# The TBI-AD/ADRD Caregiver Support Intervention (TACSI): Protocol of a Pilot Randomized Controlled Trial Evaluation of a Remote Intervention for Family Caregivers

## TL;DR

This study tests a new support program for caregivers of people with both traumatic brain injury and Alzheimer's/dementia to see if it reduces stress and improves caregiving skills.

## Contribution

The TACSI program is the first intervention designed specifically for caregivers of individuals with dual diagnoses of TBI and AD/ADRD.

## Key findings

- The TACSI program will be evaluated for its impact on caregiver burden and relationship satisfaction.
- Qualitative interviews will provide insights into how the program benefits caregivers.
- The study will assess the feasibility of conducting a larger trial on this dual-diagnosis caregiver support.

## Abstract

Across the United States, there are millions of informal (ie, unpaid) caregivers helping individuals with Alzheimer Disease/Alzheimer Disease and Related Dementias (AD/ADRD), traumatic brain injury (TBI), or both. TBI is a risk factor for developing, and often co-occurs with, AD/ADRD. In the next decade, more informal caregivers will have to navigate the complexities of the dual diagnosis of TBI and AD/ADRD. Currently, there is a paucity of interventions for caregivers dealing with this dual diagnosis. Our team designed the TBI-AD/ADRD caregiver support intervention (TACSI) as a support program to meet the needs of those providing care to individuals with dual diagnoses of TBI and AD/ADRD.

This pilot randomized controlled trial (RCT) evaluates the preliminary efficacy and successful implementation of TACSI, a 6-session semistructured psychosocial and psychoeducational program, over a 6-month period.

This pilot RCT uses an embedded mixed methods randomized controlled evaluation. Caregivers of individuals with a dual diagnosis of AD/ADRD and a history of TBI are randomly assigned to the TACSI (n=41) or a usual care control condition (n=39). Primary outcomes include perceived burden, caregiver relationship satisfaction, and caregiving mastery. Secondary outcomes include caregiver self-efficacy, well-being, and personal resources. Qualitative elements (up to 20 semistructured interviews at the conclusion of the 6-month evaluation and an open-response item at follow-up surveys) allow for better interpretation of quantitative results and understanding of TACSI’s mechanisms of benefit.

Recruitment for the study was completed in October 2024. Survey collection and intervention were completed in June 2025. Data analysis will follow.

Having a dual diagnosis of AD/ADRD and a history of TBI is relatively common. However, there are currently no caregiver support interventions specific to this dual diagnosis. It is important to support these caregivers as they encounter the unique challenges of managing TBI and AD/ADRD. This pilot RCT will help determine if the TACSI program can help to increase caregiving skills and strategies and provide support to improve mood and reduce stress for caregivers of individuals with AD/ADRD and a history of TBI, and also determine if it is feasible to proceed to a full-scale RCT.