Psychological Health of Primary Caregivers of Home-Based Older Adults With Dementia in India, Taiwan, and the United States

Caregiver burden among dementia caregivers in low-and middle-income countries in Asia: a systematic review

OBJECTIVES

Long-term caregiving can lead to a high caregiver burden for caregivers of community-dwelling people with dementia in Asia's low- and middle-income countries (LMICs). It is essential to assess the level of caregiver burden and its factors in such settings to understand the impact on caregivers' well-being.

METHOD

A systematic review was conducted based on the PRISMA. Articles were identified from seven databases published from 2000 to November 2023. Each article's methodological quality was assessed with an appraisal checklist developed by the Joanna Briggs Institute.

RESULTS

64 studies with 12 measurement tools were identified from 9 countries. Only 20% of studies using 22-item ZBI show caregivers experienced no or little burden while caring for their care recipients. The mean 22-item ZBI score ranged from 24.5 in Turkey to 34.7 in India, while the mean CBI score varied from 24.0 in Thailand to 47.8 in China. Patient, caregiver characteristics, and caregiving context are associated with caregiver burden.

CONCLUSION

Dementia caregivers in Asian LMICs exhibit a wide variation in caregiver burden. Programs that promote protective factors and address modifiable factors are imperative to mitigate burdens and enhance caregivers' quality of life in these settings.

Caregivers' experiences, challenges, and needs in caring for people with dementia in India: a scoping review

BACKGROUND

As the world's most populous country, India faces a growing challenge in addressing dementia, in which advancing age remains the strongest risk factor. Approximately 8.8 million Indians over the age of 60 are currently affected by this condition. While much of the research on dementia caregiving focuses on Western societies, caregiving experiences are shaped profoundly by cultural and socioeconomic contexts, which vary significantly in India. Unique social norms, combined with limited resources, make the burden on dementia caregivers in India both distinct and understudied. This scoping review synthesized existing literature on the experiences, challenges, and needs of dementia caregivers in India, providing critical insights for developing culturally tailored support systems and informing public health initiatives.

METHODS

A comprehensive database search for literature was conducted in April 2022 and updated in September 2024 in six databases (Medline, Embase, PsycINFO, CINAHL, Web of Science and Epistemonikos). The databases were systematically searched for original qualitative and quantitative peer-reviewed studies conducted in India between 2000 and 2024. The scoping review was registered with the Open Science Framework and was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-ScR).

RESULTS

After identifying, screening, and reviewing articles for eligibility, we critically appraised and included a sample of 27 studies in this review. The data synthesis process identified three main themes: (1) navigating the dual realities of caregiving: challenges and rewards for family caregivers in India, (2) gaps in support for home-based care: challenges faced by family caregivers in rural parts of India, and (3) addressing the present and future needs of caregivers for people with dementia in India.

CONCLUSION

This scoping review reveals the experiences, challenges, and needs of caregivers for people with dementia, including caregiver burden, stress, and poor health among caregivers resulting from inadequate support, insufficient respite care, and a lack of information about dementia. Health and social services offering dementia care are critically needed in India, where population aging is imminent.

TRIAL REGISTRATION

https://doi.org/10.17605/OSF.IO/4MJDC .

A Pilot Study on the Efficacy of Stress Relief Programs for Family Caregivers of Older People with Dementia

The aim of this study was to evaluate the effects of stress-relief programs on positive aspects of caregiving and depression among caregivers of older people with dementia. A quasi-experimental design was employed. Participants in the experimental group received a 8-week period and 120 minutes each session cognitive-behavioral therapy. Participants in the control group received standard health education. Stress relief programs may alleviate depression and increase positive aspects of caregiving among family caregivers of older people with dementia. These findings will help health professionals to implement stress-relief strategies for family caregivers of older people with dementia, or to use those strategies to increase positive aspects of caregiving, or to alleviate depression in caregivers.