three groups: 1) intervention (active cognitive stimulation), 2) intervention (passive cognitive stimulation), or 3) wait-list control no stimulation). The intervention and placebo groups will meet for 12 consecutive weekly sessions. All three groups will be assessed initially, after the training period, and after six months. Multivariate analysis of variance procedures will be used to test the effect of the intervention over time on the outcomes for both groups, covarying for stress, coping, and supports in the caregiver groups. Findings have potential to enhance life quality in the Alzheimer family, and to be implemented by nursing in health care practice and education as a potentially cost-effective viable intervention.