MedPath

Effect of Cognitive Empathy Training on Dementia Caregivers

Not Applicable
Recruiting
Conditions
Caregivers of People Living With Dementia
Dementia
Registration Number
NCT06650527
Lead Sponsor
Emory University
Brief Summary

The goal of this project is to investigate the effect of cognitive empathy training on mental health, inflammation, and immune function in caregivers of people living with dementia (PLWD), and to examine the underlying psychological and neurobiological mechanisms.

The primary aim is to establish the effectiveness of cognitive empathy training in improving caregiver mental health and immune function, and in decreasing caregiver inflammation

The secondary aim is to investigate the psychological and neurobiological mechanism by which cognitive empathy training improves caregiver well-being

Detailed Description

In the U.S., over 7 million people currently live with Alzheimer's disease and related disorders (ADRD), a number projected to exceed 16 million by 2060. Family caregivers, numbering more than 11 million, play a crucial role in managing the care of these individuals, often bearing significant emotional and financial burdens. In 2021, the cost of care for dementia reached $593 billion, with families contributing a substantial portion. Caregivers frequently experience negative mental and physical health impacts due to chronic stress, including increased rates of depression and inflammation. Research indicates that caregiving leads to decreased immune function, with elevated Epstein-Barr virus antibody titers serving as a marker for immune health. Interventions aimed at supporting caregivers, such as psychoeducational programs, have shown benefits, particularly in enhancing coping skills. Additionally, fostering cognitive empathy in caregivers may improve their mental health and the quality of care provided to individuals with dementia, potentially mitigating some of the adverse health effects associated with caregiving stress.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
118
Inclusion Criteria
  • Caregivers must live with their care recipient
  • Caregivers must have a Zarit Burden Scale score of 19 or higher
  • Caregivers must have no plans to move their care recipient to an institutional setting within the next year
  • Caregivers must be able to read and write English
  • Care recipient not in hospice
  • Access to a mobile phone that can take and email photographs
Exclusion Criteria
  • Subjects with a history of seizures or other neurological disorders, alcoholism, or any other substance abuse
  • Subjects with a history of psychiatric illness (excluding depression and anxiety disorders) will also be excluded
  • Subjects with a history of head trauma based on Survey
  • Subjects with MRI contra-indications

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Primary Outcome Measures
NameTimeMethod
fMRI activation within ventrolateral prefrontal cortex for contrast (own person - unknown person)Baseline, immediately post-training (10-Day), 6 months post-training

Measure of activation within an emotion regulation ROI

Zarit Burden Scale scoreBaseline, immediately post-training (10-Day) , 6 months post-training

Zarit Burden Inventory (ZBI) score is a 22-item Likert scale. Each item is a statement which the caregiver is asked to endorse using a 5-point scale. Response options range from 0 (Never) to 4 (Nearly Always). Total score is obtained by summing all items endorsed. Higher scores indicate greater perceived burden.

The Center for Epidemiological Studies Depression (CESD) Scale scoreBaseline, immediately post-training (10-Day), 6 months post-training

The CESD-R is a 20 item Likert scale scored 0-3 with somatic and psychological subscales. Total scores range from 0 to 60, with high scores indicating greater depressive symptoms.

The State/Trait Anxiety Index (STAI) scoreBaseline, immediately post-training (10-Day), 6 months post-training

The STAI State (STAI-S) is a 20-item 4-point Likert scale commonly used measure of state anxiety. Respondents report the intensity of their anxiety at that moment on a 4-point scale where 1 = not at all and 4 = very much so. Total scores range from 20 to 80 and higher scores indicate greater anxiety.

Perspective-taking subscale if the Interpersonal Reactivity Index (IRI)Baseline, immediately post-training (10-Day), 6 months post-training

The Perspective-Taking scale of the IRI ranges from 0-28, and higher scores are a better outcome

Dyadic Relationship Scale scoreBaseline, immediately post-training (10-Day), 6 months post-training

The Dyadic Relationship Scale ranges from 0-33 and higher scores are a worse outcome.

IL-6 levelsBaseline, immediately post-training (10-Day), 6 months post-training

Cytokine (Measure of inflammation)

IL-10 levelsBaseline, immediately post-training (10-Day), 6 months post-training

Cytokine (Measure of inflammation)

TNF-α levelsBaseline, immediately post-training (10-Day), 6 months post-training

Cytokine (Measure of inflammation)

Epstein-Barr virus antibody titersBaseline, immediately post-training (10-Day), 6 months post-training

Measure of immune system functioning

fMRI activation within dorsomedial prefrontal cortex (DMPFC) for contrast (own person - unknown person)Baseline, immediately post-training (10-Day), 6 months post-training

Measure of activation within one cognitive empathy ROI

fMRI activation within precuneus for contrast (own person - unknown person)Baseline, immediately post-training (10-Day), 6 months post-training

Measure of activation within one cognitive empathy ROI

fMRI activation within temporo-parietal junction for contrast (own person - unknown person)Baseline, immediately post-training (10-Day), 6 months post-training

Measure of activation within one cognitive empathy (region of interest) ROI

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (3)

Alter

🇺🇸

Atlanta, Georgia, United States

Emory Integrated Memory Care

🇺🇸

Atlanta, Georgia, United States

NIA Goizueta Alzheimer's Disease Research Center

🇺🇸

Atlanta, Georgia, United States

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