ACT for Individuals With MNCD and Their Care Partners

Alzheimer's Disease (AD) and Alzheimer's Disease Related Dementias (AD/ADRD) are life-limiting, long-term, neurodegenerative conditions estimated to affect more than 6.5 million adults over the age of 65 in the U.S. (Alzheimer's Association, 2023a). A majority of persons with AD/ADRD are over the age of 75 (73%; Alzheimer's Association, 2023a). With an aging population (estimated 1 in 6 people in the world will be over the age of 60 by 2030; World Health Organization, 2022), no known cure, and modern medical advances increasing life expectancy, the prevalence of AD/ADRD continues to rise, an estimated 13.8 million by 2060 (Alzheimer's Association, 2023a). Due to this mostly affecting older adults, 69.1% are living with a comorbid diagnosis (e.g., hypertension; diabetes) (Bennett et al., 2018; Poblador-Plou et al., 2014). AD/ADRD presents a global health crisis, posing profound challenges to not only the individuals with the disease, but has downstream effects on the family unit and the healthcare systems. As number of individuals with AD/ADRD are expected to increase over the next 10 years, it is vital to investigate non-pharmacological interventions for this population in order to improve the negative consequences of this diagnosis. This study aims to bridge this gap by investigating a modified evidence-based intervention, Acceptance Commitment Therapy (ACT), for persons with AD/ADRD and their care partners.

An integral part of an AD/ADRD journey is the care partner, who is usually a spouse or adult child. These care partners provide more than 10 billion hours of care in the United States to individuals with AD/ADRD. This has been found to result in negative outcomes, including high rates of pre-death grief, caregiver burden, and stress. There have been numerous non-pharmacological interventions for these care partners, but few studies have investigated the effects of dyadic interventions for persons with AD/ADRD and their care partners. Dyadic interventions have been found to be effective in improving psychosocial outcomes with persons with other chronic conditions (e.g., cancer) and their care partners (Hu etl a., 2019). The overarching goal of this project is to evaluate if acceptance commitment therapy will have a positive effect on persons recently diagnosed with early stage AD/ADRD.

More specifically, we will:

• Evaluate the feasibility and acceptability of this shortened ACT program for persons with MCI or MNCD.
• Assess the preliminary efficacy of this ACT program for persons with MCI or MNCD.
• Evaluate if this intervention program has positive downstream effects on the care partners.

Inclusion criteria

Inclusion (person with MCI or MNCD):

• 18+
• MMSE= 21-27
• Able to communicate in English

Inclusion (care partner):

• 18+
• Identifies as a care partner of a person with MNCD
• Able to communicate in English
• MMSE= 28-30
• Is a family member or friend of the person with MNCD

Exclusion criteria

Exclusion (person with MCI or MNCD):

• Currently in an intervention for reducing anxiety or depression related to their dementia
• MMSE= 28+ or less than 21

Exclusion (care partner):

• MMSE= <28
• Is a formal (paid) caregiver