Effect of Cognitive Empathy Training on Dementia Caregivers

NCT ID: NCT06650527

Last Updated: 2025-08-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

118 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-13

Study Completion Date

2028-11-01

Brief Summary

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The goal of this project is to investigate the effect of cognitive empathy training on mental health, inflammation, and immune function in caregivers of people living with dementia (PLWD), and to examine the underlying psychological and neurobiological mechanisms.

The primary aim is to establish the effectiveness of cognitive empathy training in improving caregiver mental health and immune function, and in decreasing caregiver inflammation

The secondary aim is to investigate the psychological and neurobiological mechanism by which cognitive empathy training improves caregiver well-being

Detailed Description

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In the U.S., over 7 million people currently live with Alzheimer's disease and related disorders (ADRD), a number projected to exceed 16 million by 2060. Family caregivers, numbering more than 11 million, play a crucial role in managing the care of these individuals, often bearing significant emotional and financial burdens. In 2021, the cost of care for dementia reached $593 billion, with families contributing a substantial portion. Caregivers frequently experience negative mental and physical health impacts due to chronic stress, including increased rates of depression and inflammation. Research indicates that caregiving leads to decreased immune function, with elevated Epstein-Barr virus antibody titers serving as a marker for immune health. Interventions aimed at supporting caregivers, such as psychoeducational programs, have shown benefits, particularly in enhancing coping skills. Additionally, fostering cognitive empathy in caregivers may improve their mental health and the quality of care provided to individuals with dementia, potentially mitigating some of the adverse health effects associated with caregiving stress.

Conditions

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Caregivers of People Living With Dementia Dementia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Using a crossover design, caregivers will be randomized to either cognitive empathy training (n=59) or a control condition (n=59). Neuroimaging, questionnaire, and biomarker data will be collected before the 10-day training, immediately after the training, and six months after. At the 6 month visit, participants will cross over to the other treatment
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Group 1: Empathy Training

Participants will be randomly assigned to the empathy training or control condition for 6 months. During the first phase of the study, participants in Group 1 will receive the photo captioning intervention.

At the 6-month time point, participants in Group 1 will crossover to control.

Assessments will be collected at baseline, 10-day (immediate post-training), 6-month (crossover), 6-month and 10-day (immediate post-crossover) and 12-month (completion)

Group Type EXPERIMENTAL

Cognitive Empathy Training

Intervention Type BEHAVIORAL

Participants will engage in a mentalization activity by captioning photos of their care recipients, reflecting on what the care recipient might be thinking or feeling. Over 10 days, caregivers will take 3-5 daily pictures of their care recipient and caption each with descriptive text representing the recipient's inner voice. This task encourages caregivers to consider the care recipient's perspective and motivations behind their behavior or emotional experiences. Photos will be shared securely via encrypted email. Utilizing accessible smartphone technology, the study allows caregivers to capture and reflect on meaningful moments with their care recipients

Pre and post intervention blood spot collection

Intervention Type PROCEDURE

At their initial study visit, participants will provide a blood spot sample for measurement of C-reactive protein, pro-inflammatory cytokines and Epstein-Barr virus antibody titers.

Pre and post intervention MRI session

Intervention Type PROCEDURE

In this study, caregivers will be positioned in a Siemens Trio 3T MRI scanner for functional imaging. They will view images of their care recipient care recipient, other similar care recipients care recipient, and photographs of friends or family members, pressing a button each time they see their care recipient care recipient's photo to monitor attention. The task involves viewing eight photos of four individuals with happy and neutral expressions, followed by rest periods. This sequence repeats five times, with each stimulus presented for 5 seconds and inter-trial intervals of 2, 3, or 4 seconds, totaling 11 minutes and 15 seconds. A subsequent 10-minute diffusion-weighted scan will assess brain white matter integrity, using 60 diffusion directions. All scans will be completed within 40 minutes.

Group 2: Control Condition

During the first phase of the study, participants in Group 2 are controls. At the 6-month time point, participants in Group 2 will crossover and initiate the intervention.

Assessments will be collected at baseline, 10-day (immediate post-training), 6-month (crossover), 6-month and 10-day (immediate post-crossover), and 12-month (completion)

Group Type OTHER

Control Condition

Intervention Type BEHAVIORAL

In the control condition, participants will be asked to take 3-5 daily photographs of nature over 10 days. They will be asked to caption each photo with a description of what they see. This exercise will involve many of the same activities as the cognitive empathy training, except that participants will not be mentalizing or taking the the perspective of their PLWD or anyone else.

Pre and post intervention blood spot collection

Intervention Type PROCEDURE

At their initial study visit, participants will provide a blood spot sample for measurement of C-reactive protein, pro-inflammatory cytokines and Epstein-Barr virus antibody titers.

Pre and post intervention MRI session

Intervention Type PROCEDURE

In this study, caregivers will be positioned in a Siemens Trio 3T MRI scanner for functional imaging. They will view images of their care recipient care recipient, other similar care recipients care recipient, and photographs of friends or family members, pressing a button each time they see their care recipient care recipient's photo to monitor attention. The task involves viewing eight photos of four individuals with happy and neutral expressions, followed by rest periods. This sequence repeats five times, with each stimulus presented for 5 seconds and inter-trial intervals of 2, 3, or 4 seconds, totaling 11 minutes and 15 seconds. A subsequent 10-minute diffusion-weighted scan will assess brain white matter integrity, using 60 diffusion directions. All scans will be completed within 40 minutes.

Interventions

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Cognitive Empathy Training

Participants will engage in a mentalization activity by captioning photos of their care recipients, reflecting on what the care recipient might be thinking or feeling. Over 10 days, caregivers will take 3-5 daily pictures of their care recipient and caption each with descriptive text representing the recipient's inner voice. This task encourages caregivers to consider the care recipient's perspective and motivations behind their behavior or emotional experiences. Photos will be shared securely via encrypted email. Utilizing accessible smartphone technology, the study allows caregivers to capture and reflect on meaningful moments with their care recipients

Intervention Type BEHAVIORAL

Control Condition

In the control condition, participants will be asked to take 3-5 daily photographs of nature over 10 days. They will be asked to caption each photo with a description of what they see. This exercise will involve many of the same activities as the cognitive empathy training, except that participants will not be mentalizing or taking the the perspective of their PLWD or anyone else.

Intervention Type BEHAVIORAL

Pre and post intervention blood spot collection

At their initial study visit, participants will provide a blood spot sample for measurement of C-reactive protein, pro-inflammatory cytokines and Epstein-Barr virus antibody titers.

Intervention Type PROCEDURE

Pre and post intervention MRI session

In this study, caregivers will be positioned in a Siemens Trio 3T MRI scanner for functional imaging. They will view images of their care recipient care recipient, other similar care recipients care recipient, and photographs of friends or family members, pressing a button each time they see their care recipient care recipient's photo to monitor attention. The task involves viewing eight photos of four individuals with happy and neutral expressions, followed by rest periods. This sequence repeats five times, with each stimulus presented for 5 seconds and inter-trial intervals of 2, 3, or 4 seconds, totaling 11 minutes and 15 seconds. A subsequent 10-minute diffusion-weighted scan will assess brain white matter integrity, using 60 diffusion directions. All scans will be completed within 40 minutes.

Intervention Type PROCEDURE

Other Intervention Names

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Labs MRI scan

Eligibility Criteria

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Inclusion Criteria

* Caregivers must live with their care recipient
* Caregivers must have a Zarit Burden Scale score of 19 or higher
* Caregivers must have no plans to move their care recipient to an institutional setting within the next year
* Caregivers must be able to read and write English
* Care recipient not in hospice
* Access to a mobile phone that can take and email photographs

Exclusion Criteria

* Subjects with a history of seizures or other neurological disorders, alcoholism, or any other substance abuse
* Subjects with a history of psychiatric illness (excluding depression and anxiety disorders) will also be excluded
* Subjects with a history of head trauma based on Survey
* Subjects with MRI contra-indications
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role lead

Responsible Party

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James K. Rilling

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James Rilling, PhD

Role: PRINCIPAL_INVESTIGATOR

Emory College of Arts & Sciences

Kenneth Hepburn, PhD

Role: PRINCIPAL_INVESTIGATOR

Emory School of Nursing

Locations

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Alter

Atlanta, Georgia, United States

Site Status RECRUITING

Emory Integrated Memory Care

Atlanta, Georgia, United States

Site Status RECRUITING

NIA Goizueta Alzheimer's Disease Research Center

Atlanta, Georgia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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James Rilling, PhD

Role: CONTACT

404-727-3062

Kenneth Hepburn, PhD

Role: CONTACT

404-712-9286

Facility Contacts

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Fayron Epps, PhD,RN

Role: primary

770-686-7730

Carolyn Clevenger, PhD

Role: primary

404-712-2394

Allen Levey, MD, PhD

Role: primary

404-727-6050

Other Identifiers

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1R01AG087216-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY00007266

Identifier Type: -

Identifier Source: org_study_id

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