Systematic review and meta-analysis of psychological interventions for informal dementia caregivers
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Purpose: This review evaluates the impact of intervention studies for informal dementia caregivers. Methods: Meta-analytic methods were used to integrate the findings of 14 intervention studies evaluating the cognitive behaviour therapy for caregivers. Meta-regression and analysis of variance were used to evaluate the impact of caregiver and intervention characteristics on the outcomes. Results: Significant effects sizes were found for the impact of CBT on depression, burden, and mental health difficulties, g* = -0.55, 95% CI [-0.92, -0.19], g *= -0.37, 95% CI [-0.57, - 0.17], and g* = -0.54, 95% CI [-0.78, -0.30], respectively. CBT facilitated more adaptive coping, with significant effects on caregiver adaptive coping and dysfunctional thoughts, g* = 0.48, 95% CI (0.02, 0.24) and g* = -1.33, 95% CI (-2.22, -0.44). The impact of CBT on caregiver outcomes was associated with the nature of the study control condition, and the intervention delivery, timing and specificity to dementia type. Caregiver ethnicity and gender were not predictive of the CBT outcome. Implications: Overall, caregiver interventions are efficacious in alleviating caregiver distress and facilitating more adaptive coping responses, with prominent effects established for CBT. Future research needs to consider CBT as part of multi-intervention approach tailored to the needs of caregivers across the disease progression. Further improvements are needed, with greater consideration of the impact of the intervention design in alleviating caregiver distress.