P25: Effects of iSupport for reducing burden and improving the mental health of informal caregivers of people living with dementia in Brazil: Results of a randomized controlled trial

Abstract

Background: Most people living with dementia rely on their family members for the care and support they need. However, unpaid care can lead to multiple negative impacts on the wellbeing and mental health of carers.

Objectives: The Objectives of this study was to evaluate the effects of iSupport-Brasil (an online, psychoeducational program) on perceptions of burden and on the mental health of informal caregivers of people living with dementia.

Methods: A randomized controlled trial was carried out from January 2023 to April 2024 in Brazil. A total of 162 individuals were randomly allocated to an intervention group (IG) (n = 77) or a control group (CG) (n = 85). The IG had free access to the iSupport-Brasil platform for three months. Simultaneously, the CG participants were provided with a link to access the Brazilian Alzheimer’s Association website and a copy of the “Care Guide for Older People”, published by the Brazilian Ministry of Health. Pre- and post-intervention assessments were carried out using measures of burden (a single-item Burden Scale and the Zarit Burden Interview – ZBI), and of anxiety and depressive symptoms (Hospital Anxiety and Depression Scale - HADS).

Results: Based on an intention-to-treat analysis, a reduction in anxiety symptoms was observed for the IG (p = 0.02). Based on a per-protocol analysis, significant reductions in burden (p <0.01) and anxiety symptoms (p < 0.01) were found for the IG. No significant effects were found for depressive symptoms, although scores decreased. For the CG, the regression model indicated that, on average, burden and depressive symptoms worsened somewhat, but this result was not statistically significant.

Conclusions: The iSupport-Brasil program was effective in reducing perceptions of burden and anxiety symptoms among informal caregivers in Brazil. Therefore, we recommended that informal caregivers of people living with dementia use this program to help them broaden their interpersonal coping strategies and improve their emotional health, in addition to using mainstream long-term care support services.