Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-20T05:22:32.526Z Has data issue: false hasContentIssue false
  • English
  • Français

Dyadic interventions for community-dwelling people with dementia and their family caregivers: a systematic review

Published online by Cambridge University Press:  24 July 2013

Netta Van't Leven ,
Anna-Eva J. C. Prick ,
Johanna G. Groenewoud ,
Pepijn D. D. M. Roelofs ,
Jacomine de Lange  and
Anne Margriet Pot
Netta Van't Leven*
Affiliation:
Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
Anna-Eva J. C. Prick
Affiliation:
Department of Clinical Psychology, VU University of Amsterdam, and EMGO Institute for Health and Care Research (EMGO+), Amsterdam, The Netherlands
Johanna G. Groenewoud
Affiliation:
Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
Pepijn D. D. M. Roelofs
Affiliation:
Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
Jacomine de Lange
Affiliation:
Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands Program on Aging, Netherlands Institute on Mental Health and Addiction, Utrecht, The Netherlands
Anne Margriet Pot
Affiliation:
Department of Clinical Psychology, VU University of Amsterdam, and EMGO Institute for Health and Care Research (EMGO+), Amsterdam, The Netherlands Program on Aging, Netherlands Institute on Mental Health and Addiction, Utrecht, The Netherlands
*
Correspondence should be addressed to: Netta van't Leven, MSc, Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198 3015 EK Rotterdam, The Netherlands. Phone: +31-10-794-51-85; Fax: +31-10-794-51-59. Email: m.a.van.t.leven@hr.nl.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In this review, we study the effects of dyadic psychosocial interventions focused on community-dwelling people with dementia and their family caregivers, and the relationship of the effects with intervention components of programs.

Methods:

A search from January 2005 to January 2012 led to 613 hits, which we reviewed against our inclusion criteria. We added studies from 1992 to 2005 reviewed by Smits et al. (Smits, C. H. M., De Lange, J., Droes, R.-M., Meiland, F., Vernooij-Dassen, M. and Pot, A. M. (2007). Effects of combined intervention programs for people with dementia living at home and their caregivers: a systematic review. International Journal of Geriatric Psychiatry, 22, 1181–1193). We assessed the methodological quality of 41 programs with the Cochrane criteria and two items of the Oxford Centre of Evidence-based Medicine guidelines.

Results:

Studies of moderate to high quality concerning 20 different dyadic psychosocial programs for people with dementia and caregivers were included. Nineteen of these programs show significant effects on the patient with dementia, the caregiver, or both. Due to differences in the programs and the studies, this study does not provide an unequivocal answer about which programs are most effective. Programs with intervention components that actively train one or more specific functional domains for the person with dementia and/or the caregiver seem to have a beneficial impact on that domain, although there are exceptions. Reasons can be found in the program itself, the implementation of the program, and the study design.

Conclusions:

Dyadic psychosocial programs are effective, but the outcomes for the person with dementia and the caregiver vary. More attention is needed for matching the targeted functional domains, intervention components, and delivery characteristics of a program with the needs of the person with dementia and the family caregiver.

Keywords

Alzheimerdementiainformal caregiverspsychosocial treatmentinterventionburdenmoodquality of life
Type
Review Article
Information
International Psychogeriatrics , Volume 25 , Issue 10 , October 2013 , pp. 1581 - 1603
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalten, P. (2004). Behavioural Problems in Dementia: Course and Risk Factors. Maastricht, Netherlands: Universiteit Maastricht.Google Scholar
Acton, G. J. and Kang, J. (2001). Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis. Researh in Nursing & Health, 24, 349–360.CrossRefGoogle ScholarPubMed
Aupperle, P. M. and Coyne, A. C. (2000). Primary vs subspecialty care: a structured follow-up of dementia patients and their caregivers. American Journal of Geriatric Psychiatry, 8, 167–170.CrossRefGoogle Scholar
Bakker, T. J., Duivenvoorden, H. J., Van Der Lee, J., Olde Rikkert, M. G., Beekman, A. T. and Ribbe, M. W. (2011). Integrative psychotherapeutic nursing home program to reduce multiple psychiatric symptoms of cognitively impaired patients and caregiver burden: randomized controlled trial. American Journal of Geriatric Psychiatry, 19, 507–520.CrossRefGoogle ScholarPubMed
Berger, G.et al. (2004). No effects of a combination of caregivers support group and memory training/music therapy in dementia patients from a memory clinic population. International Journal of Geriatric Psychiatry, 19, 223–231.CrossRefGoogle ScholarPubMed
Brodaty, H. and Arasaratnam, C. (2012). Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 169, 946–953.CrossRefGoogle ScholarPubMed
Brodaty, H. and Gresham, M. (1989). Effect of a training programme to reduce stress in carers of patients with dementia. British Medical Journal, 299, 1375–1379.CrossRefGoogle ScholarPubMed
Brodaty, H., Green, A. and Koschera, A. (2003). Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657–664.CrossRefGoogle ScholarPubMed
Brodaty, H., Gresham, M. and Luscombe, G. (1997). The Prince Henry Hospital dementia caregivers’ training programme. International Journal of Geriatric Psychiatry, 12, 183–192.3.0.CO;2-J>CrossRefGoogle Scholar
Callahan, C. M.et al. (2006). Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial. Journal of the American Medical Association, 295, 2148–2157.CrossRefGoogle ScholarPubMed
Carbonneau, H., Caron, C. D. and Desrosiers, J. (2011). Effects of an adapted leisure education program as a means of support for caregivers of people with dementia. Archives of Gerontology and Geriatrics, 53, 31–39.CrossRefGoogle ScholarPubMed
Chien, W. T. and Lee, I. Y. (2011). Randomized controlled trial of a dementia care programme for families of home-resided older people with dementia. Journal of Advanced Nursing, 67, 774–787.CrossRefGoogle ScholarPubMed
Chu, P., Edwards, J., Levin, R. and Thomson, J. (2000). The use of clinical case management for early stage Alzheimer's patients and their families. American Journal of Alzheimer's Disease and other Dementias, 15, 284–290.CrossRefGoogle Scholar
Clare, L.et al. (2010). Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: a single-blind randomized controlled trial of clinical efficacy. American Journal of Geriatric Psychiatry, 18, 928–939.CrossRefGoogle ScholarPubMed
Coon, D. W., Thompson, L., Steffen, A., Sorocco, K. and Gallagher-Thompson, D. (2003). Anger and depression management: psychoeducational skill training interventions for women caregivers of a relative with dementia. The Gerontologist, 5, 678–689.CrossRefGoogle Scholar
Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: a systematic review. Aging and Mental Health, 9, 325–330.CrossRefGoogle ScholarPubMed
Czaja, S. J., Schulz, R., Lee, C. C. and Belle, S. H. (2003). A methodology for describing and decomposing complex psychosocial and behavioral interventions. Psychology and Aging, 18, 385–395.CrossRefGoogle ScholarPubMed
De Vugt, M.et al. (2004). Do caregiver management strategies influence patient behaviour in dementia? International Journal of Geriatric Psychiatry, 19, 85–92.CrossRefGoogle ScholarPubMed
Dias, A.et al. (2008). The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India. PLoS One, 3, e2333.CrossRefGoogle ScholarPubMed
Dröes, R. (2010). Focus and effectiveness of psychosocial interventions for people with dementia in institutional care settings from the perspective of coping with the disease. Non-Pharmacological Therapies in Dementia, 1, 139–161.Google Scholar
Dröes, R. M., Breebaart, E., Ettema, T. P., Van Tilburg, W. and Mellenbergh, G. J. (2000). Effect of integrated family support versus day care only on behavior and mood of patients with dementia. International Psychogeriatrics, 12, 99–115.CrossRefGoogle ScholarPubMed
Dröes, R. M., Breebaart, E., Meiland, F. J., Van Tilburg, W. and Mellenbergh, G. J. (2004a). Effect of Meeting Centres Support Program on feelings of competence of family carers and delay of institutionalization of people with dementia. Aging Mental and Health, 8, 201–211.CrossRefGoogle ScholarPubMed
Dröes, R. M., Meiland, F., Schmitz, M. and Van Tilburg, W. (2004b). Effect of combined support for people with dementia and carers versus regular day care on behaviour and mood of persons with dementia: results from a multi-centre implementation study. International Journal of Geriatric Psychiatry, 19, 673–684.CrossRefGoogle ScholarPubMed
Dröes, R. M., MeiIand, F., Schmitz, M. and Van Tilburg, W. (2006). Effect of the Meeting Centres Support Program on informal carers of people with dementia: results from a multi-centre study. Aging and Mental Health, 10, 112–124.CrossRefGoogle ScholarPubMed
Eloniemi-Sulkava, U., Notkola, I. L., Hentinen, M., Kivela, S. L., Sivenius, J. and Sulkava, R. (2001). Effects of supporting community-living demented patients and their caregivers: a randomized trial. Journal of the American Geriatrics Society, 49, 1282–1287.CrossRefGoogle ScholarPubMed
Eloniemi-Sulkava, U.et al. (2009). Family care as collaboration: effectiveness of a multicomponent support program for elderly couples with dementia. Randomized controlled intervention study. Journal of the American Geriatrics Society, 57, 2200–2208.CrossRefGoogle Scholar
Furlan, A. D., Pennick, V., Bombardier, C. and Van Tulder, M. (2009). 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine (Phila Pa 1976), 34, 1929–1941.CrossRefGoogle ScholarPubMed
Gitlin, L. N., Corcoran, M., Winter, L., Boyce, A. and Hauck, W. W. (2001). A randomized, controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia. The Gerontologist, 41, 4–14.CrossRefGoogle ScholarPubMed
Gitlin, L. N.et al. (2003). Effects of the home environmental skill-building program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH Initiative. The Gerontologist, 43, 532–546.CrossRefGoogle ScholarPubMed
Gitlin, L. N., Winter, L., Burke, J., Chemett, N., Dennis, M. P. and Hauck, W. W. (2008). Tailored activities to manage neuropsychiatric behaviors in persons with dementia and reduce caregiver burden: a randomized pilot study. American Journal of Geriatric Psychiatry, 16, 229–239.CrossRefGoogle ScholarPubMed
Gitlin, L. N., Winter, L., Dennis, M. P., Hodgson, N. and Hauck, W. W. (2010a). Targeting and managing behavioral symptoms in individuals with dementia: a randomized trial of a non-pharmacological intervention. Journal of the American Geriatrics Society, 58, 1465–1474.CrossRefGoogle Scholar
Gitlin, L. N., Winter, L., Dennis, M. P., Hodgson, N. and Hauck, W. W. (2010b). A biobehavioral home-based intervention and the well-being of patients with dementia and their caregivers: the COPE randomized trial. Journal of the American Medical Association, 304, 983–991.CrossRefGoogle ScholarPubMed
Graff, M. J. L., Vernooij-Dassen, M. J. M., Thijssen, M., Dekker, J., Hoefnagels, W. H. L. and Rikkert, M. G. M. O. (2006). Community-based occupational therapy for patients with dementia and their caregivers: randomised controlled trial. British Medical Journal, 333, 1196–1199.CrossRefGoogle ScholarPubMed
Graff, M. J. L., Vernooij-Dassen, M. J. M., Thijssen, M., Dekker, J., Hoefnagels, W. H. L. and Olderikkert, M. G. M. (2007). Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: a randomized controlled trial. Journals of Gerontology Series A Biological Sciences and Medical Sciences, 62, 1002–1009.CrossRefGoogle ScholarPubMed
Grol, R. and Wensing, M. (2011). Implementatie: Effectieve Verbetering van de Patiëntenzorg (Implementation: Effective Improvement of Patient Care). Amsterdam, Netherlands: Reed Business.Google Scholar
Hepburn, K. W.et al. (2005). Partners in caregiving: a psychoeducation program affecting dementia family caregivers’ distress and caregiving outlook. Clinical Gerontologist, 29, 53–69.CrossRefGoogle Scholar
Higgins, J. T. P. and Green, S. (eds.), (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). London: Cochrane Collaboration.Google Scholar
Hincliffe, A. C., Hyman, I. L., Blizard, B. and Livingston, G. (1995). Behavioural complications of dementia—can they be treated? International Journal of Geriatric Psychiatry, 10, 839–847.CrossRefGoogle Scholar
Jansen, A. P.et al. (2011). Effectiveness of case management among older adults with early symptoms of dementia and their primary informal caregivers: a randomized clinical trial. International Journal of Nursing Studies, 48, 933–943.CrossRefGoogle ScholarPubMed
Leontjevas, R., Gerritsen, D. L., Koopmans, R. T., Smalbrugge, M. and Vernooij-Dassen, M. J. (2012). Process evaluation to explore internal and external validity of the “Act in Case of Depression” care program in nursing homes. Journal of the American Medical Directors Association, 13, e1–8.CrossRefGoogle ScholarPubMed
Logiudice, D., Waltrowicz, W., Brown, K., Burrows, C., Ames, D. and Flicker, L. (1999). Do memory clinics improve the quality of life of carers? A randomized pilot trial. International Journal of Geriatric Psychiatry, 14, 626–632.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Logsdon, R. G., McCurry, S. M. and Teri, L. (2007). Time-limited support groups for individuals with early stage dementia and their care partners: Preliminary outcomes from a controlled clinical trial. Clinical Gerontologist, 30, 5–19.CrossRefGoogle Scholar
Logsdon, R. G.et al. (2010). Early-stage memory loss support groups: outcomes from a randomized controlled trial. Journal of Gerontology: Psychological Sciences, 65B, 691–697.CrossRefGoogle Scholar
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and Dekosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Martin-Cook, K., Davis, B. A., Hynan, L. S. and Weiner, M. F. (2005). A randomized, controlled study of an Alzheimer's caregiver skills training program. American Journal of Alzheimer's Disease and other Dementias, 20, 204–210.CrossRefGoogle ScholarPubMed
McCurry, S. M., Logsdon, R. G., Vitiello, M. V. and Teri, L. (2005). Nighttime insomnia treatment and education for Alzheimer's disease: a randomized, controlled trial. Journal of the American Geriatrics Society, 53, 793–802.CrossRefGoogle ScholarPubMed
McCurry, S., Pike, K. C., Logsdon, R. G., Vitiello, M. V., Larson, E. B. and Teri, L. (2010). Walking, bright light, and a combination intervention all improve sleep in community-dwelling persons with Alzheimer's disease and caregivers: results of a randomized, controlled trial. Sleep, 33, A353.Google Scholar
McCurry, S., Pike, K. C., Logsdon, R. G., Larson, E. B., Vitiello, M. V. and Teri, L. (2011). Increasing walking and bright light exposure to improve sleep in community-dwelling persons with Alzheimer's disease: results of a randomized, controlled trial. Journal of the American Geriatrics Society, 59, 1393–1402.CrossRefGoogle Scholar
Miller, R., Newcomer, R. and Fox, P. (1999). Effects of the medicare Alzheimer's disease demonstration on nursing home entry. Health Services Research, 34, 691–714.Google ScholarPubMed
Moniz-Cook, E., Agar, S., Gibson, G., Win, T. and Wang, M. (1998). A preliminary study of the effects of early intervention with people with dementia and their families in a memory clinic. Aging and Mental Health, 2, 199–211.CrossRefGoogle Scholar
Moniz-Cook, E. and Manthorpe, J. (eds.) (2009). Introduction: personalising psychosocial interventions to individual need and context. In Psychosocial Interventions in Early Dementia: Evidence-Based Practice (pp. 11–36). London: Jessica Kingsley.Google Scholar
Moniz-Cook, E., Vernooij-Dassen, M., Woods, B. and Orrell, M. (2011). Psychosocial interventions in dementia care research: the INTERDEM manifesto. Aging and Mental Health, 15, 283–290.CrossRefGoogle ScholarPubMed
Neely, A. S., Vikstrom, S. and Josephsson, S. (2009). Collaborative memory intervention in dementia: caregiver participation matters. Neuropsychological Rehabilitation, 19, 696–715.CrossRefGoogle ScholarPubMed
Newcomer, R., Miller, R., Clay, T. and Fox, P. (1999). Effects of the medicare Alzheimer's disease demonstration on caregiver burden and depression. Health Services Research, 34, 669–689.Google ScholarPubMed
Olazarán, J.et al. (2010). Non-pharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dementia and Geriatric Cognitive Disorders, 30, 161–178.CrossRefGoogle Scholar
Onder, G.et al. (2005). Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial. British Journal of Psychiatry, 187, 450–455.CrossRefGoogle ScholarPubMed
Onor, M. L., Trevisiol, M., Negro, C., Alessandra, S., Saina, M. and Aguglia, E. (2007). Impact of a multimodal rehabilitative intervention on demented patients and their caregivers. American Journal of Alzheimer's Disease and other Dementias, 22, 261–272.CrossRefGoogle ScholarPubMed
Ostwald, S. K., Hepburn, K. W., Caron, W., Burns, T. and Mantell, R. (1999). Reducing caregiver burden: a randomized psychoeducational intervention for caregivers of persons with dementia. The Gerontologist, 39, 299–309.CrossRefGoogle ScholarPubMed
Peeters, J., Van Beek, A., Meerveld, J., Spreeuwenberg, P. and Francke, A. (2010). Informal caregivers of persons with dementia, their use of and needs for specific professional support: a survey of the National Dementia Programme. BMC Nursing, 9, 1–9.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sorensen, S. (2006). Helping caregivers of persons with dementia: which interventions work and how large are their effects? International Psychogeriatrics, 18, 577–595.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sorensen, S. (2007). Correlates of physical health of informal caregivers: a meta-analysis. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 62, P126–P137.CrossRefGoogle ScholarPubMed
Quayhagen, M. P. and Quayhagen, M. (2001). Testing of a cognitive stimulation intervention for dementia caregiving dyads. Neuropsychological Rehabilitation, 11, 319–332.CrossRefGoogle Scholar
Riordan, J. M. and Bennett, A. V. (1998). An evaluation of an augmented domiciliary service to older people with dementia and their carers. Aging and Mental Health, 2, 137–143.CrossRefGoogle Scholar
Romero, B. and Wenz, M. (2002). Concept and effectiveness of a treatment program for patients with dementia and their relatives: Results from the Bad Aibling Alzheimer Disease Therapy Center (in German). Zeitschrift für Gerontology und Geriatrie, 35, 118–128.Google Scholar
Schoenmakers, B., Buntinx, F. and Delepeleire, J. (2010). Supporting the dementia family caregiver: the effect of home care intervention on general well-being. Aging and Mental Health, 14, 44–56.CrossRefGoogle ScholarPubMed
Smits, C. H. M., De Lange, J., Droes, R.-M., Meiland, F., Vernooij-Dassen, M. and Pot, A. M. (2007). Effects of combined intervention programmes for people with dementia living at home and their caregivers: a systematic review. International Journal of Geriatric Psychiatry, 22, 1181–1193.CrossRefGoogle ScholarPubMed
Teri, L., Logsdon, R. G., Uomoto, J. and McCurry, S. M. (1997). Behavioral treatment of depression in dementia patients: a controlled clinical trial. Journals of Gerontology Series B Psychological Sciences and Social Sciences, 52, P159–P166.CrossRefGoogle ScholarPubMed
Teri, L.et al. (2003). Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. Journal of the American Medical Association, 290, 2015–2022.CrossRefGoogle ScholarPubMed
Thompson, C. A., Spilsbury, K., Hall, J., Birks, Y., Barnes, C. and Adamson, J. (2007). Systematic review of information and support interventions for caregivers of people with dementia. BMC Geriatrics, 7, 18.CrossRefGoogle ScholarPubMed
Vernooij-Dassen, M. (1993). Dementie en thuiszorg: een onderzoek naar determinanten van het competentiegevoel van centrale verzorgers en het effect van professionele interventie [Dementia and Homecare: A Study into Determinants of The sense of Competence of Caregivers and the Effect of Professional Intervention]. Amsterdam: Swets & Zeitlinger.Google Scholar
Vernooij-Dassen, M., Huygen, F., Felling, A. and Persoon, J. (1995). Home care for dementia patients. Journal of the American Geriatrics Society, 43, 456–457.CrossRefGoogle ScholarPubMed
Voigt-Radloff, S.et al. (2011a). A multicentre RCT on community occupational therapy in Alzheimer's disease: 10 sessions are not better than one consultation. BMJ Open, 1, e000096.CrossRefGoogle Scholar
Voigt-Radloff, S.et al. (2011b). Why did an effective Dutch complex psycho-social intervention for people with dementia not work in the German healthcare context? Lessons learnt from a process evaluation alongside a multicentre RCT. BMJ Open, 1, e000094.CrossRefGoogle Scholar
Yordi, C., Dunah, R., Bostrom, A., Fox, P., Wilkinson, A. and Newcomer, R. (1997). Caregiver supports: outcomes from the medicare Alzheimer's disease demonstration. Health Care Financing Review, 19, 97–117.Google ScholarPubMed