Effectiveness of dementia literacy interventions for caregivers of people with dementia: A meta-analysis of randomized controlled trials
Chiu H.L., Pradana A.A., Susanto H., Widiyaningsih
Abstract
Background: Dementia is a significant global health challenge, placing a considerable burden on caregivers. Dementia literacy encompasses the ability to seek, evaluate, and apply dementia-related information, influencing dementia prevention and care. Interventions aimed at improving dementia literacy among caregivers have the potential to support caregiving by enhancing knowledge, confidence, and coping strategies. However, the effectiveness of these interventions in reducing caregiver burden remains unclear. Objective: To evaluate the effectiveness of dementia literacy interventions for caregivers of people with dementia. Design: Systematic review and meta-analysis. Methods: Randomized controlled trials of dementia literacy interventions were searched comprehensively in PubMed, Embase, and Web of Science up to July 12, 2024. Trials included family caregivers of people with dementia. Primary outcomes were caregiver burden; secondary outcomes included knowledge, attitudes toward dementia, and self-efficacy. Two authors independently reviewed the eligible studies, evaluated their quality, and extracted relevant data. The risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool for randomized trials. Meta-analysis was conducted using Comprehensive Meta-Analysis vers. 3.0, while narrative synthesis was applied when meta-analysis was not suitable. Results: 40 eligible studies, comprising a total of 4336 caregivers were analyzed. Interventions varied in structure, delivery modes, durations, and frequencies and included education on dementia, caregiving techniques, stress management, and communication skills. The findings revealed that dementia literacy interventions significantly reduced caregivers' burden (Hedges' g = − 0.446, p < 0.001) and improved caregivers' knowledge (Hedges' g = 0.806, p < 0.001), attitudes toward dementia (Hedges' g = 0.621, p = 0.002), and self-efficacy (Hedges' g = 0.272, p < 0.001). Subgroup analyses and meta-regression indicated that the different intervention characteristics influenced caregiver burden, knowledge, and attitudes toward dementia, such as session duration, intervention frequency, mode of delivery, use of technology, total intervention duration, and number of sessions. However, significant heterogeneity and risks of bias were observed across studies. Conclusion: This study highlights the potential of dementia literacy interventions to address caregiver challenges and improve outcomes, emphasizing the importance of structured and sustained programs tailored to caregivers' needs. Future research should focus on optimizing intervention designs, such as session length and delivery methods, to maximize their impact and ensure long-term effectiveness. Registration: The protocol was registered on PROSPERO (Registration number: CRD42024565023).