Systematic review of the effect of psychological interventions on family caregivers of people with dementia
Abstract
Background Caregivers of people with dementia are at high risk of psychological morbidity and associated breakdown in care. Many psychologically based interventions have been designed to help caregivers of people with dementia. More work is needed to identify which, if any, are helpful for such caregivers.Method We conducted a systematic review of the immediate and long term efficacy of different types of psychological interventions for the psychological health of caregivers of people with dementia, using standardized criteria, to assist clinicians in implementing rational, evidence-based management recommendations. We reviewed studies examining the effects of any therapy derived from a psychological approach that satisfied pre-specified criteria. Using the Oxford Centre for Evidence-Based Medicine criteria we rated the quality of each study, extracted data and gave overall ratings to different types of intervention.Results We identified 244 references in our search of which 62 met our inclusion criteria.Limitations Our findings are limited by lack of good quality evidence, with only ten level 1 studies identified.Conclusions We found excellent evidence for the efficacy of six or more sessions of individual behavioral management therapy centered on the care recipient's behavior in alleviating caregiver symptoms both immediately and for up to 32 months. Teaching caregivers coping strategies either individually or in a group also appeared effective in improving caregiver psychological health both immediately and for some months afterwards. Group interventions were less effective than individual interventions. Education about dementia by itself, group behavioral therapy and supportive therapy were not effective caregiver interventions.
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Caregiver coping interventions were particularly effective in improving their mental health.
“Caregiver coping interventions were particularly effective in improving their mental health”
From Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol (2022) · cites this paper as [18]
The intervention provides caregivers skills they can use to manage difficult behaviors in the individual with dementia, which has been shown to be particularly effective at reducing stress.
“The intervention provides caregivers skills they can use to manage difficult behaviors in the individual with dementia, which has been shown to be particularly effective at reducing stress [31].”
From A novel two-day intervention reduces stress in caregivers of persons with dementia (2018) · cites this paper as [31]
Individual and family counseling, psychoeducational programs, skills training programs and multi-component intervention programs have shown potential in improving caregiver mood, quality of life and delaying institutionalization of the care recipient.
“Individual and family counseling, psychoeducational programs, skills training programs and multi-component intervention programs have shown potential in improving caregiver mood, quality of life and delaying institutionalization of the care recipient [7–9].”
From CareACT - internet-based intervention for enhancing the psychological well-being of elderly caregivers - a study protocol of a controlled trial (2019) · cites this paper as [9]
Specialist, individually tailored, psychological support to people with dementia and their family carers has been shown to reduce the rate of, although not necessarily the time to, care home admission in the USA, although there is no evidence in the UK.
“Specialist, individually tailored, psychological support to people with dementia and their family carers has been shown to reduce the rate of, although not necessarily the time to, care home admission in the USA, although there is no evidence in the UK.10,11”
Education about dementia by itself, group behavioural therapy and supportive therapy were not effective carer interventions.
“Education about dementia by itself, group behavioural therapy and supportive therapy were not effective carer interventions.”
There is evidence from systematic reviews that therapies individualised to the carer receiving them are most effective in delaying institutionalisation, and that individual behavioural therapies are more effective than group interventions in reducing carer morbidity.
“There is evidence from systematic reviews that therapies individualised to the carer receiving them are most effective in delaying institutionalisation,11 and that individual behavioural therapies are more effective than group interventions in reducing carer morbidity.10”
In the team's earlier systematic review, behavioural management and coping strategy-based interventions had been efficacious, interventions targeting individuals tended to work better than group interventions, and the minimum number of sessions of individual behaviour management shown efficacious was six.
“We found that behavioural management and coping strategy-based interventions had been efficacious, that interventions targeting individuals tended to work better than group interventions and that the minimum number of sessions of individual behaviour management which had been shown to be efficacious was six.”
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Dementia prevention, intervention, and care
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“Many psychosocial interventions have been developed to offer support for informal caregivers of patients with dementia (Selwood et al., 2007; Van Mierlo et al., 2012b), and these interventions have demonstrated great potential in improving caregiver mood, improving caregiver quality of life, and…”
BackgroundA meta-review of stress, coping and interventions in dementia and dementia caregiving
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“From Table 3, it appears that benefits for CGs accrued from both Table 1 Intervention reviews classified by focus Study Focus Caregivers People with Dementia Both CG and PWD Knight, Lutzky, Macofsky-Urban (1993) [1*] Zabalegui, Hamers, Karlsson et al. (2014) [3*] Brodaty & Arasaratnam (2012) [10*] Brodaty, Green, Kosc…”
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“Again, several systematic reviews on family caregivers’ strain point to the need for psychosocial interventions for informal caregivers to relieve their burden and improve depressive symptoms (Brodaty et al., 2003; Burns et al., 2003; Selwood et al., 2007; Zarit and Femia, 2008).”
BackgroundCoping strategies, anxiety and depression in caregivers of people with Alzheimer’s disease
Cooper, C., Katona, C., Orrell, M., & Livingston, G. (2008) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2007 · Cited by 307 · see citing works
“Our results might explain why Cognitive Behavioural Therapy based interventions in which teaching problem-focused strategies is a key component do not seem to alleviate anxiety (Selwood et al., 2007).”
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“care and the growing demand nationally and internationally due to the aging population [9].”
BackgroundLivingston, G., Leavey, G., Manela, M., Livingston, D., Rait, G., Sampson, E., Bavishi, S., Shahriyarmolki, K., & Cooper, C. (2010) · BMJ · doi:10.1136/bmj.c4184 · Cited by 239 · see citing works
Self-citationElliott, A., Burgio, L. D., & DeCoster, J. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2009.02631.x · Cited by 237 · see citing works
“The relationship between the caregiving role and CG depression has been well documented, finding depression levels ranging from 28% to 55% for CGs of persons with dementia, compared with 15% in community surveys of older adults.(7,8,10,39,40) There is a significant correlation between higher levels of CG depression an…”
BackgroundLivingston, G., Barber, J., Rapaport, P., Knapp, M., Griffin, M., King, D., Livingston, D., Mummery, C., Walker, Z., Hoe, J., et al. (2013) · BMJ · doi:10.1136/bmj.f6276 · Cited by 233 · see citing works
Self-citationReviews: Developing Culturally Sensitive Dementia Caregiver Interventions: Are We There Yet?
Nápoles, A. M., Chadiha, L., Eversley, R. B., & Moreno-John, G. (2010) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317510370957 · Cited by 225 · see citing works
Coping strategies and anxiety in caregivers of people with Alzheimer’s disease: the LASER-AD study
Cooper, C., Katona, C., Orrell, M., & Livingston, G. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2005.08.017 · Cited by 208 · see citing works
Self-citationBlom, M. M., Zarit, S. H., Groot Zwaaftink, R. B. M., Cuijpers, P., & Pot, A. M. (2015) · PLOS ONE · doi:10.1371/journal.pone.0116622 · Cited by 212 · see citing works
Cooper, C., Mukadam, N., Katona, C., Lyketsos, C. G., Ames, D. J., Rabins, P. V., Engedal, K., Lima, C. D. M., Blazer, D. G., Teri, L. L., et al. (2012) · International Psychogeriatrics · doi:10.1017/s1041610211002614 · Cited by 200 · see citing works
“This is part of a series of systematic reviews by the Old Age Task Force of the World Federation of Biological Psychiatry (Livingston et al., 2005; Selwood et al., 2007; Cooper et al., 2011).”
BackgroundSelf-citationLivingston, G., Barber, J., Rapaport, P., Knapp, M., Griffin, M., Romeo, R., King, D., Livingston, D., Lewis-Holmes, E., Mummery, C., et al. (2014) · Health Technology Assessment · doi:10.3310/hta18610 · Cited by 192 · see citing works
Self-citationStall, N. M., Kim, S. J., Hardacre, K. A., Shah, P. S., Straus, S. E., Bronskill, S. E., Lix, L. M., Bell, C. M., & Rochon, P. A. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15690 · Cited by 177 · see citing works
Martı́n-Carrasco, M., Franco, M., Valero, C. P., Millán, P. R., García, C. I., Montalbán, S. R., Vázquez, A. L. G., Piris, S. P., & Vilanova, M. B. (2008) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2142 · Cited by 181 · see citing works
“Unfortunately, scientific evidence to support their efficacy remains limited, due mainly to the lack of studies or because of limitations in their methodology (Cooke et al., 2001; Sörensen et al., 2002; Brodaty et al., 2003; Selwood et al., 2007).”
BackgroundA Systematic Review of Treatments for Refractory Depression in Older People
Cooper, C., Katona, C., Lyketsos, K., Blazer, D., Brodaty, H., Rabins, P., de Mendonça Lima, C. A., & Livingston, G. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10081165 · Cited by 176 · see citing works
“This review was part of a series carried out by the Old Age Task Force of the World Federation of Biological Psychiatry to synthesize current evidence critical to the practice of old-age psychiatry (10, 11).”
BackgroundSelf-citationCheng, S.-T., & Zhang, F. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01547-2 · Cited by 166 · see citing works
Cheng, H. Y., Chair, S. Y., & Chau, J. P. C. (2014) · Patient Education and Counseling · doi:10.1016/j.pec.2014.01.005 · Cited by 162 · see citing works
“Concurring with the systematic reviews of interventions for family caregivers of dementia [80] and terminal illnesses [81], it was found that it was difficult to alleviate the burden imposed on caregivers by means of psychosocial interventions.”
BackgroundWhitlatch, C. J., & Orsulic‐Jeras, S. (2017) · The Gerontologist · doi:10.1093/geront/gnx162 · Cited by 161 · see citing works
“In their review of psychological interventions for caregivers, Selwood et al., 2007 found that behavioral management techniques taught to individual care partners rather than groups of caregivers decreased caregiver depression over both the short-and long-term.”
Technology-Driven Interventions for Caregivers of Persons With Dementia
Godwin, K. M., Mills, W. L., ANDERSON, J. A., & Kunik, M. E. (2013) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317513481091 · Cited by 159 · see citing works
“One systematic review of psychological interventions for caregivers of PWD found caregivers’ psychological health improved with 6 or more individual behavioral management therapy sessions focused on the PWDs’ behavioral problems.(3) It also found support for improving caregivers’ psychological health by teaching careg…”
BackgroundDepression and quality of informal care: A longitudinal investigation of caregiving stressors.
Smith, G. R., Williamson, G. M., Miller, L. S., & Schulz, R. (2011) · Psychology and Aging · doi:10.1037/a0022263 · Cited by 148 · see citing works
A systematic review of psychosocial interventions to improve cancer caregiver quality of life
Waldron, E. A., Janke, E. A., Bechtel, C. F., Ramirez, M., & Cohen, A. (2013) · Psycho-Oncology · doi:10.1002/pon.3118 · Cited by 147 · see citing works
“Although the small to nil effects may suggest limited efficacy of interventions on caregiver QoL, given the limited data available for this review and observed efficacy of caregiver-targeted interventions to improve well being and coping in cancer [27] and in other areas such as dementia and palliative care [35,36], i…”
BackgroundSheehan, O. C., Haley, W. E., Howard, V. J., Huang, J., Rhodes, J. D., & Roth, D. L. (2021) · The Gerontologist · doi:10.1093/geront/gnaa108 · Cited by 146 · see citing works
“In previous studies, this one-item caregiving strain measure has proven an effective measure of the mental and emotional strain associated with caregiving and to predict caregiver well-being and mortality (Fauth et al., 2016; Schulz & Beach, 1999; Selwood et al., 2007).”
BackgroundDucharme, F., Lévesque, L., Lachance, L., Kergoat, M., Legault, A., Beaudet, L., & Zarit, S. H. (2011) · The Gerontologist · doi:10.1093/geront/gnr014 · Cited by 141 · see citing works
Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R., & Livingston, G. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.05.001 · Cited by 136 · see citing works
Self-citationFunctional analysis-based interventions for challenging behaviour in dementia
Moniz-Cook, E. D., Swift, K., James, I. A., Malouf, R. S., de Vugt, M. E., & Verhey, F. R. J. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006929.pub2 · Cited by 136 · see citing works
Vandepitte, S., Noortgate, N. V. D., Putman, K. D., Verhaeghe, S. T. L., Faes, K., & Annemans, L. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-151011 · Cited by 132 · see citing works
“Finally, many reviews included both controlled and uncontrolled studies making comparison between interventions difficult [12, 45].”
BackgroundGallagher-Thompson, D., Tzuang, Y. M., Au, A., Brodaty, H., Charlesworth, G., Gupta, R., Lee, S. E., Losada, A., & Shyu, Y.-I. (2012) · Clinical Gerontologist · doi:10.1080/07317115.2012.678190 · Cited by 128 · see citing works
“Selwood and colleagues (2007 ) reviewed studies conducted in the United Kingdom and the United States, using the Oxford Centre for Evidence-Based Medicine to evaluate 244 studies, of which 62 were included, but only 10 of which met their “level one” (strict) criteria ( Selwood, Johnston, Katona, Lyketsos, & Livingston…”
MethodCaregiver Burden and Psychoeducational Interventions in Alzheimer’s Disease: A Review
Beinart, N., Weinman, J., Wade, D., & Brady, R. (2012) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000345777 · Cited by 124 · see citing works
Schulz, R., Czaja, S. J., Lustig, A., Zdaniuk, B., Martire, L. M., & Perdomo, D. (2009) · Rehabilitation Psychology · doi:10.1037/a0014932 · Cited by 119 · see citing works
Needs of caregivers of the patients with dementia
Rosa, E., Lussignoli, G., Sabbatini, F., Chiappa, A., Cesare, S. D., Lamanna, L., & Zanetti, O. O. (2009) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2009.07.008 · Cited by 118 · see citing works
Young, H. M., Bell, J. F., Whitney, R. L., Ridberg, R. A., Reed, S. C., & VITALIANO, P. P. (2019) · The Gerontologist · doi:10.1093/geront/gnz148 · Cited by 118 · see citing works
A systematic review of intervention studies about anxiety in caregivers of people with dementia
Cooper, C., Balamurali, T. B. S., Selwood, A., & Livingston, G. (2007) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1656 · Cited by 117 · see citing works
Self-citationMeasuring dementia carers' unmet need for services - an exploratory mixed method study
Stirling, C., Andrews, S., Croft, T., Vickers, J. C., Turner, P. A., & Robinson, A. (2010) · BMC Health Services Research · doi:10.1186/1472-6963-10-122 · Cited by 114 · see citing works
Guay, C., Auger, C., Demers, L., Mortenson, W. B., Miller, W. C., Gélinas-Bronsard, D., & Ahmed, S. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7896 · Cited by 95 · see citing works
“Likely, traditional education interventions, delivered through printed material or face-to-face, have been shown to have little to no effect on caregivers’ outcomes [74].”
BackgroundRemotely delivered information, training and support for informal caregivers of people with dementia
González-Fraile, E., Ballesteros, J., Rueda, J.-R., Santos-Zorrozúa, B., Solà, I., & McCleery, J. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006440.pub3 · Cited by 100 · see citing works
Livingston, G., Barber, J., Rapaport, P., Knapp, M. R. J., Griffin, M., King, D., Romeo, R., Livingston, D., Mummery, C. J., Walker, Z., et al. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)00073-x · Cited by 98 · see citing works
Self-citationMacleod, A., Tatangelo, G. L., McCabe, M. P., & You, E. C. (2017) · International Psychogeriatrics · doi:10.1017/s1041610216002532 · Cited by 97 · see citing works
“A cognitive behavioral therapy (CBT) approach has been shown to be efficacious in intervention programs aimed at enhancing caregiver health and wellbeing (Selwood et al., 2007).”
BackgroundDickson, A., O’Brien, G., Ward, R., Allan, D., & O’Carroll, R. E. (2009) · Psychology and Health · doi:10.1080/08870440903038949 · Cited by 95 · see citing works
The Tele.TAnDem Intervention: Telephone-based CBT for Family Caregivers of People With Dementia
Wilz, G., Reder, M., Lechner‐Meichsner, F., & Soellner, R. (2017) · The Gerontologist · doi:10.1093/geront/gnx183 · Cited by 96 · see citing works
Jansen, A. P. D., van Hout, H. P. J., Nijpels, G., Rijmen, F., Dröes, R., Pot, A. M., Schellevis, F., Stalman, W. A. B., & van Marwijk, H. (2011) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2011.02.004 · Cited by 91 · see citing works
“Meanwhile, reviews of the effects of health, social and psychological interventions on caregiver’s psychological well-being and burden are inconclusive (Schoenmakers et al., 2010; Selwood et al., 2007; Thompson et al., 2007).”
BackgroundPredictors of Depressive Symptoms in Caregivers of Patients With Heart Failure
Chung, M. L., Pressler, S. J., Dunbar, S. B., Lennie, T. A., & Moser, D. K. (2010) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0b013e3181d2a58d · Cited by 90 · see citing works
“caregivers of Alzheimer disease or dementia patients indicated that nonpharmacological interventions, including individual or group counseling or support programs, are effective in improving depressive symptoms of caregivers.(40,41) However, the effectiveness of these interventions has not been studied in caregivers o…”
BackgroundBelief into Action Scale: A Brief but Comprehensive Measure of Religious Commitment
Koenig, H. G., Nelson, B., Shaw, S. F., Zaben, F. A., Wang, Z., & Saxena, S. (2015) · Open Journal of Psychiatry · doi:10.4236/ojpsych.2015.51010 · Cited by 89 · see citing works
Caregiver burden characterization in patients with Alzheimer's disease or vascular dementia
D’Onofrio, G., Sancarlo, D., Addante, F., Ciccone, F., Cascavilla, L., Paris, F., Picoco, M., Nuzzaci, C., Elia, A. C., Greco, A., et al. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4232 · Cited by 86 · see citing works
“Given the relatively higher physical and objective burden found in the present study, especially for relatives engaged in their caregiving activities for a longer and intensive period of time, interventions should focus on the dementia-specific burden factors, like aggressiveness and personality changes on the part of…”
BackgroundGreenwood, N., Habibi, R., Mackenzie, A., Drennan, V. M., & Easton, N. (2013) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317513494449 · Cited by 85 · see citing works
Effects of social supports on burden in caregivers of people with dementia
Han, J. W., Jeong, H., Park, J. Y., Kim, T. H., Lee, D. Y., Lee, D. W., Ryu, S., Kim, S.-K., Yoon, J. C., Jhoo, J. H., et al. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214001331 · Cited by 84 · see citing works
“One systematic review (Selwood et al., 2007) has suggested that support therapies were ineffective and made no immediate improvement in caregiver depression, anxiety or burden because they could not engender change since they instead aim to maintain.”
BackgroundPsychosocial issues facing lung transplant candidates, recipients and family caregivers
Rosenberger, E. M., Dew, M. A., DiMartini, A. F., DeVito Dabbs, A. J., & Yusen, R. D. (2012) · Thoracic Surgery Clinics · doi:10.1016/j.thorsurg.2012.08.001 · Cited by 81 · see citing works
Morris, L., Horne, M., McEvoy, P., & Williamson, T. (2017) · Aging & Mental Health · doi:10.1080/13607863.2017.1399343 · Cited by 79 · see citing works
“, 2007), while coping and communication skills could be effectively delivered individually or in groups (Pinquart & S€ orensen, 2006; Selwood et al., 2007).”
BackgroundWilliams, F., Moghaddam, N. G., Ramsden, S., & Boos, D. D. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1515886 · Cited by 81 · see citing works
Boots, L. M., de Vugt, M. E., Withagen, H. E., Kempen, G. I., & Verhey, F. R. (2016) · JMIR Research Protocols · doi:10.2196/resprot.5142 · Cited by 79 · see citing works
“Although recent face-to-face caregiver interventions appeared to be promising [6,7], the increasing gap between care supply and demand calls for alternative and cheaper methods for providing education and support to informal caregivers [3,8].”
BackgroundMüller, C., Lautenschläger, S., Meyer, G., & Stephan, A. (2017) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2017.03.013 · Cited by 77 · see citing works
Scott, J. L., Dawkins, S., Quinn, M. G., Sanderson, K., Elliott, K.-E. J., Stirling, C., Schüz, B., & Robinson, A. (2016) · Aging & Mental Health · doi:10.1080/13607863.2015.1040724 · Cited by 77 · see citing works
“Given the symptomology of dementia, individuals living with the illness inevitably become reliant on others for their care and well-being, with family members most often taking on these responsibilities (Selwood et al., 2007).”
BackgroundNunnemann, S., Kurz, A., Leucht, S., & Diehl-Schmid, J. (2012) · International Psychogeriatrics · doi:10.1017/s104161021200035x · Cited by 75 · see citing works
“Group behavioral management techniques and interventions with fewer than six sessions were not effective (Selwood et al., 2007).”
BackgroundThree-Year Trajectories of Caregiver Burden in Alzheimer's Disease
Conde‐Sala, J. L., Garriga, O. T., Calvó‐Perxas, L., Franch, J. V., Pousa, S. L., & Garre‐Olmo, J. (2014) · Journal of Alzheimer s Disease · doi:10.3233/jad-140360 · Cited by 75 · see citing works
“These more detailed analyses should also lead to the design of interventions that, as noted by previous studies, are tailored to individual needs [53–55], call for the active participation of caregivers [56], and are linked to the context in which care is provided [57].”
BackgroundGonyea, J. G., López, L. M., & Velásquez, E. E. M. (2014) · The Gerontologist · doi:10.1093/geront/gnu045 · Cited by 73 · see citing works
Consistency of dementia caregiver intervention classification: an evidence-based synthesis
Gaugler, J. E., Jutkowitz, E., Shippee, T. P., & Brasure, M. (2016) · International Psychogeriatrics · doi:10.1017/s1041610216001514 · Cited by 73 · see citing works
“Education (e.g. information provision) was included as a category in eight SRs (Pusey and Richards, 2001; Selwood et al., 2007; Parker et al., 2008; Elvish et al., 2013; Brasure et al., 2015; Jensen et al., 2015).”
BackgroundSørensen, L. V., Waldorff, F. B., & Waldemar, G. (2008) · Aging & Mental Health · doi:10.1080/13607860802224342 · Cited by 72 · see citing works
“In a review, (Selwood, Johnston, Katona, Lyketos, & Livingstone, 2006 ) found that group interventions were less effective than individual interventions regarding caregivers’ experienced burden and depression.”
BackgroundRabins, P. V., Rovner, B. W., Rummans, T. A., Schneider, L. S. S., & Tariot, P. N. (2017) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.15106 · Cited by 73 · see citing works
Novais, T., Dauphinot, V., Krolak‐Salmon, P., & Mouchoux, C. (2017) · BMC Geriatrics · doi:10.1186/s12877-017-0481-9 · Cited by 71 · see citing works
Coping and subjective burden in caregivers of older relatives: a quantitative systematic review
Casado, R. D. P., Osuna, A. F., Moral, P. Á. P., & Pancorbo-Hidalgo, P. L. (2011) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2011.05725.x · Cited by 70 · see citing works
Caregivers as Therapeutic Agents in Dementia Care
Gitlin, L. N., & Hodgson, N. A. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-417046-9.00017-9 · Cited by 69 · see citing works
Life Enhancing Activities for Family Caregivers of People With Frontotemporal Dementia
Dowling, G. A., Merrilees, J., Mastick, J., Chang, V. Y., Hubbard, E., & Moskowitz, J. T. (2014) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e3182a6b905 · Cited by 69 · see citing works
“24) Perceived stress (PSS) Skills (12) 22.”
InfluentialJácome, C. I. O., de Figueiredo, D. M. P., Gabriel, R., Cruz, J., & Marques, A. S. P. D. D. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214000337 · Cited by 68 · see citing works
“Thus, similarly to family carers of these chronic diseases (Selwood et al., 2007), carers of patients with COPD need specific services and supportive interventions (e.”
BackgroundThakur, K. T., Albanese, E., Giannakopoulos, P., Jetté, N., Linde, M., Prince, M. J., Steiner, T. J., & Dua, T. (2016) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0426-7_ch5 · Cited by 67 · see citing works
Mindfulness-based stress reduction for family carers of people with dementia
Liu, Z., Sun, Y.-Y., & Zhong, B.-L. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012791.pub2 · Cited by 66 · see citing works
“Various psychosocial interventions have been developed for family carers of people with dementia (Acton 2001; Peacock 2003; Pinquart 2006; Selwood 2007; Sörensen 2002).”
BackgroundLivingston, G., Manela, M., O'Keeffe, A., Rapaport, P., Cooper, C., Knapp, M., King, D., Romeo, R., Walker, Z., Hoe, J., et al. (2020) · The British Journal of Psychiatry · doi:10.1192/bjp.2019.160 · Cited by 61 · see citing works
“In general those that have been effective are multicomponent and delivered to individuals rather than groups for at least six sessions (35) (36) and our study was designed to follow this model.”
Self-citationGarcía‐Alberca, J. M., Cruz, B., Lara, J. P., Garrido, V., Gris, E., Lara, A., & Castilla, C. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.09.026 · Cited by 61 · see citing works
“Teaching caregivers coping strategies either individually or in a group appeared effective in improving caregiver psychological health (Hepburn et al., 2001; Selwood et al., 2007).”
BackgroundEvaluation of a brief educational program for dementia carers: The AENEAS Study
Kurz, A., Wagenpfeil, S., Hallauer, J. F., Schneider‐Schelte, H., Jansen, S., & for the AENEAS Study Group (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2428 · Cited by 61 · see citing works
“There is some evidence that individually tailored interventions are more effective in reducing caregiver depression than programs in group format (Mittelman et al., 1995; Gitlin et al., 2003; Mittelman et al., 2004; Selwood et al., 2007).”
BackgroundEvangelista, L. S., Strömberg, A., & Dionne-Odom, J. N. (2016) · Current Opinion in Supportive & Palliative Care · doi:10.1097/spc.0000000000000182 · Cited by 60 · see citing works
“As a comparison, published reviews of cancer family caregiving identified 49 interventions [48] and of dementia family caregiving identified 62 interventions [49].”
Caregiving experiences and knowledge about dementia in Portuguese clinical outpatient settings
Gonçalves‐Pereira, M., Carmo, I., da Silva, J. A., Papoila, A. L., Mateos, R., & Zarit, S. H. (2009) · International Psychogeriatrics · doi:10.1017/s1041610209991050 · Cited by 60 · see citing works
“…and spouse caregivers as eligible targets for education about Alzheimer’s disease or other dementias (Werner, 2001; 2003; Shaji et al., 2003), though education about dementia by itself has not been shown to be effective for caregiver burden or distress (Selwood et al., 2007; Thompson et al., 2007).”
BackgroundResultPot, A. M., Blom, M., & Willemse, B. M. (2015) · International Psychogeriatrics · doi:10.1017/s1041610215000034 · Cited by 60 · see citing works
“Effective components of face-to-face interventions that have been found to reduce psychological distress of family caregivers of people with dementia are: cognitive behavioral therapy (CBT), interactive psycho-education, management of behavioral problems, and coping, social support and problem-solving techniques (Pinq…”
Blom, M., Bosmans, J. E., Cuijpers, P. J., Zarit, S. H., & Pot, A. M. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-17 · Cited by 60 · see citing works
“Psychological treatment is aimed at improving caregivers’ abilities to cope with problem behavior or stressful situations or to enhance communication skills and asking support from others [9].”
BackgroundEvans, S., Evans, S. C., Brooker, D., Henderson, C., Szcześniak, D. M., Atkinson, T. J., Bray, J., Rehill, A., Saibene, F. L., d’Arma, A., et al. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1544207 · Cited by 59 · see citing works
Li, R., Cooper, C., Austin, A., & Livingston, G. (2013) · International Psychogeriatrics · doi:10.1017/s1041610212001755 · Cited by 56 · see citing works
“…outcome measure of interest, but none have systematically explored intervention effects on different types of coping, or coping as a potential mediator of treatment effects on psychological morbidity (Schulz et al., 2002; Sorensen et al., 2002; Selwood et al., 2007; Vernooij-Dassen et al., 2011).”
BackgroundSelf-citationDie Belastung pflegender Angehöriger bei Demenz
Kurz, A., & Wilz, G. (2010) · Der Nervenarzt · doi:10.1007/s00115-010-3108-3 · Cited by 56 · see citing works
Factors that contribute to adult children caregivers' well-being: a scoping review
Wasilewski, M. B., Gignac, M. A. M., Kapral, M. K., & Cameron, J. I. (2014) · Health & Social Care in the Community · doi:10.1111/hsc.12144 · Cited by 56 · see citing works
Caregiving by Teens for Family Members With Huntington Disease
Williams, J. K., Ayres, L., Specht, J. P., Sparbel, K. J. H., & Klimek, M. L. (2009) · Journal of Family Nursing · doi:10.1177/1074840709337126 · Cited by 56 · see citing works
Meaning and measurement of caregiver outcomes
Brodaty, H. (2007) · International Psychogeriatrics · doi:10.1017/s1041610207005182 · Cited by 54 · see citing works
“Interventions designed primarily for caregivers are demonstrably effective (Sorensen et al., 2002; Brodaty et al., 2003; Pinquart and Sorensen, 2006a; Pinquart and Sorensen, 2006b; Selwood et al., 2006).”
BackgroundOverview of dementia care under the three‐tier long‐term care system of China
Wang, S., Cheung, D. S. K., & Leung, A. Y. M. (2018) · Public Health Nursing · doi:10.1111/phn.12573 · Cited by 53 · see citing works
Cooper, C., Mukadam, N., Katona, C., Lyketsos, C. G., Blazer, D. G., Ames, D. J., Rabins, P. V., Brodaty, H., Lima, C. D. M., & Livingston, G. (2013) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2012.10.018 · Cited by 53 · see citing works
Self-citationAcceptability of psychosocial interventions for dementia caregivers: a systematic review
Qiu, D., Hu, M., Yu, Y., Tang, B.-W., & Xiao, S. (2019) · BMC Psychiatry · doi:10.1186/s12888-018-1976-4 · Cited by 52 · see citing works
Aboulafia-Brakha, T., Suchecki, D., Gouveia-Paulino, F., Nitríni, R., & Ptak, R. (2014) · Aging & Mental Health · doi:10.1080/13607863.2014.880406 · Cited by 51 · see citing works
“psychoeducation coupled with an active participation of caregivers within a cognitive–behavioural therapy (CBT) framework are considered to be the most effective in reducing burden and increasing general well-being (Losada Baltar, Izal Fernandez de Troconiz, Montorio Cerrato, Marquez Gonzalez, & Perez Rojo, 2004; Pinq…”
BackgroundImpact of a psychoeducational program on three types of caregiver burden among spouses
Savundranayagam, M. Y., Montgomery, R. J. V., Kosloski, K., & Little, T. D. (2010) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2538 · Cited by 51 · see citing works
“This may reflect a dearth of welldesigned studies and the diversity among caregivers in their need for different types of psychoeducational programs (Gallagher-Thompson and Coon, 2007; Selwood et al., 2007).”
BackgroundChung, P., Ellis‐Hill, C., & Coleman, P. G. (2017) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2016.1267316 · Cited by 51 · see citing works
Brodaty, H., Mittelman, M. S., Gibson, L., Seeher, K. M., & Burns, A. S. (2009) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181a65187 · Cited by 50 · see citing works
Nascimento, C. M. C., Teixeira, C. V. L., Gobbi, L. T. B., Gobbi, S., & Stella, F. (2012) · Brazilian Journal of Physical Therapy · doi:10.1590/s1413-35552012005000017 · Cited by 50 · see citing works
Managing Cognition in Progressive Supranuclear Palsy
Rittman, T., Coyle-Gilchrist, I. T. S., & Rowe, J. B. (2016) · Neurodegenerative Disease Management · doi:10.2217/nmt-2016-0027 · Cited by 50 · see citing works
McLennon, S. M., Habermann, B., & Davis, L. L. (2010) · Journal of Neuroscience Nursing · doi:10.1097/jnn.0b013e3181ce5c45 · Cited by 50 · see citing works
Donnelly, N.-A., Hickey, A., Burns, A., Murphy, P., & Doyle, F. (2015) · PLoS ONE · doi:10.1371/journal.pone.0128213 · Cited by 49 · see citing works
“For example, the General Health Questionnaire was classified as ‘distress’, an approach also adopted in a similar systematic review [41, 42].”
MethodDeciding to institutionalize: why do family members cease caregiving at home?
McLennon, S. M., Habermann, B., & Davis, L. L. (2010) · PubMed · Cited by 48 · see citing works
Gaugler, J. E., Potter, T., & Pruinelli, L. (2014) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2014.04.003 · Cited by 47 · see citing works
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Lauritzen, J., Pedersen, P. U., Sørensen, E. E., & Bjerrum, M. B. (2015) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/01938924-201513060-00018 · Cited by 46 · see citing works
Orden, K. A. V., & Heffner, K. L. (2022) · The Gerontologist · doi:10.1093/geront/gnac032 · Cited by 45 · see citing works
Xu, X., Kwan, R. Y. C., & Leung, A. Y. M. (2019) · Journal of International Medical Research · doi:10.1177/0300060519845472 · Cited by 48 · see citing works
“, educational interventions, individual coping strategies, supportive therapy).(83) Social and clinical workers could also use behavioral activation intervention(84) and leisure education(85) to promote pleasant leisure activities among family caregivers of PWD, and thus reduce CVD risk among them.”
BackgroundFamily Caregiver's Perception of Alzheimer's Disease and Caregiving in Chinese Culture
Dai, B., Mao, Z., Wu, B., Mei, Y. J., Levkoff, S. E., & Wang, H. (2015) · Social Work in Public Health · doi:10.1080/19371918.2014.969858 · Cited by 43 · see citing works
- Authors
- Selwood, A., Johnston, K., Katona, C., Lyketsos, C., & Livingston, G.
- Affiliations
- University College London (GB)
- University of Kent (GB)
- Corresponding author
- Selwood, A.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2007-08
- Volume
- 101
- Issue
- 1-3
- Pages
- 75-89
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1970959510
- Cited by
- 342
- References
- 80
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 11 · 2023: 5 · 2022: 10 · 2021: 14 · 2020: 18 · 2019: 19 · 2018: 29 · 2017: 20 · 2016: 29 · 2015: 28 · 2014: 27 · 2013: 26 · 2012: 16
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Kent Academic Repository (University of Kent) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Keywords
- dementia, family caregivers, psychological intervention, caregiver burden, coping strategies, group intervention, individual interventions, caregiver mental health, dementia education, supportive therapy
- MeSH terms
- Adaptation, Psychological, Aged, Alzheimer Disease, Anxiety, Depression, Humans, Psychotherapy, Randomized Controlled Trials as Topic, Treatment Outcome, Caregivers, Cost of Illness, Evidence-Based Medicine
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