Effects of Mindfulness-Based Interventions on Depressive Symptoms, Anxiety, Stress, and Quality of Life in Family Caregivers of Persons Living with Dementia: A Systematic Review and Meta-analysis

2021 ◽  
pp. 016402752110434
Author(s):  
Areum Han

Objective: This systematic review and meta-analysis examined effects of mindfulness-based interventions (MBIs) on depressive symptoms, anxiety, stress, and quality of life in family caregivers of people with dementia. Methods: A comprehensive search was conducted within the PubMed, CINAHL, PsycINFO, and SCOPUS databases to identify relevant randomized controlled trials (RCTs). Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the types of control groups and MBIs. Results: 15 RCTs met the eligibility criteria. Meta-analyses showed medium to large effects of MBIs on depressive symptoms, anxiety, stress, and quality of life at the immediate posttest. Small to large effects of MBIs were found at follow-up. Conclusions: Future high-quality studies involving different types of MBIs and delivery modes are needed to better understand effects of MBIs on family caregivers of people with dementia and examine effective intervention features.

2019 ◽  
Vol 26 (10) ◽  
pp. 1035-1049 ◽  
Author(s):  
Christian Albus ◽  
Christoph Herrmann-Lingen ◽  
Katrin Jensen ◽  
Matthes Hackbusch ◽  
Nina Münch ◽  
...  

Background Exercise-based cardiac rehabilitation (ebCR) often includes various psychological interventions for lifestyle change or distress management. However, the additional benefit of specific psychological interventions on depression, anxiety, quality of life, cardiac morbidity and cardiovascular or total mortality is not well investigated. Design Systematic review and meta-analysis. Methods Randomized controlled trials and controlled cohort trials published between January 1995 and October 2017 comparing ebCR with or without pre-specified psychosocial interventions were selected and evaluated on the basis of predefined inclusion and outcome criteria. Results Out of 15,373 records, 20 studies were identified, including 4450 patients with coronary artery disease (88.5%) or congestive heart failure (11.5%), respectively. Studies were of low to moderate quality and methodological heterogeneity was high. As compared with ebCR alone, additional psychological interventions for lifestyle change or distress management showed a trend to reduce depressive symptoms (standardized mean difference –0.13, 95% confidence interval (CI) –0.30; 0.05). Furthermore, during a follow-up of five years, distress management was associated with a trend to reduce cardiac morbidity (risk ratio 0.74, 95% CI 0.51; 1.07). There was no evidence for an additional impact of either psychological lifestyle change interventions or distress management on anxiety, quality of life, cardiovascular or total mortality. Conclusions Specific psychological interventions offered during ebCR may contribute to a reduction of depressive symptoms and cardiac morbidity, but there remains considerable uncertainty under which conditions these interventions exert their optimal effects. (CRD42015025920).


2013 ◽  
Vol 25 (7) ◽  
pp. 1097-1105 ◽  
Author(s):  
Maria Fernanda Barroso Sousa ◽  
Raquel Luiza Santos ◽  
Cynthia Arcoverde ◽  
Pedro Simões ◽  
Tatiana Belfort ◽  
...  

ABSTRACTBackground: The validity of self-reported quality-of-life (QoL) assessments of people with dementia (PWD) is a critical issue. We designed this study to determine the non-cognitive factors that are associated with self-reported QoL and PWD QoL as rated by family caregivers.Methods: Using a cross-sectional study, we assessed QoL of 41 people with mild Alzheimer's disease (AD). The individuals with AD and their family caregivers completed the Quality of Life in Alzheimer's Disease Scale (QoL-AD), the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR) scale, the Cornell Scale for Depression in Dementia (CSDD), the Pfeffer Functional Activities Questionnaire (FAQ), and the Zarit Burden Interview (ZBI). Univariate and multivariate regression analyses were conducted to examine the contribution of the various cofactors.Results: We observed a significant difference (t = 3.292, p < 0.01, d = 0.727) in the QoL measures of PWD after comparing self-reported assessments with the assessments of family caregivers. Linear regression analysis demonstrated that awareness of disease was related to PWD QoL-AD scores. Both the education levels of family caregivers and the depressive symptoms in PWD were related to the family caregivers’ ratings of PWD QoL.Conclusions: The difference between self-reported QoL and family caregivers’ ratings of QoL in people with mild dementia indicated that cognitive impairment was not the primary factor that accounted for the differences in the QoL assessments. Our findings suggested that non-cognitive factors, such as awareness of disease and depressive symptoms, played an important role in the differences between the self-reported AD QoL ratings and the caregivers’ AD QoL ratings. A major implication is that discrete measures such as cognition or level of function are likely to miss important factors that influence QoL.


2018 ◽  
Vol 48 (13) ◽  
pp. 2130-2139 ◽  
Author(s):  
Anthony Martyr ◽  
Sharon M. Nelis ◽  
Catherine Quinn ◽  
Yu-Tzu Wu ◽  
Ruth A. Lamont ◽  
...  

AbstractCurrent policy emphasises the importance of ‘living well’ with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1–0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.


2021 ◽  
Author(s):  
Maria Margareta Pertl ◽  
Perez ◽  
Sonya Collier ◽  
Emer Guinan ◽  
Garret Monahan ◽  
...  

Abstract Background: Depression is common among patients with cancer and is associated with lower treatment participation, lower satisfaction with care, poorer quality of life, greater symptom burden, and higher healthcare costs. Various types of interventions (e.g., pharmacological, psychotherapy) are used for the treatment of depression. However, evidence for these among patients with cancer is limited. Furthermore, the relative effectiveness and acceptability of different approaches is unknown because a direct comparison between all available treatments has not been carried out. We will address this by conducting a network meta-analysis (NMA) of interventions for depression among people with cancer using a hybrid overview of reviews and systematic review methodology. Methods: We will search for and extract data from systematic reviews of randomised controlled trials (RCTs) of depression interventions for patients with cancer from inception, before performing a supplemental search for more recent RCTs. We will include RCTs comparing pharmacological, psychotherapy, exercise, combination therapy, collaborative care, or complementary and alternative medicine interventions with pill placebo, no treatment, waitlist, treatment as usual, or minimal treatment control groups, or directly in head-to-head trials, among adults who have a current or previous diagnosis of cancer and elevated depressive symptoms (scores above a cut-off on validated scales or meeting diagnostic criteria). Our primary outcomes will be change in depressive symptoms (standardised mean difference) and intervention acceptability (% who withdrew). Our secondary outcomes will be 6-month change in depressive symptoms, health-related quality of life, adverse events and mortality. We will independently screen for eligibility, extract data, and assess risk of bias using the RoB2 tool. We will use frequentist random-effects multivariate NMA in Stata, Rankograms and surface under the cumulative ranking curves to synthesize evidence and obtain a ranking of intervention groups. We will explore heterogeneity and inconsistency using local and global measures and evaluate the credibility of results using the Confidence in NEtwork Meta-Analysis (CINeMA) framework.Discussion: Our findings will provide the best available evidence for managing depression among patients with cancer. Such information will help to inform clinical guidelines, evidence-based treatment decisions and future research by identifying gaps in the current literature. Systematic review registration: Submitted to PROSPERO (record number: 290145), awaiting registration


2021 ◽  
Vol 12 ◽  
Author(s):  
Zhuo Liu ◽  
Fan Yang ◽  
Yifan Lou ◽  
Wei Zhou ◽  
Feng Tong

Objective: Depression is one of the most common problems faced by older adults. Reminiscence therapy, defined as using the recall of past events, feelings, and thoughts facilitating pleasure, is one type of psychotherapy that could alleviate depressive feelings among older adults, improve their quality of life, and help them live independently. Reminiscence therapy originated from geriatric psychiatry, and is an effective non-pharmacological intervention that could be structured or unstructured and be conducted individually or in a group. The current systematic review was designed to summarize and review existing evidence on the effect of reminiscence therapy on depression in older adults.Methods: We conducted a systematic review from January 2000 to Mar 2021 using 10 electronic databases in English and Chinese languages, including Medline, Embase, Cinahl, PsychInfo, Cochrane, Web of Science, Google Scholar, Science Direct, CNKI, and WANFANG. We excluded studies that didn't use randomized controlled trials (RCT) from the meta-analysis. The selected studies were scored using the Cochrane Risk of Bias tool. The RevMan 5.0 was used in subgroup analysis depending on how the interventions were classified.Results: We extracted 527 studies based on keyword searches, of which 10 RCTs met inclusion criteria were included in the meta-analysis. The meta-analysis yielded high heterogeneity, and the analyses of significant subgroups showed that reminiscence therapy has a significant effect on relieving depressive symptoms in older adults. Reminiscence therapy benefits older adults with chronic illness and those on antidepressants as well. The effect and cost-effectiveness of group reminiscence therapy were higher than individual reminiscence therapy. And some specific types of group reminiscence therapy have a significant effect on improving depression and secondary outcomes, including life satisfaction. Although the effectiveness of structured and unstructured group reminiscence on depression has no significant differences according to current evidence, the structured therapy is more replicable, generalizable, and user-friendly due to its detailed protocol for new therapists. Furthermore, reminiscence therapy is more effective for older women and older adults with more severe depressive symptoms.Conclusion: Reminiscence therapy significantly increased older adults' remission from depression and quality of life immediately after the intervention. However, the evidence-based protocol and implementation of reminiscence interventions need to be further developed and standardized to facilitate global use. Moreover, it remains unclear on the long-term effect of reminiscence therapy. Based on the limitations of the current study, more rigorous evidence is needed from studies with large sample sizes, RCT design, and longer follow-up periods. Future studies could also explore the effect of different types of reminiscence therapy. Furthermore, qualitative data should be included to better understand older adults' narrative and experiences with reminiscence therapy. Future studies could also investigate the impact of reminiscence therapy on older relatives as a part of outcome measure to explore the efficacious mechanism of reminiscence therapy in alleviating older adults' depressive symptoms.


BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e048917
Author(s):  
Shiyu Lu ◽  
Anna Y Zhang ◽  
Tianyin Liu ◽  
Jacky C P Choy ◽  
Maggie S L Ma ◽  
...  

ObjectivesTo understand and assess the degree of personalisation of tailored activities for people with dementia (PWD); and to estimate the magnitude of the effects of levels of personalisation on reducing behavioural and psychological symptoms of dementia (BPSD), improving quality of life (QoL) and level of engagement.DesignSystematic review with meta-analysis.Data sourcesProQuest, PubMed, Ovid, Cochrane Library, Web of Science and CINAHL were searched from the start of indexing to May 2020.Eligibility criteriaWe included randomised controlled trials and quasi-experimental studies assessing the effects of tailored activities for people aged 60 years or older with dementia or cognitive impairment on the outcomes of BPSD, QoL, depression and level of engagement with control groups.Data extraction and synthesisTwo researchers screened studies, extracted data and assessed risks of bias. A rating scheme to assess the degree of personalisation of tailored activities was developed to classify tailored activities into high/medium/low groups. Effect sizes were expressed using standardised mean differences at 95% Confidence Interval (CI). Subgroup analyses were conducted to assess whether the degree of personalisation of tailored activities affected outcomes of interest.ResultsThirty-five studies covering 2390 participants from 16 countries/regions were identified. Studies with a high-level of personalisation interventions (n=8) had a significant and moderate effect on reducing BPSD (standardised mean differences, SMD=−0.52, p<0.05), followed by medium (n=6; SMD=−0.38, p=0.071) and low-level personalisation interventions (n=6; SMD=−0.15, p=0.076). Tailored activities with a high-level of personalisation had a moderate effect size on improving QoL (n=5; SMD=0.52, p<0.05), followed by a medium level (n=3; SMD=0.41, p<0.05) of personalisation.ConclusionsTo develop high-level tailored activities to reduce BPSD and improve QoL among PWD, we recommend applying comprehensive assessments to identify and address two or more PWD characteristics in designed tailored activities and allow modification of interventions to respond to changing PWD needs/circumstances.PROSPERO registration numberCRD42020168556.


2019 ◽  
Vol 54 (5) ◽  
pp. 263-271 ◽  
Author(s):  
Andrew Craig Hislop ◽  
Natalie J Collins ◽  
Kylie Tucker ◽  
Margaret Deasy ◽  
Adam Ivan Semciw

ObjectivesTo determine, in people with knee osteoarthritis (KOA): i) the effectiveness of adding hip strengthening exercises to quadriceps exercises and ii) the type of hip strengthening exercise with the greatest evidence for improving pain, function and quality of life.DesignSystematic review with meta-analysis.Data sourcesMedline, Embase, Cochrane, CINAHL and SportDiscus databases were searched from inception to January 2018.Eligibility criteria for selecting studiesRandomised controlled trials investigating the effect of adding hip exercises to quadriceps exercises in people with KOA on pain, function and/or quality of life were included. Three subgroups of hip exercises were included: resistance, functional neuromuscular or multimodal exercise.ResultsEight studies were included. Pooled data provide evidence that combined hip and quadriceps exercise is significantly more effective than quadriceps exercise alone for improving walking function (standardised mean difference −1.06, 95% CI −2.01 to −0.12), but not for outcomes of pain (−0.09, 95% CI –0.96 to 0.79), patient-reported function (−0.74, 95% CI –1.56 to 0.08) or stair function (−0.7, 95% CI –1.67 to 0.26). Subgroup analyses reveal that hip resistance exercises are more effective than functional neuromuscular exercises for improving pain (p<0.0001) and patient-reported function (p<0.0001). Multimodal exercise is no more effective than quadriceps strengthening alone for pain (0.13, 95% CI –0.31 to 0.56), patient-reported function (−0.15, 95% CI –0.58 to 0.29) or stair function (0.13, 95% CI –0.3 to 0.57).ConclusionWalking improved after the addition of hip strengthening to quadriceps strengthening in people with KOA. The addition of resistance hip exercises to quadriceps resulted in greater improvements in patient-reported pain and function.


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