Assessing an evidence-based intervention for spouse caregivers of persons with Alzheimer’s disease: results of a community implementation of the NYUCI in Israel

Perla Werner, Olivio J. Clay, Dovrat Goldstein, Ile Kermel-Schifmann, Michal Karen Herz, Cynthia Epstein, Mary S. Mittelman

Research output: Contribution to journalArticlepeer-review


Objectives: Alzheimer’s disease (AD) affects not only the person with the illness, but family caregivers as well. The NYU Caregiver Intervention (NYUCI), a psychosocial intervention which has demonstrated both short and long-term benefits for caregivers, has been used widely in the United States and in Australia and England. The Israeli study was a hybrid between a community implementation study and a randomized controlled trial (RCT) of the NYUCI in a non-English speaking country. Method: A sample of 100 spouse caregivers participated in trial comparing the NYUCI provided by ten Israeli clinicians (enhanced care), to support group participation (usual care). The major outcome of interest was caregiver depressive symptoms, measured with the Geriatric Depression Scale. A linear random effects regression model controlling for factors associated with depressive symptoms was used to plot the longitudinal trajectories of depressive symptoms over the two-year study period and compare outcomes for the enhanced care and control groups. Results: One hundred spouse caregivers enrolled, of whom 81 provided data at baseline and at one or more post intervention assessments. The Israeli adaptation of the NYUCI was effective in reducing depressive symptoms reported by caregivers compared to their counterparts in the control group, b= −1.29 [95%CI (−2.43, −0.15)], p=.0265. Conclusion: While implementing a randomized controlled trial of an intervention developed and tested in traditional research settings using community providers in Israel, posed unique challenges, the study demonstrated benefits to caregivers. As a result, 30 municipalities in Israel are currently implementing an ongoing adaptation of the NYUCI.

Original languageEnglish
Pages (from-to)1676-1683
Number of pages8
JournalAging and Mental Health
Issue number9
StatePublished - 2021

Bibliographical note

Funding Information:
In this manuscript, we describe the implementation of the Israeli adaptation of the NYUCI in a new cultural environment with a different healthcare system than the one in which the evidence base was developed. The Israeli NYUCI, which was named Lituf (an acronym standing for Individual Support, and a Hebrew word meaning caress) is the first replication of the NYUCI to be conducted in a non-English speaking country with a culture that places a strong focus on the family and has a comprehensive medical and social care system. The project was initiated by the Israeli Alzheimer’s Association. Formed in 1988, the Israeli Alzheimer’s Association is a voluntary organization providing information, support and care to persons with AD and their family members. The Association’s funds come from fees payed by its members, donations, and grants received from foundations and governmental sources. The implementation of the Israeli NYUCI was funded by a grant from the National Insurance Institute to the Alzheimer’s Association, covering the salary of the coordinator, the reimbursement to the counselors, and the evaluation of the effectiveness of the intervention, which was conducted by researchers who were not members of the Israeli Alzheimer’s Association. The research team communicated on a regular basis with the project coordinator who maintained steady contact with the counselors and reminded them to complete the assessments as required. Moreover, the research team was in charge of performing data entry and data analyses, interpreting the results, and writing the reports.

Funding Information:
The research evaluation was funded by a grant from the Israeli Alzheimer?s Association.

Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.


  • Caregiver
  • counseling
  • dementia
  • intervention
  • support

ASJC Scopus subject areas

  • Psychiatric Mental Health
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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