The effectiveness of psychosocial and behavioral interventions for informal dementia caregivers: Meta-analyses and meta-regressions

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Abstract

Background: 

Many psychosocial and behavioral interventions have been developed for informal dementia caregivers. Because existing meta-analyses only focused on a limited number of interventions and outcomes, how effective these interventions are overall and which interventions components are associated with larger effects has yet to be explored.

Objective: 

To provide a comprehensive meta-analysis of the effectiveness of psychosocial and behavioral interventions on burden, depression, anxiety, quality of life, stress, and sense of competence in informal dementia caregivers. In addition, we examined if interventions which utilized more sessions and/or were delivered personally (face-to-face) had larger effect sizes. In exploratory meta-regressions, we examined seven additional moderators.

Methods: 

The protocol was registered with PROSPERO, number CRD42017062555. We systematically searched the literature to identify controlled trials assessing the effect of psychosocial and behavioral interventions on the six outcome measures, for informal dementia caregivers. We performed six random effects meta-analyses, to assess the pooled effect sizes of the interventions. In addition, we performed separate meta-regressions, for each outcome, for each moderator.

Results: 

The sample consisted of 60 studies. For all outcomes except anxiety, the pooled effects were small and in favor of the intervention group. No moderator was found to systematically predict these effects. There were no indications for publication bias or selection bias based on significance.

Conclusion: 

Overall, the interventions yield significant (small) effects, independent of intervention characteristics. Future research should explore options to enhance the effectiveness of interventions aimed at assisting informal caregivers.

Original languageEnglish
Pages (from-to)149-172
JournalJournal of Alzheimers Disease
Volume66
Issue number1
DOIs
Publication statusPublished - 2018

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Caregivers
Publication Bias
Selection Bias
Mental Competency
Depression

Keywords

  • ALZHEIMERS-DISEASE
  • Burden
  • CONDUCTING METAANALYSES
  • DEPRESSIVE SYMPTOMS
  • FAMILY CAREGIVERS
  • HONG-KONG
  • QUALITY-OF-LIFE
  • RANDOMIZED CONTROLLED-TRIAL
  • SYSTEMATIC REVIEWS
  • TELEPHONE SUPPORT
  • TRAINING-PROGRAM
  • dementia
  • depression
  • informal caregivers
  • interventions
  • meta-analysis
  • meta-regression
  • psychobehavioral
  • psychosocial

Cite this

@article{9783f065709f48b6943f2cfd4bffc406,
title = "The effectiveness of psychosocial and behavioral interventions for informal dementia caregivers: Meta-analyses and meta-regressions",
abstract = "Background: Many psychosocial and behavioral interventions have been developed for informal dementia caregivers. Because existing meta-analyses only focused on a limited number of interventions and outcomes, how effective these interventions are overall and which interventions components are associated with larger effects has yet to be explored.Objective: To provide a comprehensive meta-analysis of the effectiveness of psychosocial and behavioral interventions on burden, depression, anxiety, quality of life, stress, and sense of competence in informal dementia caregivers. In addition, we examined if interventions which utilized more sessions and/or were delivered personally (face-to-face) had larger effect sizes. In exploratory meta-regressions, we examined seven additional moderators.Methods: The protocol was registered with PROSPERO, number CRD42017062555. We systematically searched the literature to identify controlled trials assessing the effect of psychosocial and behavioral interventions on the six outcome measures, for informal dementia caregivers. We performed six random effects meta-analyses, to assess the pooled effect sizes of the interventions. In addition, we performed separate meta-regressions, for each outcome, for each moderator.Results: The sample consisted of 60 studies. For all outcomes except anxiety, the pooled effects were small and in favor of the intervention group. No moderator was found to systematically predict these effects. There were no indications for publication bias or selection bias based on significance.Conclusion: Overall, the interventions yield significant (small) effects, independent of intervention characteristics. Future research should explore options to enhance the effectiveness of interventions aimed at assisting informal caregivers.",
keywords = "ALZHEIMERS-DISEASE, Burden, CONDUCTING METAANALYSES, DEPRESSIVE SYMPTOMS, FAMILY CAREGIVERS, HONG-KONG, QUALITY-OF-LIFE, RANDOMIZED CONTROLLED-TRIAL, SYSTEMATIC REVIEWS, TELEPHONE SUPPORT, TRAINING-PROGRAM, dementia, depression, informal caregivers, interventions, meta-analysis, meta-regression, psychobehavioral, psychosocial",
author = "J{\"u}tten, {Linda H} and Mark, {Ruth E} and Wicherts, {Jelte M} and Sitskoorn, {Margriet M}",
year = "2018",
doi = "10.3233/JAD-180508",
language = "English",
volume = "66",
pages = "149--172",
journal = "Journal of Alzheimers Disease",
issn = "1387-2877",
publisher = "IOS Press",
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TY - JOUR

T1 - The effectiveness of psychosocial and behavioral interventions for informal dementia caregivers

T2 - Meta-analyses and meta-regressions

AU - Jütten, Linda H

AU - Mark, Ruth E

AU - Wicherts, Jelte M

AU - Sitskoorn, Margriet M

PY - 2018

Y1 - 2018

N2 - Background: Many psychosocial and behavioral interventions have been developed for informal dementia caregivers. Because existing meta-analyses only focused on a limited number of interventions and outcomes, how effective these interventions are overall and which interventions components are associated with larger effects has yet to be explored.Objective: To provide a comprehensive meta-analysis of the effectiveness of psychosocial and behavioral interventions on burden, depression, anxiety, quality of life, stress, and sense of competence in informal dementia caregivers. In addition, we examined if interventions which utilized more sessions and/or were delivered personally (face-to-face) had larger effect sizes. In exploratory meta-regressions, we examined seven additional moderators.Methods: The protocol was registered with PROSPERO, number CRD42017062555. We systematically searched the literature to identify controlled trials assessing the effect of psychosocial and behavioral interventions on the six outcome measures, for informal dementia caregivers. We performed six random effects meta-analyses, to assess the pooled effect sizes of the interventions. In addition, we performed separate meta-regressions, for each outcome, for each moderator.Results: The sample consisted of 60 studies. For all outcomes except anxiety, the pooled effects were small and in favor of the intervention group. No moderator was found to systematically predict these effects. There were no indications for publication bias or selection bias based on significance.Conclusion: Overall, the interventions yield significant (small) effects, independent of intervention characteristics. Future research should explore options to enhance the effectiveness of interventions aimed at assisting informal caregivers.

AB - Background: Many psychosocial and behavioral interventions have been developed for informal dementia caregivers. Because existing meta-analyses only focused on a limited number of interventions and outcomes, how effective these interventions are overall and which interventions components are associated with larger effects has yet to be explored.Objective: To provide a comprehensive meta-analysis of the effectiveness of psychosocial and behavioral interventions on burden, depression, anxiety, quality of life, stress, and sense of competence in informal dementia caregivers. In addition, we examined if interventions which utilized more sessions and/or were delivered personally (face-to-face) had larger effect sizes. In exploratory meta-regressions, we examined seven additional moderators.Methods: The protocol was registered with PROSPERO, number CRD42017062555. We systematically searched the literature to identify controlled trials assessing the effect of psychosocial and behavioral interventions on the six outcome measures, for informal dementia caregivers. We performed six random effects meta-analyses, to assess the pooled effect sizes of the interventions. In addition, we performed separate meta-regressions, for each outcome, for each moderator.Results: The sample consisted of 60 studies. For all outcomes except anxiety, the pooled effects were small and in favor of the intervention group. No moderator was found to systematically predict these effects. There were no indications for publication bias or selection bias based on significance.Conclusion: Overall, the interventions yield significant (small) effects, independent of intervention characteristics. Future research should explore options to enhance the effectiveness of interventions aimed at assisting informal caregivers.

KW - ALZHEIMERS-DISEASE

KW - Burden

KW - CONDUCTING METAANALYSES

KW - DEPRESSIVE SYMPTOMS

KW - FAMILY CAREGIVERS

KW - HONG-KONG

KW - QUALITY-OF-LIFE

KW - RANDOMIZED CONTROLLED-TRIAL

KW - SYSTEMATIC REVIEWS

KW - TELEPHONE SUPPORT

KW - TRAINING-PROGRAM

KW - dementia

KW - depression

KW - informal caregivers

KW - interventions

KW - meta-analysis

KW - meta-regression

KW - psychobehavioral

KW - psychosocial

U2 - 10.3233/JAD-180508

DO - 10.3233/JAD-180508

M3 - Article

C2 - 30248057

VL - 66

SP - 149

EP - 172

JO - Journal of Alzheimers Disease

JF - Journal of Alzheimers Disease

SN - 1387-2877

IS - 1

ER -