Effectiveness of an Internet intervention for family caregivers of people with dementia: results of a randomized controlled trial

Marco M Blom; Steven H Zarit; Rob B M Groot Zwaaftink; Pim Cuijpers; Anne Margriet Pot

doi:10.1371/journal.pone.0116622

Effectiveness of an Internet intervention for family caregivers of people with dementia: results of a randomized controlled trial

PLoS One. 2015 Feb 13;10(2):e0116622. doi: 10.1371/journal.pone.0116622. eCollection 2015.

Authors

Marco M Blom¹, Steven H Zarit², Rob B M Groot Zwaaftink¹, Pim Cuijpers³, Anne Margriet Pot⁴

Affiliations

¹ Dutch Alzheimer's Society, Department Scientific Research, Amersfoort, The Netherlands.
² The Pennsylvania State University, Department of Human Development and Family Studies, University Park, Pennsylvania, United States of America; Gerontology Institute, University College of Health Science, Jönköping, Sweden.
³ VU University, Department of Clinical Psychology, EMGO+, Amsterdam, The Netherlands.
⁴ VU University, Department of Clinical Psychology, EMGO+, Amsterdam, The Netherlands; Netherlands Institute of Mental Health and Addiction (Trimbos-institute), Program on Aging, Utrecht, The Netherlands; University of Queensland, School of Psychology, Brisbane, Australia.

Abstract

Background: The World Health Organization stresses the importance of accessible and (cost)effective caregiver support, given the expected increase in the number of people with dementia and the detrimental impact on the mental health of family caregivers.

Methods: This study assessed the effectiveness of the Internet intervention 'Mastery over Dementia'. In a RCT, 251 caregivers, of whom six were lost at baseline, were randomly assigned to two groups. Caregivers in the experimental group (N = 149) were compared to caregivers who received a minimal intervention consisting of e-bulletins (N = 96). Outcomes were symptoms of depression (Center for Epidemiologic Studies Depression Scale: CES-D) and anxiety (Hospital Anxiety and Depression Scale: HADS-A). All data were collected via the Internet, and an intention-to-treat analysis was carried out.

Results: Almost all caregivers were spouses or children (in-law). They were predominantly female and lived with the care recipient in the same household. Age of the caregivers varied from 26 to 87 years. Level of education varied from primary school to university, with almost half of them holding a bachelor's degree or higher. Regression analyses showed that caregivers in the experimental group showed significantly lower symptoms of depression (p = .034) and anxiety (p = .007) post intervention after adjustment for baseline differences in the primary outcome scores and the functional status of the patients with dementia. Effect sizes were moderate for symptoms of anxiety (.48) and small for depressive symptoms (.26).

Conclusions: The Internet course 'Mastery over Dementia' offers an effective treatment for family caregivers of people with dementia reducing symptoms of depression and anxiety. The results of this study justify further development of Internet interventions for family caregivers of people with dementia and suggest that such interventions are promising for keeping support for family caregivers accessible and affordable. The findings are even more promising because future generations of family caregivers will be more familiar with the Internet.

Trial registration: Dutch Trial Register NTR-2051 www.trialregister.nl/trialreg/admin/rctview.asp?TC=2051.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Anxiety / prevention & control
Caregivers / education*
Caregivers / psychology*
Dementia*
Depression / prevention & control
Family / psychology*
Female
Humans
Internet*
Male
Middle Aged

Associated data

NTR/NTR-2051

Grants and funding

This study was funded by Alzheimer Nederland (Dutch Alzheimer’s Society), Geriant and the VU University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.