Effects of a lifestyle physical activity intervention on family caregivers of persons with dementia: A randomized controlled trial

Background: The selfless and honorable actions of over 15 million Americans who provide unpaid care to persons with Alzheimer's disease (AD) benefit care recipients but often result in adverse health consequences for the caregivers themselves. Interventions that support these caregivers have almost exclusively been psychosocial or psychoeducational, with little attention to lifestyle modifications. To address this dearth, we conducted a study to help caregivers increase physical activity as a conduit to maintaining better health and well-being. Methods: A 12-month randomized controlled trial was conducted with N=211 caregivers of persons with AD. Participants received either the Enhanced Physical Activity Intervention (EPAI, n=106) or Caregiver Skill Building Intervention (CSBI, n=105). Interventions were delivered through one home visit at baseline and by telephone at weekly, bi-weekly, then monthly intervals. EPAI promoted physical activity in the context of caregiving whereas CSBI concentrated on dementia care tasks, stress management, and optimizing resource use. Standardized instruments were utilized to measure care burden, physical activity, and mental and emotional health. Assessments were completed at baseline, 3, 6, 9, 12 and 18 months. Results: Adjusted multivariate models revealed that the EPAI group significantly increased their physical activity over time as compared to the CSBI group (p=0.02). Significant baseline correlates of improvement in physical activity were higher care recipient cognition (p=0.01), higher general and physical self-efficacy (p=0.01 and p<0.001, respectively), and having more positive affective emotions (p=0.04). Conclusions: EPAI is an effective intervention that helps family caregivers increase their physical health by adopting and sustaining a more active lifestyle.