# SAGE LEAF:  Reducing Burden in Alzheimer's Disease Caregivers through Positive Emotion Regulation and Virtual Support

> **NIH NIH R43** · BRIGHTOUTCOME INC. · 2020 · $490,152

## Abstract

PROJECT SUMMARY
The prevalence of Alzheimer’s Disease (AD) and other dementias is steadily climbing and predicted to affect
as many as 16 million Americans by 2050. In 2016, 59% of dementia caregivers reported experiencing high
levels of emotional and physical stress, and the risk that the chronic stress of dementia caregiving places on
caregivers for developing a range of physical and mental health issues is extensively documented.
Caregiving-related stress contributes to social isolation, loneliness, and physical illness and increases the risk
of caregiver death. Interventions for dementia caregivers have primarily focused on reducing negative
emotions and burden. However, over the past few decades, it has become clear that positive emotions are
uniquely related to better psychological and physical well-being, independent of the effects of negative
emotion suggesting that an intervention that specifically targets positive emotion holds promise for improving
caregiver well-being and, ultimately, quality of care for the individual living with AD. Our recent randomized
trial of the positive emotion skills intervention, delivered by trained facilitators via the web in N = 170 family
caregivers of people with dementia resulted in significant improvements in caregiver psychological well being.
However, facilitator-delivered interventions are costly and difficult to implement with fidelity on a large scale.
Furthermore, a major challenge to advancing behavioral interventions delivered by trained facilitators is
assuring fidelity. We have developed a self-guided online version of the intervention that has shown feasibility
and acceptability in several samples, but this version does not capture the critical social connection aspects
of the facilitator-delivered intervention. We propose to take the next step toward closing the science-to-
practice gap for the positive emotion regulation intervention by tailoring the self-guided online version
specifically for dementia caregivers that incorporates the social connection components to combat the
loneliness and isolation experienced by many Alzheimer’s caregivers. The intervention, called SAGE LEAF
(Social Augmentation of self-Guided Electronic delivery of the Life Enhancing Activities for Family caregivers)
is in response to the National Institute on Aging’s PAR-18-588 “Assistive Technology for Person’s with
Alzheimer’s Disease and Related Dementias and Their Caregivers.” The SAGE LEAF intervention leverages
the lessons learned from the original LEAF project and adapts its positive emotion intervention to AD
caregivers in a self-guided format while incorporating social connection components and adaptive system
feedback mechanisms to promote intervention adherence.

## Key facts

- **NIH application ID:** 10019458
- **Project number:** 5R43AG065080-02
- **Recipient organization:** BRIGHTOUTCOME INC.
- **Principal Investigator:** JUDITH T. MOSKOWITZ
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $490,152
- **Award type:** 5
- **Project period:** 2019-09-30 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10019458

## Citation

> US National Institutes of Health, RePORTER application 10019458, SAGE LEAF:  Reducing Burden in Alzheimer's Disease Caregivers through Positive Emotion Regulation and Virtual Support (5R43AG065080-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10019458. Licensed CC0.

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