title: Effectiveness of Supporting Informal Caregivers of People with Dementia: A Systematic Review of Randomized and Non-Randomized Controlled Trials.
abstract: Dementia is known as a major public health problem affecting both patients and caregivers, and placing a high financial strain upon society. In community-dwelling patients, it is important to support informal caregivers in order to help them sustain their demanding role. Previous reviews about effectiveness of such supporting strategies often included a small number of studies, focused only on particular supportive types, particular outcomes, or solely on caregivers.
  
  
  
  A general systematic review was conducted investigating effectiveness of different supportive strategies on at least the well-being of the caregiver or the care-recipient.
  
  
  
  A systematic literature search was conducted in Web of Science and PubMed. An adapted version of the Downs and Black (1998) checklist was used to assess methodological quality. A new classification was developed to group different types of caregiver support.
  
  
  
  Fifty-three papers met the inclusion criteria. Although 87% of the interventions were to some extent effective, methods and findings were rather inconsistent. Psychoeducational interventions generally lead to positive outcomes for caregivers, and delay permanent institutionalization of care-recipients. Cognitive behavioral therapy decreases dysfunctional thoughts among caregivers. Occupational therapy decreases behavioral problems among patients and improves self-efficacy of caregivers. In general, those interventions tailored on individual level generate better outcomes. Comparative research on respite care was very rare.
  
  
  
  Despite methodological inconsistency, supporting caregivers appears to be an effective strategy often improving well-being of caregiver or care-recipient and resulting in additional benefits for society. However, there is a need for more research on the (cost)-effectiveness of respite care.
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium.
authors.forename: Sophie
authors.initials: S
authors.lastname: Vandepitte
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Internal Medicine, Ghent University, Brussels, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Van Den Noortgate
authors.affiliation: Faculty of Medicine and Pharmacy, Department of Medical Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Verhaeghe
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Faes
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium.
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
mesh_terms: D017028:Caregivers / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D003704:Dementia / Q000451:nursing* / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012944:Social Support
keywords: Alzheimer’s disease; caregiver; dementia; effectiveness; support