Fourteen RCTs (n=1,503) were included.
Six studies reported no significant difference between the treatment and control groups.
Two studies using interventions based on a progressively lowered stress threshold theory and five studies based on problem-solving behavioural therapy reported significant benefits with the interventions. Both of these interventions met EBT criteria. One study found a positive effect of individualised caregiver counselling interventions. However, a further study would be required for this intervention to meet EBT criteria.
Progressively lowered stress threshold theory.
One study reported significantly lower caregiver distress about behavioural problems (p<0.01) and a lower frequency of behaviour problems reported by non-spouses (p<0.01). The other study reported a significant reduction in behaviour problems.
Problem-solving behavioural treatments.
Three studies evaluated the 'Seattle Protocol'. One study reported significantly reduced caregiver and patient depressive behaviours (p<0.001 and p<0.01); another study reported significantly improved physical functioning and fewer restricted activity days (p<0.001) and significantly fewer depressive behaviours (p<0.02); and the third study reported significantly reduced frequency and severity of patients' behaviours (p<0.001), improved quality of life (p<0.05), reduced caregiver burden and depression, and improved caregiver sleep (all p<0.05). Two studies conducted in residential units reported a significant reduction in depressive symptoms (p<0.01 in one study) and a decrease in troublesome and dangerous behaviour (p<0.01 in the other study) for the intervention group.