Family caregiver perspectives on administering home-based stimulation in patients with mild cognitive impairment

BackgroundWhile transcranial alternating current stimulation (tACS) shows therapeutic promise for neurological and psychiatric disorders when applied repeatedly, its potential is constrained by multiple laboratory visits.ObjectiveTraining caregivers to administer tACS at home could make therapy more practical, especially for vulnerable populations such as individuals with mild cognitive impairment (MCI). This study aimed to evaluate caregivers' perceptions and experiences of administering home-based tACS to MCI patients under remote clinical supervision.MethodsTwenty family caregivers (M age: 70 ± 12 years, 11 female) were trained to operate a six-electrode tACS device and administered 20 home-based sessions to MCI patients under real-time remote supervision. Quantitative ratings assessed caregivers' confidence, burden, and perceived benefits.ResultsCaregivers demonstrated high confidence in technical procedures (85-100% across tasks) and rated training as very satisfactory. The majority (85%) would feel comfortable administering tACS independently without remote support. Although most caregivers (70%) experienced daily life interference, nearly all (90%) would reuse the system. Clinically, 45% of caregivers observed patient benefits, and 57% of MCI patients believed sessions were beneficial. Effects on quality of life and memory were mixed, with some reporting mild deterioration, possibly reflecting natural disease progression or the double-blind design.ConclusionsCaregiver-administered home-based tACS proved feasible and acceptable among older caregivers (average age 70), despite daily life interference and mixed clinical perceptions. These findings support the expansion of caregiver-delivered protocols while emphasizing the importance of enhanced training and ongoing remote support to reduce the burden and optimize outcomes.Clinical trial registryhttps://clinicaltrials.gov/study/NCT05708001.