Prevention of Depression in Spouses of People With Cognitive Impairment

People with a diagnosis of mild cognitive impairment (MCI) have an estimated 12% probability
each year of progressing to a dementing disorder. Pilot data suggest that the spouses of
people with MCI begin to adopt the caregiver role and its burdens as they cope with this
condition. Although levels of caregiver burden and psychiatric illness are lower than those
typically observed in family dementia caregiving samples, our findings suggest that MCI
spousal caregivers have already begun to experience distress associated with elevated
caregiver burden. In order to protect the mental health and well-being of caregivers as they
cope with their spouses' current and future health care needs, it may be ideal to implement
selective preventive strategies while they are in the very earliest stages of caregiving.
This study evaluates the effectiveness of a problem-solving training program in preventing
depression in the spouses or significant others of people with MCI.

Participants in this open-label study are randomly assigned to receive either a
self-management intervention targeted at problem-solving training or an attention-matched
intervention targeted at nutritional education. The self-management intervention trains
participants to effectively use problem-solving skills with the aim of strengthening their
ability to cope with burdens of caregiving and preventing the onset or worsening of
depression. The nutritional education program is based on the new United States Department of
Health and Human Services 2005 dietary recommendations. All participants attend weekly
individual training sessions, either in their home or another convenient location for a total
of 6 weeks. At the end of 6 weeks, participants receive a weekly phone call for an additional
3 weeks to support the training they received. Follow-up data is collected at Months 1, 3, 6,
and 12 post-intervention. If a participant's spouse is diagnosed with dementia during the
study, additional follow-up data is collected after the Month 12 visit.

Inclusion Criteria:

- Spouse or non-married partner of a patient being treated at the University of
Pittsburgh Alzheimer's Disease Research Center (ADRC) for a new or subsequent
diagnosis of MCI

Exclusion Criteria:

- Does not speak English

- Cohabitating adult child of a person with MCI

- Resides in an institutional or assisted-living setting