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方案的最新进展，许多AD患者现在在疾病早期被诊断出来。早期诊断有许多好处：可以更早开始治疗，可以在个人能够参与决策的同时进行法律的和财务规划，可以更早地调动支助服务。然而，早期诊断也可能对被诊断个体的生活质量产生负面影响。因此，诊断产生了一种义务，帮助个人及其家庭更多地了解AD并科普诊断的影响。许多阿尔茨海默氏症协会分会已经开始提供早期支持小组，重点是提高参与者及其照顾者的生活质量。轶事报告表明，这些团体提高了参与者的生活质量，但有些人也可能会因为讨论团体中当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。本提案是一项随机对照试验，旨在评估结构化的9期早期支持小组干预（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西部和中部华盛顿分会之间的合作努力。将招募总共150名参与者-照顾者二人组，并随机分配至ES或一次教育控制条件（艾德）。对治疗状况不知情的经验丰富的访谈者将在基线、3个月和6个月时评估参与者。主要结果（对于早期AD患者和家庭照顾者）侧重于生活质量。次要结果关注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规划未来需求的决策，因此将使用探索性措施来评估参与者自我效能增强的程度，并参与有关法律的、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.