A mindfulness-based multicomponent caregiver intervention (PAACC): objectives, study design, and cohort description

IF 4.9 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2025-03-24 DOI:10.1002/trc2.70064

Mamta Sapra, Lauren Hagemann, Katherine Luci, Jyoti Savla

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引用次数: 0

Abstract

INTRODUCTION

Effective interventions are needed to reduce caregiver burden and stress, particularly among family caregivers of veterans with dementia. Unique risk factors such as traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) further complicate caregiving. This study compares a four-session mindfulness-based multicomponent intervention (PAACC) with a cognitive behavioral intervention (REACH), both designed to alleviate caregiver burden, and provides a baseline evaluation of caregivers in the intervention. A two-arm, blinded, randomized controlled trial assigned 133 dementia caregivers to PAACC (n = 67) or REACH (n = 66). Baseline assessments included caregiver stress, burden, mindfulness receptivity, rumination, compassion, depressive symptoms, anxiety, and care recipient behavior. Participants averaged 67.17 years, 85% were women, and 70% were spousal caregivers. Caregivers in PAACC reported higher depressive symptoms and anxiety and lower mindfulness receptivity. This study introduces the first mindfulness-based intervention for veteran caregivers, designed to enhance cognitive flexibility, cultivate compassion, and provide practical skills to improve quality of life.

METHODS

The study utilized a two-arm, blinded, prospective randomized controlled trial to compare the PAACC and REACH interventions. A total of 133 dementia caregivers experiencing moderate to severe caregiver burden were assigned to receive either the PAACC intervention (n = 67) or the REACH intervention (n = 66). Baseline evaluations included caregiver stress, burden, mindfulness receptivity, rumination, compassion, depressive symptoms, anxiety, and the memory and behavior problems of the veteran living with dementia, using widely accepted measures from caregiving literature.

RESULTS

Baseline assessments were conducted on 133 family caregivers of veterans living with dementia. The average caregiver age was 67.17 years (SD = 9.8), 85% were women, and 70% were spousal caregivers. No significant demographic differences were found between the two intervention groups. However, baseline comparisons showed that caregivers in the PAACC intervention reported higher depressive symptoms and anxiety, and lower mindfulness receptivity. A detailed protocol for the mindfulness-based multicomponent caregiver intervention PAACC is described.

DISCUSSION

There is a growing need for multicomponent, skill-building interventions tailored for dementia caregivers who are at high risk of stress. This study introduces the first mindfulness-based intervention specifically for caregivers of veterans, designed to enhance cognitive flexibility, cultivate compassion, and equip caregivers with practical skills to improve their quality of life.

Highlights

PAACC is a mindfulness-based multicomponent intervention for dementia caregivers of veterans.
No demographic differences suggest psychological differences are not due to demographics.
Baseline mental health and mindfulness readiness may impact intervention effectiveness.

Abstract Image

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基于正念的多成分照顾者干预（PAACC）：目标、研究设计和队列描述

需要有效的干预措施来减轻照顾者的负担和压力，特别是在患有痴呆症的退伍军人的家庭照顾者中。独特的风险因素，如创伤性脑损伤（TBI）和创伤后应激障碍（PTSD）进一步复杂化护理。本研究比较了四阶段基于正念的多组分干预（PAACC）和认知行为干预（REACH），两者都旨在减轻照顾者的负担，并提供了干预中照顾者的基线评估。一项双臂、盲法、随机对照试验将133名痴呆症护理人员分配到PAACC （n = 67）或REACH （n = 66）组。基线评估包括照顾者压力、负担、正念接受性、反刍、同情、抑郁症状、焦虑和照顾者行为。参与者平均67.17岁，85%为女性，70%为配偶照顾者。PAACC的护理人员报告了更高的抑郁症状和焦虑，以及更低的正念接受性。本研究首次引入以正念为基础的护理干预，旨在增强认知灵活性，培养同情心，并提供实用技能以改善生活质量。方法采用双臂、盲法、前瞻性随机对照试验比较PAACC和REACH干预措施。共有133名患有中度至重度照顾者负担的痴呆症照顾者被分配接受PAACC干预（n = 67）或REACH干预（n = 66）。基线评估包括照顾者的压力、负担、正念接受性、反刍、同情、抑郁症状、焦虑、记忆和行为问题，采用了护理文献中广泛接受的测量方法。结果对133名痴呆退伍军人家属进行了基线评估。照顾者平均年龄67.17岁（SD = 9.8）， 85%为女性，70%为配偶照顾者。在两个干预组之间没有发现显著的人口统计学差异。然而，基线比较显示，PAACC干预组的护理人员报告了更高的抑郁症状和焦虑，以及更低的正念接受性。详细的协议为正念为基础的多组分护理干预PAACC描述。越来越多的人需要为面临高压力风险的痴呆症护理人员量身定制的多成分、技能建设干预措施。本研究首次针对退伍军人照护者引入正念干预，旨在增强认知灵活性，培养同情心，并为照护者提供实用技能，以改善他们的生活质量。PAACC是一种基于正念的多成分干预，用于退伍军人的痴呆症护理人员。没有人口统计学差异表明心理差异不是由人口统计学造成的。基线心理健康和正念准备可能影响干预的有效性。

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来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.