Highlight
- Dementia literacy interventions significantly reduce caregiver burden and improve caregiver knowledge, attitudes, and self-efficacy.
- Structured and sustained programs tailored to caregivers’ needs yield the best outcomes.
- Intervention characteristics like session duration, frequency, and delivery mode influence effectiveness.
- Significant heterogeneity and risk of bias across studies highlight the need for optimized and standardized dementia literacy programs.
Study Background
Dementia represents a growing global health challenge, affecting millions worldwide and placing substantial physical, psychological, and financial strain on informal caregivers, often family members. Effective caregiving is critical to maintain quality of life for both people with dementia and their caregivers. Dementia literacy—defined as the ability to seek, understand, evaluate, and apply information related to dementia—plays a vital role in enabling caregivers to manage the complexities of dementia care.
Despite the recognized burden, caregivers frequently lack sufficient knowledge, positive attitudes, and confidence to cope effectively. Interventions designed to improve dementia literacy have been proposed to empower caregivers, potentially alleviating caregiver burden and improving care quality. However, before this meta-analysis, the overall effectiveness of dementia literacy interventions on caregiver outcomes remained unclear.
Study Design
The study by Widiyaningsih et al. undertook a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of dementia literacy interventions among caregivers. Comprehensive search strategies were employed across three major databases—PubMed, Embase, and Web of Science—up to July 12, 2024.
Eligible studies included RCTs that enrolled family caregivers of people diagnosed with dementia. Interventions varied broadly, incorporating educational content about dementia pathophysiology, caregiving strategies, stress management, and communication skills. Delivery modes included face-to-face, technology-assisted, or mixed formats, with variations in session duration, frequency, and total program duration.
The primary endpoint was caregiver burden, a comprehensive measure of psychological, emotional, and physical strain experienced by caregivers. Secondary endpoints included caregiver knowledge about dementia, attitudes toward dementia, and self-efficacy in caregiving tasks. Risk of bias assessment followed the Cochrane Risk-of-Bias 2 tool, and data synthesis utilized Comprehensive Meta-Analysis version 3.0. Narrative synthesis was applied for outcomes or subgroups unsuitable for meta-analysis.
Key Findings
The meta-analysis aggregated data from 40 eligible RCTs involving 4336 caregivers. Interventions varied distinctly, but their collective impact was clear:
- Caregiver Burden: Dementia literacy interventions produced a significant moderate reduction in caregiver burden (Hedges’ g = -0.446, p < 0.001). This implies that structured literacy programs help alleviate the multidimensional stresses associated with dementia caregiving.
- Knowledge of Dementia: Interventions robustly increased caregivers’ dementia-related knowledge with a large effect size (Hedges’ g = 0.806, p < 0.001), indicating improved understanding of disease mechanisms and care strategies.
- Attitudes Toward Dementia: Positive shifts in caregiver attitudes were observed (Hedges’ g = 0.621, p = 0.002), suggesting reduced stigma and greater empathy.
- Self-Efficacy: Caregivers’ confidence to manage caregiving tasks also improved significantly (Hedges’ g = 0.272, p < 0.001), though effect size was smaller compared to knowledge and attitudes.
Subgroup analyses and meta-regression highlighted that intervention characteristics influenced outcomes. Longer session durations, higher intervention frequency, technology involvement, total duration, and the number of sessions were all associated with varying degrees of benefit, underscoring the importance of tailoring programs to caregiver needs.
Nonetheless, significant heterogeneity (variation in effect sizes across studies) and risks of bias were noted, primarily due to differences in study design, intervention components, and quality, which limits definitive conclusions about optimal intervention formats.
Expert Commentary
This meta-analysis provides compelling evidence in favor of dementia literacy interventions to support caregivers. The moderate reduction in caregiver burden is clinically meaningful given the high emotional and physical toll dementia caregiving entails. Improved knowledge and attitudes may promote better, more compassionate caregiving and enhance caregiver resilience.
However, limitations must be acknowledged. The substantial heterogeneity and risk of bias among included studies suggest variability in intervention effectiveness. The diversity of interventions also complicates identification of the most efficacious components. Future research should aim to establish standardized protocols evaluating specific intervention features such as digital versus in-person delivery or optimal session length.
From a mechanistic perspective, enhancing dementia literacy likely empowers caregivers by reducing uncertainty and equipping them with practical care strategies. This informed confidence may mitigate stress and foster positive attitudes toward people living with dementia.
Conclusion
The meta-analysis by Widiyaningsih et al. underscores the value of dementia literacy interventions in reducing caregiver burden and enhancing caregiver knowledge, attitudes, and self-efficacy. Structured, sustained, and tailored programs appear most beneficial. Nevertheless, further high-quality research is warranted to refine intervention designs, optimize delivery modes, and confirm long-term effectiveness.
Given the increasing global burden of dementia and reliance on family caregivers, integrating dementia literacy into caregiver support frameworks should be prioritized in clinical practice and public health policy to improve outcomes for caregivers and the persons they care for.
Funding and Clinical Trials Registration
The protocol for this systematic review and meta-analysis was registered on PROSPERO (Registration number: CRD42024565023). Details on funding sources were not specified in the available abstract.
References
Widiyaningsih, Pradana AA, Susanto H, Chiu HL. Effectiveness of dementia literacy interventions for caregivers of people with dementia: A meta-analysis of randomized controlled trials. Int J Nurs Stud. 2025 Nov;171:105191. doi: 10.1016/j.ijnurstu.2025.105191. Epub 2025 Aug 15. PMID: 40885079.
