The Coronavirus Pandemic, Caregiver Distress, And Neuropsychiatric Symptoms In Individuals With Alzheimer's Disease

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ABSTRACT/PROJECT SUMMARY FOR SUPPLEMENT Agitation is common in Alzheimer's disease (AD), and a major burden to patients and caregivers. Finding effective treatments is a priority. S-CitAD is a placebo-controlled, randomized trial investigating the efficacy of a 12-week treatment with escitalopram to reduce agitation in patients with Alzheimer's disease (AD) across 25 sites in the United States and Canada. Prior to treatment with escitalopram, caregivers are given a psychosocial intervention, and only those patients whose agitation is not improved are assigned to pharmacologic treatment. That patients' symptoms can respond to psychosocial intervention provided to caregivers underscores the influence of caregiver distress on neuropsychiatric symptoms, and agitation in particular, in patients with AD. Accordingly, characterizing the circumstances under which caregiver distress is most likely to affect agitation would provide valuable data to pursue in future studies of non-pharmacological interventions for agitation in AD. In this supplement, we propose to conduct a telephone interview with S-CitAD caregivers to examine the association between caregiver distress and neuropsychiatric symptoms in individuals with AD. Specifically, we propose to examine the role of “COVID-related factors” (i.e., personally infected, death of friend or family member, economic hardship), environmental factors (i.e. extent of quarantine by state/province, access to hospital beds, average household income), caregiver distress, and neuropsychiatric symptoms on S-CitAD participants. These measures will complement the measures already used in S-CitAD, and thereby enrich the findings of the S-CitAD trial within the scope of the parent study aims. Specifically, this supplement will allow for a penetrating examination of factors that bear relevance to the initial, non-pharmacological phase of S-CitAD treatment.