The Caregiver Outcomes of Alzheimer's Disease Screening (COADS) Trial

项目概要/摘要： 在美国，超过200万患有阿尔茨海默病和相关痴呆症的成年人从未接受过治疗。 正式诊断。对于那些这样做的人，阿尔茨海默病的诊断往往发生在晚期; 2-5年后， 症状首先表现出来。超过70%的阿尔茨海默病患者生活在社区中， 得到家人的关心和支持，他们在心理、身体和经济上都有巨大的帮助。 由家庭照顾者承担的综合征负担。这种负担可能会因延迟诊断而加重 阿尔茨海默病或相关痴呆症的症状 在阿尔茨海默病的早期阶段，老年人的家庭成员可能会将认知， 功能和心理症状的综合征“正常”老化。此外，家庭成员不得 我注意到，随着他们承担越来越多的责任，他们的角色正在发生变化， 或对即将到来的看护者角色毫无准备。通过筛查早期发现阿尔茨海默病可能 促进家庭成员向家庭照顾者的过渡，并通过提供 家庭成员有机会了解综合征，接受干预措施，并为他们的健康做好准备。 新的护理角色。或者，通过筛查的早期发现可能会引发一个角色转换的过程， 从家庭成员到照顾者，这引起了情感和社会成本，鉴于缺乏治愈方法，这些成本太高。 老年人家庭成员阿尔茨海默病筛查的风险和益处尚不清楚。 我们建议将阿尔茨海默病筛查（COADS）试验的护理结果作为第一项研究， 研究阿尔茨海默病筛查对家庭成员的影响。我们还将检验 患者和家庭成员（二分）的结果作为筛选的结果，以及筛选后的影响 关于家庭成员成果的战略。这项大型随机对照试验将测量 （抑郁和焦虑）和益处（生活质量，照顾者准备和自我效能） 通过招募1,800对老年初级保健的筛查， 患者及其家属。

Project Summary/Abstract: More than 2 million adults with Alzheimer’s disease and related dementias in the United States never receive a formal diagnosis. For those who do, the diagnosis of Alzheimer’s disease often occurs late; 2-5 years after symptoms are first exhibited. With more than 70% of people with Alzheimer’s disease living in the community and receiving care and support from their family, there is a tremendous psychological, physical, and financial burden of the syndrome borne by family caregivers. This burden may be exacerbated by a delayed diagnosis of Alzheimer’s disease or related dementia. In the earliest stages of Alzheimer’s disease, family members of older adults may attribute the cognitive, functional and psychological symptoms of the syndrome to “normal” aging. Also, family members may not notice their changing role as they take on more and more caregiving responsibilities, leaving them vulnerable or unprepared for the upcoming caregiver role. Early detection of Alzheimer’s disease through screening may enhance the family member’s transition to a family caregiver and reduce caregiver burden by providing an opportunity for the family member to learn about the syndrome, receive interventions, and to prepare for their new caregiving role. Alternatively, early detection by screening might trigger a process of role transition for the family member to a caregiver that evokes emotional and social costs that are too high given the lack of a cure. The risks and benefits of Alzheimer’s disease screening on older adults family members are unknown. We are proposing the Caregiver Outcomes of Alzheimer’s Disease Screening (COADS) trial, as the first study to examine the impact of Alzheimer’s disease screening on family members. We will also test the congruence of patient and family member (dyad) outcomes as a result of screening, and the impact of post-screening strategies on family member outcomes. This large randomized controlled trial will measure the risks (depression and anxiety) and the benefits (quality of life, caregiver preparedness and caregiving self-efficacy) of early detection of Alzheimer’s disease from screening by enrolling 1,800 dyads of older primary care patients and their family members.