Psychoeducational and multicomponent non-pharmacological interventions for informal dementia caregivers: a systematic review of strategies to reduce caregiver burden

Abstract

Background: Caregiver burden among informal caregivers of individuals with dementia syndromes represents a major public health concern and is associated with increased risk of psychological stress, depressive symptoms, and reduced quality of life. As the global population ages and the prevalence of dementia continues to rise, the impact of long-term caregiving on family members has become increasingly relevant. In this context, non-pharmacological interventions directed toward caregivers have been investigated as potential strategies to mitigate the negative consequences of prolonged caregiving. Objective: The present study aimed to systematically review the literature on structured non-pharmacological interventions designed to reduce caregiver burden among individuals caring for people with dementia. Methods: Search terms related to dementia, caregivers, health education, caregiver training, and burden were applied across the PubMed, SciELO, DOAJ, and Google Scholar databases, resulting in a total of 162 identified articles. Title and abstract screening was conducted independently by three reviewers, and 42 studies were selected for full-text analysis. Inclusion criteria comprised studies involving informal caregivers of patients with a clinical diagnosis of dementia that evaluated structured non-pharmacological interventions and reported quantitative outcomes related to caregiver burden using validated assessment instruments. Results: Psychoeducational programs constituted the most frequently investigated category of intervention and showed consistent evidence of reducing caregiver burden when delivered in a structured format and over an adequate duration. Interventions incorporating behavioral strategies applicable to everyday caregiving—such as training in the management of the psychological and behavioral symptoms of dementia and simulations of real-life caregiving situations—demonstrated larger effect sizes. Multicomponent interventions combining dementia education, skills training, emotional support, and self-care strategies produced moderate to high effects (Cohen’s d or Hedges’ g ranging from 0.5 to 0.8). The Zarit Burden Interview was the most commonly used instrument, with effective interventions typically showing mean reductions of 5 to 10 points. The main limitations observed in the literature include small sample sizes, methodological heterogeneity among interventions, limited follow-up periods, and insufficient reporting of the clinical and contextual characteristics of caregivers and care recipients. Conclusion: Overall, psychoeducational and multicomponent interventions—particularly those incorporating practical skills training and structured social support—appear to have the greatest potential to reduce caregiver burden in dementia. Nevertheless, further studies with greater methodological rigor, larger samples, and longer follow-up periods are needed to strengthen the current body of evidence.