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. 2008 Oct 1;8(4):1–98.

Table 15: Summary of Belle et al. 2006 (40)*.

Study / Year Population Description of Intervention Outcome/
Follow-Up		 Results Comment
Belle et

al.
2006		 N=642

Hispanic (n=212) White (n=219) Black (n=211)

Alzheimer’s disease or related disorders

5 US cities		 Intervention: Strategies: provision of information, role playing, problem solving, telephone support, etc.

5 target areas: depression, burden, self-care and healthy behaviours, social support, problem behaviours

Delivered by interventionist with at least a BA

12 sessions (9 in-home [1.5 hrs. each] and 3 telephone sessions [30 min. each]), and 5 structured telephone support group sessions over 6 months

Control: mailed basic info, 2 brief telephone calls at 3 and 5 months		 Primary outcomes:

  • CG

  • Depression

  • Burden

  • Self-care

  • Social support

  • Problem behaviours

    Secondary outcomes:

  • Institutional placement of CR

  • Prevalence of CG clinical depression

 Hispanic CGs:

  • Net improvement across all 5 domains was greater in the intervention group than in the control group(45.1% vs. 6.9%; difference 38.2% [CI,11.2%–64.4%].

  • Clinically significant changes depression scores report of problem behaviours.

White CGs:

  • Clinical meaningful differences favoured the INT for social support.

Black CGs:

  • No overall statistically significant effects.

  • Exploratory analysis –

  • clinically meaningful differences that favoured the intervention for black spouses when all domains were combined.



Secondary outcomes: Prevalence of clinical depression was significantly greater among CGs in the control group than those in INT group (22.7% vs. 12.6%; P = .001); difference remained significant after adjustment for race & ethnicity.

Number of CRs institutionalized did not differ statistically significantly between groups (7.2% control vs. 4.3% intervention). - no significant differences between groups in any racial or ethnic group.		 Loss to follow-up: 60% completed all 12 sessions; 5% did not complete any session.

Long-term efficacy unknown.

Assessing effects of the intervention on institutional placement typically requires 1-yr follow-up or longer.

Larger effects seen in Hispanic CGs – probably due to the availability of intervention in Spanish versus otherwise limited access to community resources that are culturally appropriate.
*

BA indicates Bachelor of Arts; CG, caregiver; CI, confidence interval; CR, care recipient; INT, intervention.