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Article: Research evaluating the effectiveness of dementia interventions in low‐ and middle‐income countries: A systematic mapping of 340 randomised controlled trials

TitleResearch evaluating the effectiveness of dementia interventions in low‐ and middle‐income countries: A systematic mapping of 340 randomised controlled trials
Authors
Keywordsdementia
evidence
global south
health policy
LMIC
low- and middle-income
psychosocial interventions
systematic review
traditional Chinese medicine
Issue Date10-Jul-2023
PublisherWiley
Citation
International Journal of Geriatric Psychiatry, 2023, v. 38, n. 7 How to Cite?
Abstract

Objectives More people with dementia live in low- and middle-income countries (LMICs) than in high-income countries, but best-practice care recommendations are often based on studies from high-income countries. We aimed to map the available evidence on dementia interventions in LMICs.Methods We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias.Results We included 340 RCTs with 29,882 (median, 68) participants, published 2008-2018. Over two-thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%).Conclusions Evidence-generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence-generation for LMICs.


Persistent Identifierhttp://hdl.handle.net/10722/331917
ISSN
2023 Impact Factor: 3.6
2023 SCImago Journal Rankings: 1.187

 

DC FieldValueLanguage
dc.contributor.authorSalcher-Konrad, M-
dc.contributor.authorShi, C-
dc.contributor.authorPatel, D-
dc.contributor.authorMcDaid, D-
dc.contributor.authorAstudillo-Garcia, CI-
dc.contributor.authorBobrow, K-
dc.contributor.authorChoy, J-
dc.contributor.authorComas-Herrera, A-
dc.contributor.authorFry, A-
dc.contributor.authorKnapp, M-
dc.contributor.authorLeung, DKY-
dc.contributor.authorLopez-Ortega, M-
dc.contributor.authorLorenz-Dant, K-
dc.contributor.authorMusyimi, C-
dc.contributor.authorNdetei, D-
dc.contributor.authorNguyen, TA-
dc.contributor.authorOliveira, D-
dc.contributor.authorPutra, A-
dc.contributor.authorVara, A-
dc.contributor.authorWong, GHY-
dc.contributor.authorNaci, H-
dc.contributor.authorSTRiDE Evidence Review Grp-
dc.date.accessioned2023-09-28T04:59:36Z-
dc.date.available2023-09-28T04:59:36Z-
dc.date.issued2023-07-10-
dc.identifier.citationInternational Journal of Geriatric Psychiatry, 2023, v. 38, n. 7-
dc.identifier.issn0885-6230-
dc.identifier.urihttp://hdl.handle.net/10722/331917-
dc.description.abstract<p>Objectives More people with dementia live in low- and middle-income countries (LMICs) than in high-income countries, but best-practice care recommendations are often based on studies from high-income countries. We aimed to map the available evidence on dementia interventions in LMICs.Methods We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias.Results We included 340 RCTs with 29,882 (median, 68) participants, published 2008-2018. Over two-thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%).Conclusions Evidence-generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence-generation for LMICs.<br></p>-
dc.languageeng-
dc.publisherWiley-
dc.relation.ispartofInternational Journal of Geriatric Psychiatry-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectdementia-
dc.subjectevidence-
dc.subjectglobal south-
dc.subjecthealth policy-
dc.subjectLMIC-
dc.subjectlow- and middle-income-
dc.subjectpsychosocial interventions-
dc.subjectsystematic review-
dc.subjecttraditional Chinese medicine-
dc.titleResearch evaluating the effectiveness of dementia interventions in low‐ and middle‐income countries: A systematic mapping of 340 randomised controlled trials-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1002/gps.5965-
dc.identifier.scopuseid_2-s2.0-85164300955-
dc.identifier.volume38-
dc.identifier.issue7-
dc.identifier.eissn1099-1166-
dc.identifier.issnl0885-6230-

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