Design: Systematic review and network meta-analysis of randomised trials
Population: 67 trials of informal dementia caregivers (43 in the burden network)
Primary outcome: Caregiver burden
Effect: Multicomponent vs control SMD −0.33 (95% CI −0.63 to −0.04)

A systematic review and network meta-analysis in the International Journal of Geriatric Psychiatry, published on 1 October, included 67 randomised trials of non-drug interventions for family caregivers of people with dementia, 43 of which contributed to the analysis of caregiver burden.

Multicomponent interventions — combining elements such as education, skills training, support and respite — significantly reduced caregiver burden compared with control (SMD −0.33, 95% CI −0.63 to −0.04). No single-component intervention showed a significant effect. Evidence on positive aspects of caregiving was too sparse to pool.

The effect is modest, and the upper end of the interval is close to zero. But the direction is clear: a leaflet or a single session is unlikely to help; a combined programme might.

Ask dementia caregivers directly how they are coping, and record it.
Refer caregivers to programmes that combine education, practical skills and emotional support, rather than a single element.
Include respite planning in the care plan.
In India, where most dementia care is given by family at home, involve the wider family in the plan.

Why it matters

Caregiver strain is a leading reason for care breakdown and admission, and it is rarely assessed.

The statistics, in plain English

A standardised mean difference of −0.33 is a small-to-moderate effect. Network meta-analysis compares interventions indirectly, so rankings are less certain than head-to-head trials.