Carer Involvement in Rehabilitation for People Living With Dementia: A Systematic Review.

The review included many pilot studies and multicomponent interventions, so it could not tell which part of a programme produced an effect. Outcome measures varied widely across studies, and the authors did not pool effect sizes, so comparisons are descriptive. Carer involvement was classified from study descriptions rather than measured directly, and studies did not directly test the carer role. The search was limited to English papers from the last 5 years, and most included studies were from Western countries, so global relevance is uncertain. Blinding of participants and therapists was not feasible, and two studies had high dropout rates. Only 12 main trials were available for the primary comparison, and several intervention types had very few studies. The excluded studies without carer involvement limit any comparison of rehabilitation with and without carer involvement. The carer depression trend came from pilot studies and was not seen in main trials, so it cannot be treated as established.

The authors report no conflicts of interest.

Do not conclude that involving carers more will improve outcomes. The review found no statistical difference between low/medium and high carer involvement, and in pilot studies high involvement was associated with worsened carer depressive symptoms in six studies, although this was not seen in main trials.