This study seeks to establish the acceptability and evaluate the limited efficacy of Simple
Reminiscence (SR), a home-delivered non-pharmacological intervention designed to relieve
stress, improve affect, and prevent or quell disruptive or maladaptive behaviors in
community-residing individuals diagnosed with early Alzheimer's disease (EAD). Unmanaged
episodes of anxiety can be antecedents of maladaptive behaviors, including agitation, anger,
and sometimes even violence.
SR is a dyadic strategy; both the person with EAD and the caregiver engaged the patient's
memory to interrupt a current episode of anxiety.
Through the intervention, family caregivers are trained to collaborate with and guide
patients to access positive memories as a way to manage or move past the anxiety that
plagues individuals with EAD - often arising when confronted by common complex tasks they
previously were able to perform.
During the project's first six months (phase 1), the investigators will develop a series of
4 video-vignettes illustrating dyads (including one member with EAD) managing a variety of
anxiety provoking scenarios associated with EAD (e.g., trouble reconciling a checkbook)
through the use of SR.
During the second phase of the project, a research assistant will administer SR at four home
visits. The SR intervention has three components:
1. A didactic component using the SR manual that the couple retains (15 minutes);
2. Viewing one of the brief video-vignettes illustrating the application of reminiscence
techniques (5 minutes; a different video-vignette will be viewed at each visit; and
3. Facilitation of caregiver practice in applying the techniques, using a recent example
of anxiety-linked experience of the person with EAD (10 minutes). The caregiver is
encouraged to learn and practice the techniques in order to cue and coach the person
with EAD in their use.
The attention control treatment, a Social Visit, is a 30-minute activity in which the person
with EAD, the caregiver and the research assistant (RA) review and discuss the day's
newspaper headlines. The RA will use communication techniques specifically designed to keep
the conversation present focused.
Both members of the dyad will collect saliva to evaluate diurnal cortisol secretion.
- Live in the community
- Reside with a primary caregiver who must be willing to participate in all study
activities (the primary caregiver must have a familial or marital relationship with
the person with EAD of sufficient length to support reminiscence activity [i.e., an
adult child, a long-term spouse or committed partner])
- Have received a diagnosis of Early Alzheimer's Disease from a primary care provider
- Achieve a score on the mini-mental state examination (MMSE) between 19 and 25
- Unable to give consent
- MMSE score lower than 19 or greater than 25.