Abstract
BackgroundInformal caregivers of persons living with dementia have an increased risk of adverse mental health effects. It is therefore important to systematically summarize published literature in order to find out which mental health interventions generate effective support for informal caregivers of persons living with dementia. The objective of this study is to conduct a systematic review of intervention content, effectiveness and subgroup differentiation of mental health interventions for informal caregivers of persons with dementia living at home.MethodWe searched four electronic databases (PubMed, PsychINFO, Scopus and CINAHL) and included only methodically high-quality randomized controlled trials (RCTs), published in English or German language between 2009 and 2018. The intervention programmes focused on mental health of family caregivers. A narrative synthesis of the included studies is given.ResultsForty-eight publications relating to 46 intervention programmes met the inclusion criteria. Burden, depression and quality of life (QoL) are the predominant parameters that were investigated. Twenty-five of forty-six interventions (54.3%) show positive effects on at least one of the outcomes examined. Most often, positive effects are reported for the outcome subjective burden (46.2%). Only six studies explicitly target on a certain subgroup of informal dementia caregivers (13%), whereas all other interventions (87%) target the group as a whole without differentiation.ConclusionThe most beneficial results were found for cognitive behavioural approaches, especially concerning the reduction of depressive symptoms. Besides this, leisure and physical activity interventions show some good results in reducing subjective caregiver burden. In order to improve effectiveness, research and practice may focus on developing more targeted interventions for special dementia informal caregiver subgroups.
Highlights
Informal caregivers of persons living with dementia have an increased risk of adverse mental health effects
This review aims to provide an update on high quality psychosocial intervention studies on mental health promotion for informal caregivers of persons living with dementia, describing intervention effects on key mental health outcomes
The content aspect plays an important role in the further course of the analysis, because individual studies are assigned to these umbrella categories and effects of the interventions on caregivers mental health is compared based on these categories
Summary
Informal caregivers of persons living with dementia have an increased risk of adverse mental health effects. The objective of this study is to conduct a systematic review of intervention content, effectiveness and subgroup differentiation of mental health interventions for informal caregivers of persons with dementia living at home. Informal caregivers - predominantly family and friends - provide a majority of dementia care, estimated to represent 40% of the total cost of dementia worldwide [4]. As models suggest, this unpaid work is mainly performed by women, contributing to 71% of the global hours of informal dementia care work [5]. Most of dementia care is provided in the private sphere, with differences according to the world region. The estimated proportion of persons with dementia cared for at home is 84% [5]
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