Effectiveness of Interventions to Support Carers of People With Dementia in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2025-02-27 DOI:10.1002/gps.70054

Frank Chen, Zhiwei Hu, Quan Li, Xuan Zheng, Meizhi Li, Maximilian Salcher-Konrad, Adelina Comas-Herrera, Martin Knapp, Cheng Shi, The STRiDE consortium

{"title":"Effectiveness of Interventions to Support Carers of People With Dementia in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis","authors":"Frank Chen, Zhiwei Hu, Quan Li, Xuan Zheng, Meizhi Li, Maximilian Salcher-Konrad, Adelina Comas-Herrera, Martin Knapp, Cheng Shi, The STRiDE consortium","doi":"10.1002/gps.70054","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>Family and other carers of people with dementia can potentially benefit from training and support to reduce the negative impacts of caregiving and prevent harm to care recipients. While interventions for carers in low- and middle-income countries (LMICs) are emerging, their effectiveness is not well understood. Through a systematic review and meta-analysis, the objective was to evaluate the effectiveness of interventions to support carers of people with dementia in improving the well-being of carers and their care recipients in LMICs.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This review, registered with PROSPERO (CRD42018106206), built on a systematic mapping of dementia interventions in LMICs under the Strengthening Responses to Dementia (STRiDE) project. It analysed evidence on interventions to support carers in these regions. Title and abstract screening, full-text review, data extraction and risk of bias assessment were each conducted by two reviewers independently, with disagreements resolved through group discussion. Pairwise meta-analyses were conducted, with robustness tested via leave-one-out analysis. Heterogeneity was explored using subgroup analysis, meta-regression and MetaForest. Medline, Embase, Global Health and PsycINFO (via Ovid) and CINAHL (via EBSCO) databases were searched. We included randomised control trials focused on carer well-being in LMICs, 2008–2022. Primary outcomes were perceived burden and depression; other health-related quantitative outcomes were collected.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>From 5228 records, 48 studies in English and Chinese were identified as eligible, reporting on 67 carer outcomes and 36 care recipient outcomes. Forty-one studies were at high risk of bias. Meta-analysis revealed statistically significant medium-to-large intervention effects on three key carer outcomes—perceived burden, depression, and anxiety—and on four major outcomes for people with dementia—neuropsychiatric symptoms, cognitive function, quality of life (QoL), and activities of daily living (ADL). These effects were larger than those typically observed in previous studies in high-income countries (HICs).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This review provides a comparative overview and summarises the characteristics of published interventions to support carers in LMICs. It reveals medium-to-large beneficial effects of the interventions on several key outcomes for carers and care recipients in LMICs. Future research employing more rigorous methodologies is recommended, particularly for broader and more diverse populations.</p>\n </section>\n </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":"40 3","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.70054","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Geriatric Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/gps.70054","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Family and other carers of people with dementia can potentially benefit from training and support to reduce the negative impacts of caregiving and prevent harm to care recipients. While interventions for carers in low- and middle-income countries (LMICs) are emerging, their effectiveness is not well understood. Through a systematic review and meta-analysis, the objective was to evaluate the effectiveness of interventions to support carers of people with dementia in improving the well-being of carers and their care recipients in LMICs.

Methods

This review, registered with PROSPERO (CRD42018106206), built on a systematic mapping of dementia interventions in LMICs under the Strengthening Responses to Dementia (STRiDE) project. It analysed evidence on interventions to support carers in these regions. Title and abstract screening, full-text review, data extraction and risk of bias assessment were each conducted by two reviewers independently, with disagreements resolved through group discussion. Pairwise meta-analyses were conducted, with robustness tested via leave-one-out analysis. Heterogeneity was explored using subgroup analysis, meta-regression and MetaForest. Medline, Embase, Global Health and PsycINFO (via Ovid) and CINAHL (via EBSCO) databases were searched. We included randomised control trials focused on carer well-being in LMICs, 2008–2022. Primary outcomes were perceived burden and depression; other health-related quantitative outcomes were collected.

Results

From 5228 records, 48 studies in English and Chinese were identified as eligible, reporting on 67 carer outcomes and 36 care recipient outcomes. Forty-one studies were at high risk of bias. Meta-analysis revealed statistically significant medium-to-large intervention effects on three key carer outcomes—perceived burden, depression, and anxiety—and on four major outcomes for people with dementia—neuropsychiatric symptoms, cognitive function, quality of life (QoL), and activities of daily living (ADL). These effects were larger than those typically observed in previous studies in high-income countries (HICs).

Conclusions

This review provides a comparative overview and summarises the characteristics of published interventions to support carers in LMICs. It reveals medium-to-large beneficial effects of the interventions on several key outcomes for carers and care recipients in LMICs. Future research employing more rigorous methodologies is recommended, particularly for broader and more diverse populations.

Abstract Image

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.