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Comparative Effectiveness of Behavioral Interventions to Prevent or Delay Dementia: One-Year Partner Outcomes



Various behavioral interventions are recommended to combat the distress experienced by caregivers of those with cognitive decline, but their comparative effectiveness is poorly understood.


Caregivers in a comparative intervention study randomly had 1 of 5 possible interventions suppressed while receiving the other four. Caregivers in a full clinical program received all 5 intervention components. Care partner outcomes in the study group were compared to participants enrolled in a full clinical program.


Two hundred and seventy-two dyads of persons with amnestic mild cognitive impairment (pwMCI) and care partners enrolled in the comparative intervention study. 265 dyads participated in the full clinical program.


Behavioral intervention components included: memory compensation training, computerized cognitive training, yoga, support group, and wellness education. Each was administered for 10 sessions over 2 weeks.


A longitudinal mixed-effect regression model was used to analyze the effects of the interventions on partner burden, quality of life (QoL), mood, anxiety, and self-efficacy at 12 months follow-up.


At 12 months, withholding wellness education or yoga had a significantly negative impact on partner anxiety compared to partners in the clinical program (ES=0.55 and 0.44, respectively). Although not statistically significant, withholding yoga had a negative impact on partner burden and mood compared to partners in the full clinical program (ES=0.32 and 0.36, respectively).


Our results support the benefits of wellness education and yoga for improving partner’\TMs burden, mood, and anxiety at one year. Our findings are the first to provide an exploration of the impact of multicomponent interventions in care partners of pwMCI.

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Corresponding author

Correspondence to Dona E. C. Locke.

Additional information

Support/Funding: Research reported in this manuscript was primarily funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER- 1306-01897). The statements in this publication are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee. Additional support for DECL: NIA P30AG19610, NIA R01 AG031581, the Arizona Alzheimer’\TMs Research Consortium, the Ralph J. Wilson Foundation Development Gift to Mayo Clinic. Additional support for GES: NIA P50AG47266, State of Florida Ed and Ethel Moore program.

Sponsor’\TMs Role: The sponsor had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; in the preparation of the manuscript; or in the review or approval of the manuscript.

Disclosure statement: No conflict of interest was reported by all authors.

Author Contribution: Study concept and design: D.E.C.L., M.C., J.E.C., C.T.B., V.P., G.E.S. Data acquisition and interpretation: All authors; Statistical analysis: C.T.B., J.E.C. Manuscript draft: P.A.A., D.E.C.L. Critical revision of manuscript: P.A.A., D.E.C.L., M.C., J.E.C., C.T.B., G.E.S.

Data availability statement: The data that support the findings of this study are available from the corresponding author, D.E.C.L., upon reasonable request.

Trial registration: Identifier: NCT02265757.

IRB: Institutional Review Boards at the Mayo Clinic (14-000885) and University of Washington (49235)

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Amofa, P.A., Locke, D.E.C., Chandler, M. et al. Comparative Effectiveness of Behavioral Interventions to Prevent or Delay Dementia: One-Year Partner Outcomes. J Prev Alzheimers Dis 8, 33–40 (2021).

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Key words

  • Non-pharmacological interventions
  • MCI
  • dementia
  • caregiver
  • patient preferences