International Health Humanities Network Membership

Mary S. Mittelman is an epidemiologist who has been evaluating psychosocial interventions for people with cognitive impairment and their family members for more than two decades. She received a Dr.P.H. in psychiatric epidemiology and an M.S. in biostatistics from Columbia University School of Public Health. Dr. Mittelman is Director of the Psychosocial Research and Support Program of the NYU Comprehensive Center on Brain Aging and Research Professor in the NYU Langone Medical Center Department of Psychiatry. For more than 20 years she was Principal Investigator of the NYU-Spouse Caregiver Intervention (NYUCI) study, first funded by the NIH in 1987. Dr Mittelman is also the Director of the Psychosocial Core of the NYU-Alzheimer’s Disease Center; there is no other ADC with a Psychosocial Core, which evolved from the NYUCI, and has been providing support and conducting assessments of participants and caregivers since 1998.

The NYUCI is unique in several ways. It includes family members in addition to the primary caregiver, It is available for the entire course of the illness. The study results are based on a randomized controlled trial of more than 400 participants, some of whom participated for as long as 18 years. Publications from the study of the NYUCI provided evidence that counseling and support for spouse caregivers and their families can have a major impact on the time a person with dementia can remain at home and on the well-being of the family caregiver. We have demonstrated the long-term effectiveness of counseling and support for caregivers in reducing symptoms of depression and the severity of their reactions to the behavior of their family members with dementia and in maintaining caregiver physical health. The mechanism through which the intervention achieves these improvements in caregiver well-being is by improving the support and assistance from family members and friends. The intervention’s effects on caregiver well-being lasted through nursing home placement and death of the person with dementia.

The NYU Caregiver Intervention has won many awards, including an award from the National Alliance for Caregiving and the Met Life Foundation in 2010 and the first global award for Alzheimer’s psychosocial research from Alzheimer’s Disease International/ Fondation Mederic Alzheimer (March 2009). Other awards include the annual New York City Family Caregiver Coalition award in 2009, the Maggie Kuhn Award from Presbyterian Senior Services and the Rosalynn Carter Caregiver Leadership Award.

In the past few years, Dr. Mittelman has made a commitment to disseminate research findings to both health care providers and the community at large and to collaborate with community organizations to implement evidence-based psychosocial interventions in community settings. She has collaborated with organizations funded by the United States Administration on Aging, the Rosalynn Carter Institute and the Veteran’s Administration, providing assistance for translations of the NYU Caregiver Intervention in communities around the United States. Replications have been conducted in England, Australia and Israel. With her colleagues, she has written several books for caregivers and health care professionals, including Counseling the Alzheimer’s Caregiver: A Resource for Health Care Professionals, published in 2003 by the American Medical Association. In partnership with a small business, HealthCare Interactive, with funding from the NIA, Dr Mittelman and clinical colleagues are developing web-enabled training for the NYUCI, so it can be disseminated more widely and effectively than has heretofore been possible.

More recently, Dr Mittelman has been evaluating and developing interventions that include the person with dementia together with the caregiver. She received an Alzheimer’s Association Zenith Fellows Award to study a couples counseling intervention. She evaluated the Meet Me at MoMA program, a monthly educational visit to the Museum of Modern Art for people with dementia and their family members. Most recently, in June 2011, she founded a chorus of people with dementia and their family caregivers and conducted a pilot study of its benefits. The chorus named themselves, The Unforgettables, and has continued to rehearse and perform even after the study funding was over. We are currently seeking funding for a larger, multisite study to more definitively demonstrate its effects, using reliable outcome measures, although the pleasure it brings are obvious to the observer.

A short video about the Unforgettables is at: http://abclocal.go.com/wabc/story?section=news/health&id=8311867

An AARP blog titled “The Power of Song” is at:

http://blog.aarp.org/2012/04/12/music-therapy-helps-alzheimers-caregivers/