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

项目摘要/摘要： 在美国，200多万患有阿尔茨海默病和相关痴呆的成年人从未收到过 正式诊断。对于那些这样做的人来说，阿尔茨海默病的诊断通常发生得很晚；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 并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压力 家庭照料者承担的综合症负担。延误诊断可能会加重这种负担。 阿尔茨海默氏症或相关痴呆症。 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能力、 将该综合征的功能和心理症状转变为“正常”衰老。此外，家庭成员可能不能 注意他们的角色变化，因为他们承担了越来越多的照看责任，这让他们变得脆弱 或者对即将到来的看护人角色毫无准备。通过筛查及早发现阿尔茨海默病可能 加强家庭成员向家庭照顾者的转变，并通过提供 让家庭成员有机会了解综合症，接受干预，并为他们的 新的看护角色。或者，通过筛查及早发现可能会触发角色转换的过程 家庭成员对照顾者造成的情感和社会成本太高，因为缺乏治愈方法。 对老年人家庭成员进行阿尔茨海默病筛查的风险和好处尚不清楚。 我们提出了阿尔茨海默病筛查(COADS)试验的照顾者结果，作为第一项研究 检查阿尔茨海默病筛查对家庭成员的影响。我们还将测试一致性 筛查结果的患者和家庭成员(DYAD)结果，以及筛查后的影响 关于家庭成员结果的战略。这项大型随机对照试验将测量风险 (抑郁和焦虑)和益处(生活质量、照顾者准备和照看自我效能) 通过招募1,800名老年初级保健人员进行筛查，早期发现阿尔茨海默病 病人和他们的家属。

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.