A meta-analysis of low-intensity cognitive behavioral therapy-based interventions for dementia caregivers

Objectives: This study aimed to review the effectiveness of low-intensity cognitive behavioural therapy (CBT)-based interventions for informal dementia caregivers, when compared to non-active control conditions.

Design: Literature searches were conducted in databases of published (PsycINFO;
MEDLINE; CINAHL; Scopus) and unpublished (Open Grey; ISRCTN registry;
Clinical Trials.gov; ProQuest) literature. Individual meta-analyses were conducted for each outcome variable. Pooled intervention effect estimates were calculated as Hedge’s g using a random-effects model.

Included studies: Studies examining the effect of low-intensity CBT-based interventions for informal caregivers for people with any progressive dementia were included. Randomised controlled trials and controlled clinical trials were included.

Measurements: Outcomes included the psychological variables of anxiety, depression, burden and distress (defined as stress or strain).

Results: A total of five studies reported anxiety outcomes, twelve reported on depression, three reported on burden and six reported distress outcomes. Results demonstrated a significant effect of low-intensity CBT-based interventions in reducing all examined psychological difficulties. Small effects sizes were found for anxiety (g = 0.35), depression (g= 0.27) and distress (g = 0.33). A medium effect was found for burden (g = 0.53).

Conclusions: The results provide initial support for low-intensity CBT-based interventions for dementia caregivers. Clinical implications and research recommendations are explored. Strengths and limitations of the study are discussed.