Effectiveness of Interventions on Dementia Caregivers' Subjective Well-Being in Northeast Asian Countries: A Systematic Review and Meta-Analysis

Background and Purpose: Taking care of dementia patients can have a negtive effect on caregivers' mental health. Northeast Asia is of the most populous regions and has a great number of older adults. This study aims to assess whether intervention programs for caregivers of dementia patients in Northeast Asian countries are effective on caregivers’ subjective well-being.

Methods: Pubmed, Web of Science, PsycINFO, and Professional Development Collection were searched. Randomised controlled trials (RCT), cohort study, and pre-post study are eligible. Formal or informal dementia caregivers in Northeast Asian countries are study population. Two authors independently assessed studies for eligibility, assessed risk of bias and extracted data.

Results: We screened 2072 citations and included nine of them with 594 participants. All of the caregivers are families or relatives of dementia patients. Meta-analysis of three trials showed a small effect on caregivers’ burden (Standardized Mean Difference (SMD) = -0.33; confidence interval (CI) -1.87 to 1.21; I²=0.01%). Meta-analysis of three trials showed a small effect on caregivers’ confidence of their ability of responding to disturbing behaviors (SMD= 0.34; CI -1.93 to 2.61; I²=0.01%). Meta-analysis of three trials showed a moderate effect on caregivers’ confidence of their ability of controlling their upsetting thoughts (SMD= 0.44; CI -1.24 to 2.11; I²=0.01%). Effect on caregivers’ depression was not analyzed due to the studies’ employment of different scales. The intervention programs whose trainers are psychologists have the greatest effect. Group discussion has a greater effect than one-to-one online/phone intervention.

Conclusions and Implications: Intervention programs have a small effect on caregivers’ burden and their confidence in their ability of responding to disturbing behaviors. They also have a moderate effect on caregivers’ confidence of their ability of controlling their upsetting thoughts. Evidence of an effect on depression remains unclear. Trainers who are experienced and professional of clinical psychology are important to conduct an effective intervention. The utilization of communication technology may have a limitation in intervention.