The efficacy of psychosocial interventions in relieving family caregiver burden in older adults with disabilities: a systematic review and network meta-analysis

Background Caregiver burden is a significant challenge for those caring for older adults with disabilities. This review aims to assess the most effective psychosocial interventions for reducing family caregiver burden, focusing on overall effectiveness, care recipients with cognitive impairment and home-based interventions. Methods Seven major databases (PubMed, Web of Science, Embase, Scopus, Cochrane Library, PsycINFO and CINAHL) were systematically searched until 2 October 2024. Continuous outcomes were assessed using standardised mean differences (SMDs) and 95% confidence intervals (CIs). Intervention rankings relied on surface under the cumulative ranking curve (SUCRA) values. Results In 31 trials with 4687 participants, comparing psychoeducation (n = 14), cognitive behavioural therapy (CBT) (n = 9), reminiscence therapy (n = 2), family caregiver support programmes (n = 2), mindfulness-based interventions (MBIs) (n = 2), progressive muscle relaxation (n = 1) and music therapy (n = 1), MBIs (SMD = −6.67, 95% CI: −12.94, −0.41) significantly reduced caregiver burden and ranked highest (SUCRA, 79.2%; mean rank, 2.4). In studies with care recipients with cognitive impairment, MBIs substantially reduced burden (SMD = −17.06, 95% CI: −25.02, −9.10) and held the top ranking (SUCRA, 98.7%; mean rank, 1.2). In studies conducted in caregivers' homes, CBT remained highly effective (SMD = −5.57, 95% CI: −8.59, −2.90) and ranked highest (SUCRA, 95.7%; mean rank, 1.2). Conclusions This network meta-analysis highlights the effectiveness of psychosocial interventions in reducing caregiver burden. MBIs were most effective, particularly for caregivers of individuals with cognitive impairment, while CBT was highly effective in home-based settings. These findings underscore the importance of context-specific strategies.