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A comprehensive meta-review of systematic reviews and meta-analyses on nonpharmacological interventions for informal dementia caregivers.

BMC geriatrics
January 1, 1970
Sheung-Tak Cheng et al. (2 authors)
Journal ArticleMeta-AnalysisHuman Study
Study Details

Study Goal

The researchers aimed to synthesize findings from systematic reviews and meta-analyses on dementia caregiver interventions, including mindfulness-based interventions, to clarify their effectiveness.

Results Summary

Mindfulness-based interventions were found to be effective in reducing depression among dementia caregivers, alongside other interventions like psychoeducation and psychotherapy. However, no intervention type, including mindfulness, had broad effects across all caregiver outcomes.

Population

Dementia caregivers

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (19)
InterventionDirectionEndpointPopulationDosageImpactClaim #
psychoeducation
decrease
depression
dementia caregivers
-
effects found
#1
counseling/psychotherapy
decrease
depression
dementia caregivers
-
effects found
#2
occupational therapy
decrease
depression
dementia caregivers
-
effects found
#3
mindfulness-based interventions
decrease
depression
dementia caregivers
-
effects found
#4
multicomponent interventions
decrease
depression
dementia caregivers
-
effects found
#5
psychoeducation
increase
quality of life
dementia caregivers
-
evidence of intervention effect
#6
psychoeducation
increase
mastery
dementia caregivers
-
evidence of intervention effect
#7
occupational therapy
increase
mastery
dementia caregivers
-
evidence of intervention effect
#8
multicomponent interventions
increase
mastery
dementia caregivers
-
evidence of intervention effect
#9
communication training
increase
communication skills
dementia caregivers
-
evidence of intervention effect
#10
-
no change
anxiety
dementia caregivers
-
null or weak results
#11
-
no change
social support
dementia caregivers
-
null or weak results
#12
-
no change
burden
dementia caregivers
-
null or weak results
#13
support groups
no change
-
dementia caregivers
-
generally ineffective
#14
respite
no change
-
dementia caregivers
-
generally ineffective
#15
dyadic programs
no change
-
dementia caregivers
-
no evidence that they were better
#16
programs delivered individually
no change
-
dementia caregivers
-
no evidence they would differ
#17
programs delivered in groups
no change
-
dementia caregivers
-
no evidence they would differ
#18
multicomponent interventions
no change
-
dementia caregivers
-
no evidence to have broader impacts
#19
Abstract

BACKGROUND: Many reviews with conflicting findings on dementia caregiver interventions have been published. A meta-review was conducted to synthesize the findings of systematic reviews and meta-analyses. METHODS: MEDLINE, PsycINFO, CINAHL and Cochrane Library were searched to identify reviews published during 2006-2018. RESULTS: Sixty reviews covering > 500 intervention studies were selected and appraised with Assessment of Multiple Systematic Reviews (AMSTAR) II. The great majority of studies were of low quality according to AMSTAR II, but quality factors appeared unrelated to the conclusions obtained. Depression was most modifiable, with effects found across a spectrum of interventions (psychoeducation, counseling/psychotherapy, occupational therapy, mindfulness-based interventions, multicomponent interventions, etc.). Evidence of intervention effect was also found for quality of life (psychoeducation), mastery (psychoeducation, occupational therapy and multicomponent interventions) and communication skills (communication training). Null or weak results were found for anxiety, social support and burden. Support groups and respite were generally ineffective. There was no evidence that dyadic programs were better than caregiver-only programs, or that programs delivered individually or in groups would differ in their impacts. The evidence also does not support multicomponent interventions to have broader impacts than single-component programs. Methodological issues in the existing reviews (e.g., selective use of studies to serve different research purposes and inconsistent classification of interventions) were noted and taken into account when interpreting findings. CONCLUSIONS: This meta-review clarified variations in review methodology and identified a few potent groups of intervention (most notably psychoeducation, psychotherapy, occupational therapy, and multicomponent interventions), although no intervention type had broad effects on caregiver outcomes. We note that improvements are needed in the reporting of intervention studies and in making the classification of interventions more transparent and consistent. We further recommend fewer and larger-scale reviews and more attention to positive outcomes in order to better inform the field. Developing interventions with broader impacts and packaging them to meet caregivers' changing needs in the course of dementia should be a priority for researchers and practitioners.

Medical Subject Headings (MeSH)
AnxietyCaregiversDementiaDepressionHumansQuality of LifeSocial SupportSystematic Reviews as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality85/10
Citation Metrics
Total Citations81
Citations/Year16.2
Relative Citation Ratio8.02
NIH Percentile96.8%
Research Impact Scores
APT Score0.95
Weight Score2.00
Normalized Score0.65
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