Efficacy of Early Stage Alzheimer's Support Groups

描述(由申请人提供)：随着诊断程序和治疗选择的最新进展，许多AD患者现在在疾病的早期被诊断出来。早期诊断有许多好处：可以更早地开始治疗，可以在个人能够参与决策的同时处理法律和财务规划，并且可以更早地动员支持服务。然而，早期诊断也可能对被诊断的个人的生活质量产生负面影响。因此，诊断产生了帮助个人及其家人更多地了解AD并应对诊断的影响的义务。许多阿尔茨海默氏症协会的分会已经开始提供早期支持小组，专注于提高参与者及其照顾者的生活质量。坊间报道表明，这些小组提高了参与者的生活质量，但一些人也可能因为讨论小组目前和未来的损失而经历与压力、抑郁或家庭冲突相关的生活质量下降。因此，有必要系统地评估这些群体的利益。这项建议是一项随机对照试验，旨在评估结构化的、9个疗程的早期支持小组干预(ES)对早期AD患者及其家庭照顾者的疗效。这是华盛顿大学和阿尔茨海默氏症协会华盛顿西部和中部分会共同努力的结果。总共将招募150名参与者-照顾者二人组，并随机分配到ES或一节课的教育控制条件(ED)。对治疗情况视而不见的有经验的面试者将在基线、3个月和6个月对参与者进行评估。主要结果(对于早期阿尔茨海默病患者和家庭照顾者)侧重于生活质量。次要结果侧重于已被证明与生活质量相关的因素，包括抑郁、参与愉快的活动和家庭关系。最后，由于早期支持小组的目标是使参与者能够参与有关未来需求规划的决策，将使用探索性措施来评估参与者增强自我效能感的程度，并参与有关法律、财务和医疗规划的决策。

DESCRIPTION (provided by applicant): With recent advances in diagnostic procedures and treatment options, many individuals with AD are now diagnosed early in the disease. Early diagnosis has many benefits: treatment can be started sooner, legal and financial planning can be addressed while the individual is able to participate in decision-making, and support services can be mobilized earlier. However, early diagnosis may also have negative consequences for the diagnosed individual's quality of life. Thus, diagnosis creates an obligation to help individuals and their families learn more about AD and cope with the impact of the diagnosis. Many Alzheimer's Association chapters have begun providing early stage support groups that focus on enhancing quality of life for participants and their caregivers. Anecdotal reports suggest that these groups improve quality of life of participants, but some individuals may also experience decreases in quality of life associated with stress, depression, or family conflict as a result of discussing current and future losses in the group. Thus, there is a need to systematically evaluate the benefits of these groups. This proposal is a randomized controlled trial to evaluate the efficacy of a structured, 9-session Early Stage Support Group intervention (ES) for individuals with early stage AD and their family caregivers. It is a collaborative effort between the University of Washington and the Alzheimer's Association Western and Central Washington Chapter. A total of 150 participant-caregiver dyads will be recruited and randomly assigned to ES or a one-session education control condition (ED). Experienced interviewers who are blind to treatment condition will assess participants at baseline, 3 months, and 6 months. Primary outcomes (for both the person with early stage AD and the family caregiver) focus on quality of life. Secondary outcomes focus on factors that have been demonstrated to be associated with quality of life, including depression, participation in pleasant activities, and family relationships. Finally, since a goal of Early Stage Support Groups is to empower participants to engage in decision-making regarding planning for future needs, exploratory measures will be used to evaluate the extent to which participants experience enhanced self-efficacy and engage in decision making regarding legal, financial, and medical planning.