The Effectiveness of the Interventions Available for Supporting Informal Caregivers of People Living with Dementia In India: A Systematic Review

Background:

In India, approximately 8.8 million people live with dementia, the majority of whom rely on informal caregivers, primarily family members, who provide unpaid care. Caregivers of people living with dementia (PLWD) experience substantial burden, particularly related to behavioural and psychological symptoms of dementia, which negatively affect their physical and mental health, often leading to emotional burnout. Limited awareness of dementia also contributes to stigma, isolation, and caregiver strain. Although various caregiver interventions exist globally, evidence specific to the Indian context remains limited and fragmented. This review synthesizes existing interventions designed for informal caregivers of PLWD in India to address research questions: 1) What types of interventions have been developed or adapted to support informal caregivers of PLWD in India? 2) What caregiver-related outcomes have been assessed? 3) What evidence exists regarding intervention effectiveness?

Methods:

A systematic review was conducted using the Joanna Briggs Institute (JBI) methodology and reported following PRISMA 2020 guidelines. Databases like APA PsycINFO, Academic Search Premier, PubMed, Web of Science, and MEDLINE were searched. Key search terms included “informal caregiver," "family caregiver," "dementia," "Alzheimer's disease," "cognitive impairment," "intervention," "training," "counseling," "therapy," "support group," and "India." Screening and selection were managed in Rayyan with two independent reviewers assessing titles, abstracts, and full texts against eligibility criteria. Included studies focused on informal caregivers of PLWD in India and evaluated interventions targeting caregiver outcomes such as burden, stress, mental health, coping, self-efficacy, and quality of life.

Results

The search yielded 799 records, and 279 duplicates were removed from them, leaving 520 studies for screening. After title and abstract screening, 496 were excluded, and 24 full texts were assessed. Fifteen studies were finally included in the study. Study designs included randomized controlled trials, quasi-experimental and qualitative studies, and mixed-methods designs. In total, the quality of evidence was low, with relatively few randomized controlled trials and a predominance of small-scale, heterogeneous study designs. Interventions spanned multiple domains, including technology-based approaches (e.g., social robots and assistive devices), human-centered design, cognitive stimulation therapy, co-designed films, psychosocial interventions (e.g., meditation and yoga), educational programs, and caregiver support groups, combining training and counseling. Findings demonstrated generally positive but variable effects. Interactive and skill-based interventions were most effective, with caregivers reporting reduced stress, improved coping, and increased self-efficacy, as well as enhanced knowledge and awareness of dementia. However, intervention effectiveness was constrained by financial difficulties, technological barriers, sociocultural stigma, and practical challenges such as a lack of respite care, transportation, and competing caregiving responsibilities.

Conclusions and implications:

Given the structural and sociocultural barriers identified, the findings underscore the need for caregiver interventions in India to be grounded in local contexts. While psychosocial, educational, and technology-assisted interventions show promise, their impact is constrained by structural barriers. There is a need for low-cost and culturally adaptable interventions that integrate caregiver education with community-based support. From a social work and policy perspective, strengthening community infrastructure, expanding respite care, and investing in caregiver training are essential to reducing caregiver burden and improving outcomes for both caregivers and PLWD.