The efficacy of psychological interventions for depressed primary caregivers of patients with Alzheimer's disease: A systematic review and meta-analysis

Abstract

Objectives: To systematically evaluate the effectiveness of psychological intervention durations and different psychological interventions on treating depression in primary caregivers of Alzheimer's disease (AD) patients.

Methods: A computerized search of PubMed, Cochrane Library, Embase, Ebsco, Web of Science, CNKI, CSBD, and CSTJ databases on randomized controlled trials (RCTs) of psychological interventions for depressed primary caregivers of AD patients was performed. Depression scores were derived from the Self-rated Depression Scale (SDS) and the Centre for Epidemiological Studies Depression Scale (CES-D). The results were analyzed using Revman 5.3 utilizing Trial Sequential Analysis (TSA) software for data analysis.

Results: Eight RCTs involving 857 depressed primary caregivers of AD patients were included in the study. Of the four psychological interventions studied, only three (i.e., cognitive-behavioral psychological, integrated psychological, and psychological interview intervention) were shown to significantly reduce depression levels in primary caregivers of AD patients after 2-months, 10-weeks, and 6-months of treatment (p ≤ 0.05). It is uncertain that a supportive psychological intervention or a 3-months psychological intervention reduced the level of depression. Sequential and sensitivity analyses confirmed the reliability of the outcome measures.

Conclusion: Cognitive-behavioral psychological, integrated psychological, and psychological interview interventions were able to significantly reduce depression levels in primary caregivers of AD patients. These findings reveal that psychological interventions may be a promising means for depressed primary caregivers of patients with AD.

Clinical relevance: For the primary caregivers of AD patients, effective interventions can help reduce psycho-depressive symptoms and improve the quality of life for the caregivers and the patients. Medical staff may want to use this information to help to provide a more effective guide for primary caregivers in an effort to reduce possible levels of depression.

Keywords: Alzheimer's disease; depression; primary caregiver; psychological intervention; sequential analysis.