Effects of a telephone -based exercise intervention among female spouse caregivers of people with dementia.

Abstract

Prior research has confirmed that caring for a family member with Alzheimer's disease or a related disorder (ADRD) has adverse effects on health and health behaviors. Physical activity has been shown to yield a number of health benefits among older adults, suggesting the value of an exercise intervention for caregivers. The current study describes the results of a randomized, controlled trial of an at-home exercise intervention among 136 women caring for a spouse with ADRD. This intervention, Health First, was based on social cognitive theory and delivered via a series of telephone calls over 6 months. Multiple linear regression models indicated that at post-intervention follow-up, program participants experienced greater increases in exercise behavior and exercise self-efficacy and greater reductions in perceived stress (all p's < .05) compared to the control group. A trend (p < .10) toward greater reduction in depressive symptoms was also observed among participants. A structural equation model demonstrated that exercise behavior, but not self-efficacy for exercise, served a mediating role between program participation and reduced stress. Finally, the role of social support in influencing exercise behavior among caregivers was explored with both qualitative and quantitative methodologies. Qualitative interviews demonstrated that the extent to which caregivers needed and received support for exercise varied greatly, with a strong theme emerging of self-reliance in achieving exercise goals. The number of a respondent's close ties, perceived support availability, and negative interaction at baseline were not associated with exercise behavior 6 months later. Contrary to hypothesis, more baseline exercise-specific support predicted lower levels of exercise at follow-up (p < .05); however, increased support for exercise over the study period predicted a concurrent increase in exercise (p < .05). Overall, results suggest that a telephone-based intervention may be an effective way to increase physical activity among caregivers. Further research is needed to determine whether increased physical activity and self-efficacy for exercise in this population can positively affect health- and caregiving-related outcomes over time.