Article Text
Abstract
Introduction Despite increasing numbers of persons living with Alzheimer’s disease and Alzheimer’s-related dementias (AD/ADRD) in Asia, particularly in low-income countries (LIC) and middle-income countries (MIC), surprisingly little is known about the current state of the evidence for family caregiver interventions. The objectives of this scoping review were to: (1) describe the evidence for efficacy of family dementia-caregiver psychosocial interventions in Asian countries, (2) compare evidence across LIC, MIC, and high-income countries (HIC), and (3) characterise cultural adaptions to interventions developed outside Asia.
Methods The inclusion criteria included: (1) conducted in Asia (2) included an intervention delivered to a family caregiver of a person living with AD/ADRD, (3) reported quantitative outcomes for the family caregiver and (4) published in a peer-reviewed journal with full text available in English.
Results Thirty intervention trials were identified meeting inclusion criteria and all reported statistically significant (p<0.05) improvement in one or more caregiver outcomes. Interventions usually included multiple components. The most frequently reported outcomes (ie, by ≥20% of studies) were caregiver depression, burden, quality of life and self-efficacy. Overall, 26 (87%) of the studies were conducted in HIC in Asia, primarily in Hong Kong SAR—China and Taiwan, and only 4 (13%) in LIC and MIC in Asia. Seven studies (23%) used interventions developed in USA and several described cultural adaptations.
Conclusion This scoping review found substantial evidence, particularly from high-income Asian countries, that a wide range of interventions improve AD/ADRD family caregiver outcomes. However, critical knowledge gaps exist, particularly for LIC and MIC in Asia, where the number of persons with dementia is numerically largest and projected to increase dramatically in coming decades. The field could also benefit from more detailed descriptions of the process and types of cultural adaptations to interventions.
- review
- mental health & psychiatry
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Footnotes
Handling editor Seye Abimbola
Contributors LH had primary responsibility for study design, overseeing data acquisition and interpretation, and drafting the manuscript. DT, JH, and T-NN made substantial contributions to data acquisition, interpretation and drafting key parts of the manuscript. LG made substantial contributions to conceptualising the study, interpreting the data and making critical revisions to drafts of the manuscript. All authors approved the final version of the manuscript and agree to be responsible for all aspects of the work.
Funding Research reported in this publication was supported by National Institute on Aging of the National Institutes of Health under award numbers R21 AG054262 (Dr. Hinton PI). LG was supported by National Institute on Aging grants R01 AG049692 and R01 AG041781.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Because this was a review of the published literature (ie, a scoping review) and did not involve human subjects, IRB approval was not necessary.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.