Subspecialty Programs

The Alzheimer's Disease and Memory Disorders Center

Family Intervention &Telephone Tracking (FITT): Research Studies for Caregivers

1.  FITT-D

Principal Investigator: Geoffrey Tremont, PhD

The primary goal of this study is to determine the efficacy of a telephone-based, psychosocial intervention to improve caregiver burden and depression in dementia caregivers. Secondary goals are to explore whether burden mediates the relationship between treatment and depression and to identify what caregiver characteristics/situational factors are predictors of the best response to treatment. Caring for a person with dementia is associated with increased feelings of burden, depression, poor quality of life, decline in health habits, and elevated risk for physical morbidity and mortality. Intensive psychosocial interventions are effective in reducing distress in dementia caregivers, although many interventions are difficult to implement on a wide scale, are financially costly, or involve extensive personnel. Multicomponent, individually-tailored interventions delivered 6 months or longer tend to have greater impact on overall caregiver well being than less comprehensive, fixed, briefer interventions. There also are poorly understood differential effects of caregiver interventions related to ethnic identity, gender, and relationship type. Our group has shown that including a family functioning component to caregiver interventions may address a unique source of caregiver burden. Overall, there is continued need for identifying efficacious, multi-component caregiver interventions that meet these criteria and are accessible to a range of caregivers.

This study will examine the efficacy of Family Intervention: Telephone Tracking-Dementia (FITT-D), a multi-component intervention that is entirely delivered by telephone. Treatment strategies are based on assessment of key areas (e.g., mood, family functioning, social support, health) and are tailored during each contact to ensure individualized application of interventions. The intervention, initially designed for stroke caregivers, was successfully modified for use with dementia caregivers by the PI and his research team as part of an R21 application (MH62561; G. Tremont, PI). During the project, a treatment manual was created, a training program for therapists was devised, and treatment adherence/competence measures were developed and tested for reliability. Cross-sectional findings from our group of caregivers show that aspects of executive functioning in the care recipient and family functioning are unique contributors to caregiver burden, beyond that accounted for by caregiver depression and patient factors. Data from a randomized, controlled pilot study of FITT-D show large effects for reducing caregiver burden and caregivers’ reactions to behavior problems, relatively uncommon findings in psychosocial caregiver interventions. Preliminary data from our pilot study also show that persisting high levels of burden (i.e., reported at two consecutive assessments) were associated with significantly higher levels of depression, suggesting that reducing perceptions of burden will minimize the future risk of depression in caregivers. The current project is designed to be an efficacy trial in which 274 dementia caregivers will be randomly assigned to receive either 6 months of FITT-D or Minimal Telephone Support (MTS). It is expected that results will support application of FITT-D in the community.  Contact Michael McQuiggan at 444-3673.

Funded by the National Institute on Nursing Research

2.  FITT-Nursing Home Study

Principal Investigator: Jennifer Davis, PhD

The purpose of this study is to 1) understand how family members adjust when placing a loved one in a long-term care facility, and 2) identify methods for helping caregivers of persons with Alzheimer's disease or other memory disorders during the transition to long-term care.

Funded by the National Institute on Aging