Technology-Based Interventions to Address Social Isolation and Loneliness Among Informal Dementia Caregivers: A Scoping Review

Feasibility and acceptability of a videoconference-based cognitive-behavioral intervention for caregivers of individuals living with mild cognitive impairment or early Alzheimer's disease

Objective

The objective of the current pilot study was to investigate the feasibility and acceptability of a videoconference-based cognitive behavioral (CBT) intervention for caregivers of individuals living with mild cognitive impairment or early Alzheimer's disease. The intervention included psychoeducation on emotions, strategies for management of unhelpful emotions and thoughts, behavioral activation, breathing and relaxation, strategies for communication and information on external resources.

Methods

This study used a cross-sectional design with two groups of four caregivers who received an 8-week CBT-based intervention via videoconference. Measures of feasibility and acceptability were collected post-intervention as well as suggestions for improvements.

Results

Eight female caregivers were enrolled in the intervention, one participant opted out at the seventh session. Of those who completed the program, all participants reported that it was very easy to participate using the online modality. All participants felt that the intervention was at least partly adapted to their experience and needs as a caregiver. Five out of seven participants (71%) indicated that they felt better and would recommend the intervention to another caregiver.

Conclusion

The current study demonstrated that it is feasible and acceptable to use a videoconference CBT-based group intervention with MCI or mild AD female caregivers.

Innovation

This is the first videoconference-based cognitive behavioral intervention for caregivers of individuals living with MCI or mild AD.

Adaptation, testing, and use of the "iSupport for Dementia" program in different countries: a systematic review

The World Health Organization developed the "iSupport for Dementia" program for family caregivers of people with dementia.

Objective

To explore studies on adaptation, randomized clinical trial protocols, and preliminary results of iSupport by unpaid caregivers of people living with dementia in different countries.

Methods

Systematic review.

Results

Ten cultural adaptation studies, eight randomized clinical trial protocols, and two preliminary results were included. Adaptation studies showed adjustments in terminology, design, and additional resources. Clinical trial protocols included burden as the primary outcome, and baseline, three months of intervention, and follow-up after six months. Studies with preliminary results found positive effects on the mental health and well-being of caregivers after using the program.

Conclusion

iSupport is an online program of the World Health Organization in response to dementia in implementation in different countries.

Correlations between Dementia and Loneliness

This review describes associations between dementia and loneliness on the neurobiological and epidemiological levels according to the recent body of literature. The aim of this study was to highlight major lines of research in this field. Sociocognitive skills and social interactions present complex interdependencies with dementia which may be explained by two theories. According to the first one, not sufficiently engaging in social or cognitive activities results in brain atrophy. The second one claims that brain neurogenesis and synaptic density are being increased by social connections. The relationship between loneliness and dementia could be mediated by sensory loss, including hearing and visual impairment, as well as depression and psychotic symptoms. Loneliness itself might cause a depletion in sensory and cognitive stimulation which results in a decrease in neural reserve. Certain changes in the structures of the brain caused by loneliness were found in imaging examination. Loneliness appears to be a crucial risk factor for dementia in recent times due to the modern lifestyle and consequences of the outbreak of COVID-19. Additional studies are required to understand more completely the key tenets of this topic and therefore to improve the prevention and treatment of dementia.