Saturday, July 25, 2009

Close Emotional Ties to Caregiver Gives Alzheimers Patients Results On Par with Drugs

Johns Hopkins and Utah State University researchers recently published 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. In fact, the beneficial effect of what they call "emotional intimacy" between patient and caregiver was on par with some drugs used to treat the disease.

This report is published in the September 2009 Journals of Gerontology Series B: Psychological Sciences and Social Sciences and is 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. of the Johns Hopkins Memory and Alzheimer’s Treatment Center.

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

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.

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.

Interestingly, the “closeness effect” was heightened where 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.


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