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Which interventions work for dementia family carers?: an updated systematic review of randomized controlled trials of carer interventions

Published online by Cambridge University Press:  18 July 2018

Naoko Kishita ,
Laura Hammond ,
Celina M. Dietrich  and
Eneida Mioshi
Naoko Kishita*
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, Norfolk, UK
Laura Hammond
Affiliation:
Research Development Programme, Norfolk and Suffolk NHS Foundation Trust, Norwich, Norwich, UK
Celina M. Dietrich
Affiliation:
Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
Eneida Mioshi
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, Norfolk, UK
*
Correspondence should be addressed to: Dr. Naoko Kishita, School of Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK. Phone: +44-1603-593599. Email: N.Kishita@uea.ac.uk.
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Abstract

Objective:

The aim of this study was to update the literature on interventions for carers of people with dementia published between 2006 and 2016 and evaluate the efficacy of psychoeducational programs and psychotherapeutic interventions on key mental health outcomes (depression, anxiety, burden, and quality of life).

Methods:

A meta-analysis was carried out of randomized controlled trials of carer interventions using MEDLINE, PsycINFO, Scopus, and Cochrane Central Register of Controlled Trials.

Results:

The majority of studies were conducted in Western and Southern Europe or the United States and recruited carers of people with Alzheimer's disease or dementia grouped as a whole. The most commonly used outcome measures were depression and burden across studies. The updated evidence suggested that psychoeducation-skill building interventions delivered face-to-face can better impact on burden. Psychotherapeutic interventions underpinned by Cognitive Behavior Therapy (CBT) models demonstrated strong empirical support for treating anxiety and depression and these effects were not affected by the mode of delivery (i.e. face-to-face vs. technology). A modern CBT approach, Acceptance and Commitment Therapy (ACT), seemed to be particularly beneficial for carers experiencing high levels of anxiety.

Conclusions:

Future research needs to explore the efficacy of interventions on multiple clinical outcomes and which combination of interventions (components) would have the most significant effects when using CBT. The generalization of treatment effects in different countries and carers of different types of dementia also need to be addressed. More research is needed to test the efficacy of modern forms of CBT, such as ACT.

Keywords

caregiverdementiaAlzheimer's diseasepsychological interventionscognitive behavioral therapymeta-analysis
Type
Review Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 11: Social Aspects of Dementia and Dementia Practice , November 2018 , pp. 1679 - 1696
Copyright
Copyright © International Psychogeriatric Association 2018 

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