Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
BMJ Open. 2019 May 10;9(5):e028441. doi: 10.1136/bmjopen-2018-028441.
Caregivers of persons with dementia and mild cognitive impairment (MCI) are at risk of decreased well-being. While many interventions for caregivers exist, evidence is sparse regarding intervention timing and effectiveness at an early stage of cognitive decline. Our systematic review aims to answer the following questions: (1) Do interventions for caregivers of persons with early stage dementia or MCI affect their well-being and ability to provide care? (2) Are particular types of caregiver interventions most effective during early stage cognitive decline? (3) How does effectiveness differ when early and later interventions are directly compared? (4) Do effects of early stage caregiver intervention vary based on care recipient and caregiver characteristics (eg, sex, type of dementia)?
The databases MEDLINE, EMBASE, PSYCINFO and CINAHL, as well as grey literature databases, will be searched for English language studies using search terms related to caregiver interventions and dementia/MCI. Abstracts and full texts will be screened by two independent reviewers; included studies must assess the effects of an intervention for caregivers of persons with early stage dementia or MCI on caregiver well-being or ability to provide care. Intervention, study and participant characteristics will be extracted by two independent reviewers, along with outcome data. Risk of bias will be assessed using the Cochrane risk of bias tool (for controlled trials with and without randomisation). Interventions will be grouped by type (eg, psychoeducational) and a narrative synthesis is planned due to expected heterogeneity, but a meta-analysis will be performed where possible. The Grading of Recommendations, Assessment, Development and Evaluations approach will be used to inform conclusions regarding the quality of evidence for each type of intervention.
Findings from this review will be disseminated via conferences and peer-reviewed publication, and a summary will be provided to the Alzheimer Society.
CRD42018114960.
痴呆症和轻度认知障碍 (MCI) 患者的照顾者有幸福感下降的风险。虽然有许多针对照顾者的干预措施，但在认知能力下降的早期阶段，关于干预时机和效果的证据很少。我们的系统评价旨在回答以下问题：(1) 针对早期痴呆症或 MCI 患者的照顾者的干预措施是否会影响他们的幸福感和提供照顾的能力？(2) 在认知能力下降的早期阶段，哪种类型的照顾者干预措施最有效？(3) 当直接比较早期和晚期干预措施时，效果有何不同？(4) 早期照顾者干预措施的效果是否因照顾对象和照顾者的特征（例如，性别、痴呆症类型）而异？
将使用与照顾者干预和痴呆症/MCI 相关的搜索词，在 MEDLINE、EMBASE、PSYCINFO 和 CINAHL 数据库以及灰色文献数据库中搜索英文研究。两名独立评审员将筛选摘要和全文；必须评估针对早期痴呆症或 MCI 患者的照顾者的干预措施对照顾者幸福感或提供照顾能力的影响的研究将被纳入。两名独立评审员将提取干预、研究和参与者特征以及结果数据。使用 Cochrane 偏倚风险工具（有和没有随机分组的对照试验）评估偏倚风险。干预措施将按类型（例如，心理教育）进行分组，并计划进行叙述性综合分析，因为预计存在异质性，但如果可能，将进行荟萃分析。将使用推荐、评估、制定和评估方法 (Grading of Recommendations, Assessment, Development and Evaluations approach) 来告知每种干预类型的证据质量的结论。
本综述的结果将通过会议和同行评审出版物进行传播，并向阿尔茨海默病协会提供摘要。
PROSPERO 注册号：CRD42018114960。
