Close caregiver relationship may slow Alzheimer's decline

July 22, 2009

A study led by Johns Hopkins and Utah State University researchers suggests that a particularly close relationship with caregivers may give people with Alzheimer's disease a marked edge over those without one in retaining mind and brain function over time. The beneficial effect of emotional intimacy that the researchers saw among participants was on par with some drugs used to treat the disease.

A report on the study, believed to be the first to show that the patient-caregiver relationship may directly influence progression of Alzheimer's disease, is published in the September 2009 The Journals of Gerontology Series B: Psychological Sciences and Social Sciences and currently available online.

"We've shown that the benefits of having a close caregiver, especially a spouse, may mean the difference between someone with AD staying at home or going to a nursing facility," says Constantine Lyketsos, M.D., M.H.S., the Elizabeth Plank Althouse Professor in Alzheimer's Disease Research and director of the Johns Hopkins Memory and Alzheimer's Treatment Center.

Lyketsos cautions that it remains unclear how or why this benefit was evident in the study, since the results may be due to milder forms of Alzheimer's disease among those who reported close relationships. "A close relationship might prompt caregivers to deliver more attentive treatment, but it might be the other way around, with a milder illness helping caregivers stay close," Lyketsos says. "Our next study is designed to detangle what's going on."

Researchers have long been interested in the relationships between caregivers and Alzheimer's disease , with many studies focusing on the well-being of caregivers. However, little was known about the converse relationship—how caregivers affect the well-being of people with .

To find out, Lyketsos and colleagues at Johns Hopkins, Utah State, University of Washington, Duke University and Boston University examined 167 pairs of caregivers and Alzheimer's patients. The pairs were recruited from the Cache County (Utah) Dementia Progression Study, which has tracked hundreds of people with Alzheimer's and other types of dementia since 1994. All of the study participants live in Cache County, whose residents topped the longevity scale in the 1990 United States census.

Starting in 2002, the researchers met with patient-caregiver pairs in their homes every six months for periods up to four years. At each meeting, the patients underwent a battery of tests to assess physical, cognitive, functional and behavioral health. The researchers also interviewed the caregivers — spouses, adult children or adult children-in-law — about the caregiving environment and gave them a survey to assess how close their relationships were with the patients. The survey asked caregivers to rate their level of agreement or disagreement with six statements, such as "My relationship with the care recipient is close"; "The care recipient makes me feel like a special person"; and "The care recipient and I can always discuss things together."

At the outset of the study, all patients scored similarly on cognitive and functional tests. However, as time progressed, the researchers found marked differences between patients whose caregivers had scored their relationships as close or more distant on the surveys. Patients with whose caregivers felt particularly close to them retained more of their cognitive function over the course of the study, losing less than half as many points on average by the end of the study on a common cognitive test called the Mini-Mental State Exam (MMSE), compared to patients with more distant caregivers. Patients with close caregivers also scored better on a functional test called the Clinical Dementia Rating, remaining significantly closer to baseline over time compared to those with more distant caregivers.

The "closeness effect" was heightened for pairs in which the caregiver was a spouse, as opposed to an adult child or in-law. Patients with close spouses declined the slowest overall, with scores on the MMSE showing changes over time similar to patients participating in recent clinical trials for FDA-approved Alzheimer's drugs called acetylcholinesterase inhibitors.

"We've shown that the benefits of having a close caregiver, especially a spouse, may be substantial. The difference in cognitive and functional decline over time between close and not-as-close pairs can mean the difference between staying at home or going to a nursing facility," says Lyketsos.

Source: Johns Hopkins Medical Institutions

Related Stories

Recommended for you

After searching 12 years for bipolar disorder's cause, team concludes it has many

December 15, 2017
Nearly 6 million Americans have bipolar disorder, and most have probably wondered why. After more than a decade of studying over 1,100 of them in-depth, a University of Michigan team has an answer - or rather, seven answers.

Suicidal thoughts rapidly reduced with ketamine, finds study

December 14, 2017
Ketamine was significantly more effective than a commonly used sedative in reducing suicidal thoughts in depressed patients, according to researchers at Columbia University Medical Center (CUMC). They also found that ketamine's ...

Do bullies have more sex?

December 14, 2017
Adolescents who are willing to exploit others for personal gain are more likely to bully and have sex than those who score higher on a measure of honesty and humility. This is according to a study in Springer's journal Evolutionary ...

Children's screen-time guidelines too restrictive, according to new research

December 14, 2017
Digital screen use is a staple of contemporary life for adults and children, whether they are browsing on laptops and smartphones, or watching TV. Paediatricians and scientists have long expressed concerns about the impact ...

Eating together as a family helps children feel better, physically and mentally

December 14, 2017
Children who routinely eat their meals together with their family are more likely to experience long-term physical and mental health benefits, a new Canadian study shows.

The iceberg model of self-harm

December 14, 2017
Researchers have created a model of self-harm that shows high levels of the problem in the community, especially in young girls, and the need for school-based prevention measures.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.