Communication problems contribute disproportionately to stress and burden of caregivers of Alzheimer's Disease (AD) patients. There has been no systematic study of communication breakdown between caregivers and their AD family member or of intervention that may prevent breakdown. Patterns of communication and breakdowns may differ between African-American and white families. This investigation is designed to characterize communication patterns and compare the effects of caregiver training in specific communication strategies on African-American and white caregivers. Caregiver training in specific communication strategies could reduce stress and burden and be effective in improving communication. Application of such strategies could improve the quality of life for both caregivers and their AD relatives and allow the caregiver to provide care for a longer period, postponing institutionalization. The project will study 36 African-American and 94 white caregivers and their AD family members who form 130 dyads. Subjects will be assessed upon entry in three areas. First, communication abilities of AD subjects will be evaluated using standardized language and delayed memory tests and conversational discourse measures. Second, communication patterns between caregivers and AD relatives will be studied using a systematic analysis of basic language features, cohesion and coherence analysis, speech act analysis and topic analysis. Third, caregivers will be assessed on overall status, stress and burden, communication satisfaction, and knowledge of AD. After the baseline pretests are completed, subject dyads will be randomly assigned to experimental or control groups in equal numbers. The experimental dyads' caregivers will complete a 10 hour training program in specific communication strategies followed by post-training reassessment. Followup testing will be completed at six and 12 month intervals. Control subjects will complete the assessments at six and 12 months after entry followed by the caregiver training. Subjects will be recruited through the Alzheimer's Center at University Hospitals of Cleveland.
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