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The effects of counseling spouse caregivers of people with Alzheimer disease taking donepezil and of country of residence on rates of admission to nursing homes and mortality


Brodaty, Henry, Mittelman, Mary, Gibson, Louisa, Seeher, Katrin, Burns, Alistair


The American Journal Of Geriatric Psychiatry: Official Journal Of The American Association For Geriatric Psychiatry, Volume: 17, No.: 9, Pages.: 734-743

Year of Publication



Objective: Does psychosocial intervention for caregivers whose spouses with Alzheimer disease (AD) are taking donepezil delay nursing home (NH) placement or death of patients?; Design: Randomized controlled trial with 2 years of active treatment and up to 8.5 years of follow-up (mean: 5.4 years, SD: 2.4).; Setting: Outpatients of research clinics in Australia, the United Kingdom, and the United States.; Participants: One hundred and fifty-five persons with AD and their spouses.; Intervention: Five sessions of individual and family counseling (+ prn ad hoc counseling) or usual care.; Measurements: Time to institutionalization and death using Cox proportional hazards methods.; Results: Over a mean of 5.4 years (SD: 2.4), there were no differences in NH placement or mortality by intervention group, but there were by country, with Australian patients admitted to NHs earlier than U.S. than U.K. patients.; Conclusion: Earlier NH admission of Australian compared to U.K. and U.S. subjects may be due to differences in health care, NH systems, availability, and affordability.;


aged, aged, 80 and over, alzheimer disease, australia, caregivers, cholinesterase inhibitors, counseling, drug therapy, female, great britain, homes for the aged, humans, indans, institutionalization, intervention, male, methods, mortality, nursing, nursing homes, piperidines, psychology, psychosocial, questionnaires, social support, spouses, statistics & numerical data, therapeutic use, united states, utilization

Countries of Study

Australia, UK, USA

Types of Dementia

Alzheimer’s Disease

Types of Study

Randomised Controlled Trial

Type of Outcomes

Carer Burden (instruments measuring burden), Service use or cost reductions (incl. hospital use reduction, care home admission delay)



Type of Interventions

Intervention for Carers

Carer Focussed Interventions

Training programmes / workshops including behavioural training