Institute for Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Social and Preventive Medicine, University of Potsdam, Potsdam, Germany.
J Alzheimers Dis. 2019;68(2):745-755. doi: 10.3233/JAD-180812.
Psychosocial interventions may improve the quality of life of both people with dementia (PWD) and their family caregivers. However, research is inconclusive and focused primarily on the quality of life of either the PWD or the caregiver, rather than on both.
Our aim was to evaluate the effect of couple-based interdisciplinary psychosocial intervention in patients with mild-to-moderate dementia on quality of life of both partners.
108 community-dwelling PWD and their caregiving partners were enrolled in this pragmatic randomized controlled trial. The intervention consisted of 7 sessions at participants' homes led by a psychotherapist and a social worker. Quality of life was evaluated at baseline, one, and six-month follow-up for patients and their partners. Mixed effects models have been applied.
Intervention allocation was not associated with an improvement in quality of life in either the patients or their partners. In subgroup analyses, intervention was negatively associated with caregiver performance. However, this was only present in those reporting poor relationship quality. Patients in the intervention group who reported good relationship quality were found to have decreased cognitive decline.
A couple-based interdisciplinary intervention did not yield improvements in quality of life. This may be the result of a bias caused by an increased awareness due to the intervention. Relationship quality and support in the long-term should be considered when designing and implementing interventions for PWD and their partners.
心理社会干预可能会提高痴呆症患者（PWD）及其家庭照顾者的生活质量。然而，相关研究尚无定论，且主要集中在 PWD 或照顾者一方的生活质量上，而不是双方。
我们旨在评估针对轻度至中度痴呆患者的基于夫妻的跨学科心理社会干预对双方生活质量的影响。
这项实用随机对照试验纳入了 108 名居住在社区的 PWD 及其照顾者。该干预措施包括在参与者家中由心理治疗师和社会工作者共同进行的 7 次会议。在基线、1 个月和 6 个月时对患者及其伴侣的生活质量进行评估。采用混合效应模型进行分析。
干预分配与患者或其伴侣的生活质量改善均无关联。在亚组分析中，干预与照顾者的表现呈负相关。然而，这仅出现在那些报告关系质量较差的人群中。在报告关系质量良好的患者中，干预组的认知能力下降幅度较小。
基于夫妻的跨学科干预并未提高生活质量。这可能是由于干预引起的意识增强而导致的偏差。在为 PWD 及其伴侣设计和实施干预措施时，应考虑长期的关系质量和支持。
