Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Sep 9;22(9):e19468.
doi: 10.2196/19468.

Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Systematic Review and Meta-Analysis

Minmin Leng #  1   2 , Yajie Zhao #  1   2 , Hongmei Xiao  1   2 , Ce Li  1   2 , Zhiwen Wang  1   2
Affiliations
Meta-Analysis

Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Systematic Review and Meta-Analysis

Minmin Leng et al. J Med Internet Res. .

Abstract

Background: Caring for people with dementia is perceived as one of the most stressful and difficult forms of caring. Family caregivers always experience high levels of psychological burden and physical strain, so effective and practical support is essential. Internet-based supportive interventions can provide convenient and efficient support and education to potentially reduce the physical and psychological burden associated with providing care.

Objective: This review aimed to (1) assess the efficacy of internet-based supportive interventions in ameliorating health outcomes for family caregivers of people with dementia, and (2) evaluate the potential effects of internet-based supportive intervention access by caregivers on their care recipients.

Methods: An electronic literature search of the PubMed, EMBASE, Web of Science, CINAHL, Cochrane Library, and PsycINFO databases was conducted up to January 2020. Two reviewers (ML and YZ) worked independently to identify randomized controlled trials (RCTs) that met the inclusion criteria and independently extracted data. The quality of the included RCTs was evaluated using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. Standardized mean differences (SMDs) with 95% CIs were applied to calculate the pooled effect sizes.

Results: In total, 17 RCTs met the eligibility criteria and were included in this systematic review. The meta-analysis showed that internet-based supportive interventions significantly ameliorated depressive symptoms (SMD=-0.21; 95% CI -0.31 to -0.10; P<.001), perceived stress (SMD=-0.40; 95% CI -0.55 to -0.24; P<.001), anxiety (SMD=-0.33; 95% CI -0.51 to -0.16; P<.001), and self-efficacy (SMD=0.19; 95% CI 0.05-0.33; P=.007) in dementia caregivers. No significant improvements were found in caregiver burden, coping competence, caregiver reactions to behavioral symptoms, or quality of life. Six studies assessed the unintended effects of internet-based supportive intervention access by caregivers on their care recipients. The results showed that internet-based supportive interventions had potential benefits on the quality of life and neuropsychiatric symptoms in care recipients.

Conclusions: Internet-based supportive interventions are generally effective at ameliorating depressive symptoms, perceived stress, anxiety, and self-efficacy in dementia caregivers and have potential benefits on care recipients. Future studies are encouraged to adopt personalized internet-based supportive interventions to improve the health of family caregivers and their care recipients.

Trial registration: PROSPERO CRD42020162434; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=162434.

Keywords: dementia; family caregivers; internet; supportive interventions; systematic review.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flow diagram for search and selection of the included studies.
Figure 2
Figure 2
Risk of bias summary: review of the authors' judgments about each risk of bias item for each included study.
Figure 3
Figure 3
The effect of internet-based supportive interventions on depressive symptoms.
Figure 4
Figure 4
The effect of internet-based supportive interventions on caregiver burden.
Figure 5
Figure 5
The effect of internet-based supportive interventions on perceived distress/stress.
Figure 6
Figure 6
The effect of internet-based supportive interventions on coping competence.
Figure 7
Figure 7
The effect of internet-based supportive interventions on caregiver reaction to behavioral symptoms.
Figure 8
Figure 8
The effect of internet-based supportive interventions on anxiety.
See this image and copyright information in PMC

References

    1. Alzheimer’s Disease International (ADI) World Alzheimer Report 2018: The State of the Art of Dementia Research: New Frontiers. 2018. [2020-04-16]. https://www.alz.co.uk/research/world-report-2018.
    1. Wimo A. Establishing and funding long term care infrastructure. 33rd International Conference of Alzheimer's Disease International; 26-29 July, 2018; Chicago, IL. 2018. Jul, pp. 26–29.
    1. Drummond N, McCleary L, Garcia L, McGilton K, Molnar F, Dalziel W, Xu TJ, Turner D, Triscott J, Freiheit E. Assessing Determinants of Perceived Quality in Transitions for People with Dementia: a Prospective Observational Study. Can Geriatr J. 2019 Mar 04;22(1):13–22. doi: 10.5770/cgj.22.332. http://europepmc.org/abstract/MED/31501679 - DOI - PMC - PubMed
    1. Spigelmyer PC, Schreiber JB. A pilot study: Resistive behavior in the context of informal caregiver-assisted activities of daily living. Geriatr Nurs. 2019 Jul;40(4):399–404. doi: 10.1016/j.gerinurse.2019.01.005. - DOI - PubMed
    1. Huis In Het Veld Judith G, van Asch IFM, Willemse BM, Verkade P, Pot AM, Blom MM, Groot Zwaaftink RBM, Francke AL. Process Evaluation of Nurse-Led Online Self-Management Support for Family Caregivers to Deal With Behavior Changes of a Relative With Dementia (Part 1): Mixed Methods Study. J Med Internet Res. 2019 Oct 11;21(10):e13002. doi: 10.2196/13002. https://www.jmir.org/2019/10/e13002/ - DOI - PMC - PubMed

Publication types

MeSH terms