Table 2.
Characteristics of Intervention studies with patients with dementia and caregivers*.
| Authors, Year | CountryStudy Design | Outcome measures | Sample SizeMean age (SD) | Intervention Tool used | Main Results |
|---|---|---|---|---|---|
| Bartels et al. (15) | The Netherlands A single-blinded randomized controlled trial |
To examine the sustainability of positive intervention effects of the mobile health intervention on caregivers’ well-being | Total: n = 76 caregivers (72.1 ± 8.4) Experimental group: n = 26 (71.7 ± 8.4) Pseudo-experimental: n = 24 (71.1 ± 7.3) Control group: n = 26 (73.2 ± 9.4) |
SSCQ, PSS, PMS, CES-D, HADS-A, NPI-Q, CDR | The results obtained showed that the intervention “Partner in Sight” can reduce feelings of stress, depressive symptoms and enhance a sense of competence in caregivers. |
| Brown et al. (16) | United States Randomized controlled trial |
To test the efficacy of MBSR program for reducing caregiver stress and enhancing the care giver-recipient relationship | Total: 38 caregivers (MBSR group n = 23, SS group n = 15). Age of participants: 61.14 ± 10.41 (39–88 years) |
MBSR program | Caregiver participants in MBSR reported lower levels of stress, tension and anger. The SS intervention highlighted an understanding and acceptance of dementia behaviors, which can help to reduce the perceived burden. |
| Bruvik et al. (17) | Norway Assessor-blinded multicenter RCT |
To describe a multicomponent tailored psychosocial intervention trial design to reduce depressive symptoms in PWD and caregivers | Total: 230 dyads of home-dwelling PWD and a principle family caregiver Intervention group (n = 115): caregiver 64.1 ± 12.2, PwD 78.3 ± 7.5; Control group (n = 115): caregiver 62.9 ± 11.4, PwD 78.5 ± 7.5 |
CSDD, GDS, RRS Norwegian version, MMSE NV, NPI-Q, PSMS, IADL | The study did not find that a structured, multicomponent and tailored psychosocial intervention program significantly reduced depressive symptoms in PWD or their family caregivers compared to usual care. |
| Burns et al. (18) | USA, Australia and the UK Randomized controlled trial |
To assess whether caregiver interventions can still be successful when anti-dementia drugs are provided to patients | 158 dyads divided equally across three centers: Sydney (n = 52), New York (n = 52) and Manchester (n = 54). Sydney: Patients 75.0 mean age (58–89 years), caregivers 71.8 (53–86); Manchester: Patients 72.7 (52–91), caregivers 72.2 (49–88); New York: Patients 73.6 (55–89), caregivers 70.2 (47–88). |
MMSE, GDS, BAI, RMBPC, BDI, Stokes Social Network List, WFCS, PMS, EuroQol, | The caregiver intervention was associated with positive results on caregiver depression across all the countries. |
| Dahlrup et al. (22) | Sweden A quasi-experimental longitudinal cohort study |
To examine the effects of a psychosocial intervention for family caregivers in describing symptoms of dementia | Intervention group: n = 129 (61 ± 12.9) Control group: n = 133 (62 ± 12.6) PWD: n = 144 (85 ± 5.9); |
MMSE, GBS-scale, The Berger scale, IADL | The family caregivers who underwent psychosocial intervention achieved a better understanding of different symptoms and the behaviors of dementia. |
| Davis et al. (23) | United States Randomised controlled trial |
To study the preliminary efficacy of a telephone intervention (FITT-NH) for improving dementia caregivers’ adjustment | Total: 27 caregivers assigned to FITT-NH and 26 to the non-contact control condition. Caregivers in the intervention group: 57.25 ± 10.67 Care recipient: 82.54 ± 5.48 Caregivers in the control group: 61.32 ± 10.46 Care recipient: 82.73 ± 9.05 |
FITT-NH | Caregivers receiving FITT-NH showed reduced guilt feelings and more staff positive interactions compared to those caregivers with no additional contact. |
| Den IJssel et al. (24) | The Netherlands Cluster randomized controlled trial |
To evaluate the effect of the intervention on nursing staff burnout, job satisfaction, and job demands. | nursing staff: n = 305 (43.5 years ± 12.2) |
APID, NPI-Q, CANE Dutch version, UBOS DV, Leiden Quality of Work Questionnaire | The intervention showed no additional improvement in three dimensions of burnout, job satisfaction and job demands. |
| Gaugler et al. (25) | United States A single-blinded randomized controlled trial |
To evaluate the effects of NYUCI-AC on decreases in family and role conflict and increases in perceived social support | Total n = 107 (treatment group n = 54 and control group n = 53). Total: 50.46 ± 8.24 Control: 49.68 ± 9.36 Treatment: 51.23 ± 6.95 |
NYUCI-AC | Effectiveness in reducing residential long term care placement for persons with ADRD and adult child caregivers’ adverse reactions to disruptive behavior problems, and depressive symptoms. |
| Johannessen et al. (26) | Norway Randomized controlled trial |
To investigate the outcome of the study from the perspective of the healthcare professionals | 19 health professionals 34–61 years |
Psychoeducation of dementia and the management of its symptoms. | The intervention can prevent burnout of the primary caregivers and social isolation and thereby promote health. |
| Johannessen et al. (27) | Norway Randomized controlled trial |
To investigate family caregivers’ experiences of a multicomponent psychosocial intervention program | 20 family caregivers 50–82 years |
Individual qualitative interviews and a psychosocial intervention program | It contributed to reducing the burden and loneliness caused by the disorder. |
| Koivisto et al. (28) | Finland Randomized controlled trial |
To assess the influence of the intervention on AD progression, behavioral symptoms, and HRQoL | 236 dyads of home-dwelling persons with AD and their family caregivers (control group n = 152; intervention group n = 84) | CDR-SOB, CERAD-NB, MMSE, ADCS-ADL, NPI, QoL-AD, VAS, BDI, SOC, 12-GHQ, 15D | The present study did not show any long-term effect of the early psychosocial intervention. |
| Langhammer et al. (29) | Norway Exploratory design |
To evaluate whether a combined intervention of physical activity and music therapy could reduce anxiety, restlessness, irritability, and aggression | 6 individuals with dementia and signs of frontal lobe problems PwD: n = 6 (75.6 ± 6.52) Caregiver: n = 6 (65.6 years ± 11.9) Mean age of 84.3 years |
BVC, NPI-Q, Semi-structured interviews | Implementation of individualized music therapy combined with increased physical activity for eight weeks was a feasible intervention that reduced anxiety, restlessness, irritability, and aggression in the current study. |
| Liang et al. (30) | New Zealand Pilot block randomized controlled trial |
To investigate the affective, social, behavioral, and physiological effects of the companion robot Paro for PwD | 30 dyads (PwD and caregivers) PwD age range: 67–98 years Caregivers age range: 30–86 years |
Paro | Paro helped improve mood, reduce anxiety, acting as a social stimulus, and increasing communication and cooperation with therapists and staff. |
| Lord et al. (31) | United Kingdom Randomized controlled trial |
To evaluate the dissemination of the program Strategies for Relatives (START) | 134 clinical psychologists and 39 admiral nurses - |
START, individual interview | The study began the new intervention dissemination process. |
| McCurry et al. (32) | United States A randomized, controlled trial with blinded assessors |
To test the effects of walking, light exposure, and a combination intervention (walking, light, and sleep education) on the sleep of persons with Alzheimer’s disease | 132 AD participants and their caregivers Walking: 82.2 ± 8.50 Light: 80.6 ± 7.3 NITE-AD: 80.0 ± 8.2 Control: 81.2 ± 8.0 |
SDI, Actigraph, CSDD, SCQ, MMSE | To test the effects of walking, light exposure, and a combination intervention (walking, light, and sleep education) on the sleep of persons with Alzheimer’s disease |
| McCurry et al. (33) | United States Randomized controlled trial |
To investigate the feasibility of implementing a Sleep Education Program (SEP) for improving sleep in an adult family home (AFH) residents with dementia, and the relative efficacy of SEP compared with usual care control | 37 adult family home (AFH) staff-caregivers and 47 residents with co-morbid dementia and sleep disturbances. AFH staff-caregivers: 86.6 ± 7.2 Residents: 48.2 ± 9.7 |
Actigraphy, CSDD, RMBPC, ESS | To investigate the feasibility of implementing a Sleep Education Program (SEP) for improving sleep in an adult family home (AFH) residents with dementia, and the relative efficacy of SEP compared with usual care control |
| Moyle et al. (34) | New Zealand Randomized controlled trial |
To compare a lifelike baby doll intervention for reducing agitation and aggression in older people with dementia in long-term care (LTC) | Total: 35 residents from five LTC facilities (Lifelike Doll n = 18, Usual Care n = 15). Total: 87.8 years ± 8.6 Intervention group: 86.1 ± 8.6 Control 89.7 (8.4) |
Semi-structured interview, OERS, CMAI-SF, MMSE, NPI-NH | There was no statistical evidence to support the hypothesis that the lifelike baby doll intervention would reduce residents’ anxiety, agitation, and aggression. |
| Orrell et al. (35) | United Kingdom A single-blind pragmatic randomized controlled trial |
To evaluate the effectiveness of a home-based, caregiver-led (iCST) program in (i) improving cognition and QoL for the PwD and (ii) mental and physical health for the caregiver. | A total of 356 dyads iCST group: n = 180 TAU group: n = 176 |
To evaluate the effectiveness of a home-based, caregiver-led (iCST) program in (i) improving cognition and QoL for the PwD and (ii) mental and physical health for the caregiver. | |
| Pihet et al. (36) | Switzerland Quasi-experimental intervention that followed the TIDieR guidelines |
To examine the feasibility and the effects of implementing the program and the participants’ use of the trained strategies | 26 ICD through service providers in the field of dementia ICD median age of 68 years (Q1 = 60, Q3 = 72, range 37–86); Patients median age of 77 years (Q1 = 71, Q3 = 82, range 56–94) |
Caregiver’s burden 22-items questionnaire, MBP, caregiver’s MBP-related distress, Ilfeld short version, VAS | The program resulted in substantial improvements in burden, psychological distress, self-efficacy and the increasing ICD quality of life. |
| Phung et al. (37) | Denmark Multicentre, randomized controlled rater-blinded trial |
36-month follow-up to rate changes in behavioral symptoms and quality of life of both PwD and caregivers in 5 Danish districts | Counseling, psychosocial support; 163 patients to DAISY intervention group and 167 to control group | QoL-AD NPI ADCS-ADL GDS EQ-VAS |
The 12-month follow-up study observed positive effects on preventing depressive symptoms and maintaining the quality of life among PwD. No effects were found on the caregiver’s quality of life after a 360-month follow-up. |
| Schall et al. (38) | Germany Randomized, wait-list controlled design |
To relieve the sense of isolation experienced by many PwD, as well as the burden on family caregivers | 44 PwD Intervention group n = 25, Wait-list control group n = 19). Intervention Group: 75.1 ± 7.70 Wait-list control group: 76.4 ± 8.68 |
ARTEMIS | ARTEMIS intervention provided positive effects on the emotional well-being and the self-assessment of quality of life in PwD and a reduction in apathy and depressive symptoms. |
| Shata et al. (39) | Egypt Randomized controlled trial |
To develop and evaluate the efficacy of a multicomponent psychosocial intervention program for informal caregivers of persons with NCDs | 114 patients (Intervention group n = 55 and control group n = 59) PWD: age range 61 -86 years: 69.29 ± 6.24 years. Total: 48.63 years (12.31); Intervention: 49.35 ± 11.89; Control: 47.97 ± 12.76 |
MMSE, Caregivers’ Dementia-related Knowledge Questionnaire, HDRS Arabic version, TMAS, ZBI, DRKQ | The study provided evidence for the short-term efficacy of a culturally sensitive multicomponent psychosocial intervention program in improving Dementia-related knowledge and the emotional status of informal caregivers of people with NCDs. |
| Søgaard et al. (40) | Denmark Randomized controlled trial |
To investigate the impact of an early psychosocial intervention aimed at patients with Alzheimer’s disease (AD) and their caregivers | 330 dyads Intervention group n = 163 and control group n = 167. | RUD | An AD intervention may burden the caregiver more than it saves costs in proper health care and institutionalization. |
| Søgaard et al. (41) | Denmark Randomized controlled trial |
To assess the cost-utility of early psychosocial intervention for patients with Alzheimer’s disease and their caregivers. | Patients in the intervention group 76 years (8), caregivers 65 (13); Patients in the control group 75 (7), caregivers 66 (13) ≥50 years | RUD, EQ-5D, QALY | Psychosocial intervention is unlikely to be cost-effective in a Danish setting because it did not generate additional QALYs, and it led to the higher average usage of informal care. |
| Tremont et al. (42) | United States Randomized controlled trial |
To examine the efficacy of the FITT-C to reduce depressive symptoms and burden in distressed dementia caregivers | 250 dyads Caregivers – total sample: ± Intervention group: n = 133 (63.32 ± 12.30) Telephone support: n = 117 62.03 ± 13.75 PwD total sample: 78.06 ± 10.06, Intervention group: 79.22 ± 9.11 Control: 76.74 ± 10.93 |
FITT-C | The study demonstrated the equivalence of face-to-face and telephone assessments on two of the primary outcome measures (depressive symptoms, perceived burden, and reaction to memory and behavior problems). |
| Tremont et al. (43) | New England Randomize controlled trial |
To examine the efficacy of Telephone Tracking-Dementia (FITT-D) and telephone support (TS) to promote psychoeducation, problem-solving, and a directive approach to behavioral disturbances. | ≥50 years Intervention group: caregivers: 65.75 ± 13.71 Care recipient 75.94 ± 9.14; Control caregivers: 61.00 ± 9.60 PwD: 75.29 ± 10.79 |
FITT-D | Caregivers receiving the FITT-C used community support services more often than those receiving TS (P = .02). FITT-C caregivers had a significantly lower rate of emergency department visits (rate difference 9.5%, P = .048) and hospital stays (rate difference 11.4%, P = .01) over the 6-month course of the intervention than TS caregivers. |
*Tables 1 and 2: references are available at the Supplementary Material .