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Article type: Systematic Review
Authors: Dessy, Alexaa; 1 | Zhao, Amanda J.a; 1 | Kyaw, Kaya | Vieira, Doriceb | Salinas, Joela; *
Affiliations: [a] Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA | [b] New York University Health Sciences Library, New York University Grossman School of Medicine, New York, NY, USA
Correspondence: [*] Correspondence to: Joel Salinas, MD, MBA, MSc, Department of Neurology, NYU Grossman School of Medicine, 222 E 41st Street, 14th Floor, New York, NY 10017, USA. Tel.: +1 212 263 3210; Fax: +1 212 263 3273; E-mail: [email protected].
Note: [1] These authors contributed equally to this work.
Abstract: Background:As the Hispanic/Latino (HL) population grows, so too does the need for HL family caregivers for persons with dementia. HL caregivers tend to have less education, lower health literacy, and lower income, each uniquely compounding burden. Research is needed to appropriately tailor interventions for this population. Objective:A systematic review and meta-analysis was conducted to 1) provide an updated review of non-pharmacologic intervention studies for HL dementia caregivers, 2) characterize promising interventions, and 3) highlight opportunities for future research. Methods:Databases were searched for articles evaluating non-pharmacologic interventions for HL dementia caregivers. Studies were excluded if target populations did not include HLs or if no intervention was delivered. Data were extracted and random effects meta-analysis was performed on two primary outcomes: caregiver depression and burden. Effect sizes were calculated as pre- and post-intervention standardized mean differences (SMD), and further depression subgroup meta-analysis was performed. Other secondary outcome measures (e.g., perceived social support, caregiver knowledge, anxiety) were evaluated qualitatively. Results:Twenty-three studies were identified. Most included multiple components pertaining to psychosocial support, caregiver education, and community resource facilitation. Many studies were successful in improving caregiver outcomes, though intervention design varied. Meta-analysis revealed minimal to moderate heterogeneity and small effect size in improving depressive symptoms (SMD = –0.31, 95% CI –0.46 to –0.16; I2 = 50.16%) and burden (SMD = –0.28, 95% CI –0.37 to –0.18; I2 = 11.06%). Conclusion:Although intervention components varied, many reported outcome improvements. Future studies may benefit from targeting physical health, addressing sociocultural and economic contexts of caregivers, and leveraging technology.
Keywords: Alzheimer’s disease, caregiver burden, caregivers, dementia, Hispanic/Latino, intervention, minority health
DOI: 10.3233/JAD-220005
Journal: Journal of Alzheimer's Disease, vol. 89, no. 3, pp. 769-788, 2022
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