Worldwide, an estimated 50 million people are living with dementia. These numbers are projected to reach 82 million by the year 2030 and 152 million by 2050, with the most individuals coming from low- and middle-income countries.

The annual number of new cases of dementia is 9.9 million, estimates that are approximately 30% higher than the annual numbers reported in 2010 (7.7 million new cases).

Dementia, which is not a normal part of aging, is overwhelming not only for the people who have it but also for their caregivers and families. In most countries, there is a lack of awareness and understanding of dementia that results in stigmatization; barriers to diagnosis and care; and stress for families, physically, psychologically, and economically.

Caring for those with dementia can be difficult, particularly as their condition deteriorates. Dementia behaviors, such as wandering, sundown syndrome, anxiety, and hallucinations, are huge sources of stress — both for the caregiver and the loved one.

Nearly 4 in 10 family members experience depression or anxiety. Now, a program of therapy and coping strategies for caregivers and family members with dementia promises to improve the caregivers’ mental status for a least a six-year follow-up.

Professor Gill Livingston (UCL, Division of Psychiatry, UK) and colleagues randomized 222 family caregivers, 173 to the START (STrAtegies for RelaTives) intervention study, an eight-session manual-based coping intervention delivered by supervised psychology graduates, and the other 87 family members randomly assigned to a control group that did not receive intervention.

The primary outcome was affective symptoms (Hospital Anxiety and Depression Scale, total score HADS-T). Secondary outcomes included patient and caregiver service costs and care home admission.

Six years after receiving the therapy, the caregivers who were in the START program had significantly fewer symptoms of depression and anxiety, and the researchers say the therapy program appeared to be both preventative and improved existing mental ill-health.

Patient-related costs were close to three times lower among the families in the START program (averaging £5,759 for those in START versus £16,964 in the control group in year six). According to James Pickett, head of research at Alzheimer's Society, being a caregiver can be a grueling job, demanding 24 hours a day and often done purely out of love. Unfortunately, depression and anxiety can be an inevitable side effect, with 90% of caregivers reporting that they experience stress and anxiety several times a week.

The START team has developed manuals to make it easier for any healthcare provider to deliver the intervention and plan to provide accredited training at UCL in the future. The training manuals are also available in Japanese and Spanish and are currently being translated into Urdu.