Impact of an Individualized Physical Activity Intervention on Improving Mental Health Outcomes in Family Caregivers of Persons with Dementia: A Randomized Controlled Trial

Abstract

Purpose This study examined secondary benefits of an individualized physical activity intervention on improving dementia family caregivers’ subjective burden, depressive symptoms and positive affect. Design and Methods A community-based randomized controlled trial (RCT) was implemented with family caregivers of persons with dementia (N = 211) who received the Enhanced Physical Activity Intervention (EPAI: treatment intervention, n = 106) or the Caregiver Skill Building Intervention (CSBI: control intervention, n = 105). Interventions were delivered over 12 months, including a baseline home visit and regularly spaced telephone calls. Data were collected in person at baseline, 6 and 12-months; and telephonically at 3 and 9-months. The EPAI integrated physical activity and caregiving content while the CSBI focused only on caregiving content. Descriptive, bivariate and intention-to-treat analyses using generalized estimating equations (GEE) were performed to examine secondary benefits of the EPAI on family caregiver burden, depressive symptoms and positive affect. Results Compared to caregivers in the CSBI group, caregivers in the EPAI significantly increased their overall and total moderate physical activity and showed a positive interaction between the intervention and time for positive affect at both six (p = 0.01) and 12-months (p = 0.03). The EPAI was significantly associated with improving burden at 3 months (p = 0.03) but had no significant effect on depressive symptoms. Implications Caregiver involvement in an individualized physical activity intervention was associated with increased overall and total moderate physical activity and improved positive affect from baseline to 12 months. Improved positive affect may help caregivers to feel better about themselves and their situation, and better enable them to continue providing care for their family member for a longer time at lower risk to their own mental health.

Psychological Symptomatology in Informal Caregivers of Persons with Dementia: Influences on Health-Related Quality of Life

“…In this regard, the most widely investigated and documented symptoms in this population are anxiety, depression and burden [8,[12][13][14][15]. Nevertheless, other research has reported that caregivers also suffer high levels of stress, emotional strain [13,16,17], social isolation [12] and sleep problems [18,19]. They have also reported irritability, hallucinations, delusions, restlessness, disinhibition, appetite alterations, hostility, somatization and abusive behaviour from the patients [20,21].…”

Cost-Effectiveness and Effects of a Home-Based Exercise Intervention for Female Caregivers of Relatives with Dementia: Study Protocol for a Randomized Controlled Trial

“…In this regard, the adverse effects on physical health and quality of life are diverse [16][17][18][19][20]. Informal caregivers show higher rates of hypertension and other cardiovascular-related disorders [21,22], as well as lower aerobic endurance [23] than non-caregivers. Informal caregivers have reported having severe back pain due to alterations in the trunk muscle extensor strength [8,20], and other osteomuscular disorders [4].…”

“…Informal caregivers have reported having severe back pain due to alterations in the trunk muscle extensor strength [8,20], and other osteomuscular disorders [4]. At the psychological level, it has been found that informal caregivers experience high levels of subjective burden, distress, and a wide variety of psychological disorders [5,13,21,[24][25][26][27][28][29], as well as sleep problems [30][31][32]. In addition, as part of their role, caregivers also suffer other symptoms such as hostility, aggression, somatization, irritability, hallucinations, delusions, restlessness, and disinhibition [2,[33][34][35].…”

“…Previous research has also shown that exercise-based therapies are effective and feasible methods of improving health-related quality of life (physical and psychological) in patients [47] and caregivers [48][49][50][51][52][53]. These interventions have usually resulted in an increase of participants' physical activity level [21,23,52]; have positive effects on their physical fitness [48]; and alleviate fatigue and subjective burden [43,50,52,54]. Other studies have found that exercise-based programs improve caregivers' psychological health.…”

Racial Differences in Program Evaluation of a Lifestyle Physical Activity Randomized Controlled Trial

“…Caregivers were randomly assigned to either the Enhanced Physical Activity Intervention (EPAI) treatment intervention, which combined physical activity and caregiver skill-building content; or to the Caregiver Skill Building Intervention (CSBI), the control, which focused on caregiver skill building content alone (N=211; Farran, Paun, et al, 2016). This was a manualized intervention where the intervention group (EPAI) received individual physical activity coaching and caregiver support, and the control (CSBI) received only individual caregiver support.…”