Design: The study used a randomized trial, pre-test/multiple post-test design.

Population, Sample, Setting, Years: Participants were community-based family caregivers of persons with Alzheimer’s disease. Ninety-nine caregivers were followed at baseline, 6, 12 and 18 months.

Intervention and Outcome Variables: Two interventions were compared: a Caregiver Skill Building and an Information and Support Only intervention. Outcome variables were caregiver depressive symptoms and salivary cortisol (SC).

Methods: Psychological data were collected during home-based and telephone interviews. Caregivers collected four saliva samples on two consecutive days (Early morning, Noon, 6 and 9 PM). Generalized linear models were used to examine changes in caregiver depressive symptoms over 18 months. Descriptive, correlational, regression and random effects procedures were used to examine SC.

Findings: Caregiver depressive symptoms significantly improved over 18-months but did not differ by intervention. Baseline SC was significantly related to stress at time of saliva collection (r=. 20 to .34). To analyze SC, sequential models were run adjusting for key variables. There were no significant differences in the average SC slope estimate over the course of a day and over time. A second set of models found that average SC significantly increased over time (estimated rate of change over 18 months: 0.123: p=0.02).

Conclusions: Both interventions were equally effective in decreasing depressive symptoms, it is feasible for community-based CGs to collect saliva samples, and additional methodological considerations need to be made when combining psychological and physiologic measures.

Implications: Future randomized trials need to consider larger samples that use physiologic markers of stress and stronger interventions that address both care receiver and caregiver needs.

Back to Caregiving of the Elderly
Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004