A systematic review of culturally tailored dementia interventions for minority ethnic groups and low‐ and middle‐income country populations: Acceptability, feasibility and outcomes

Abstract

Background There are more people living with dementia worldwide, particularly in low‐ and middle‐income countries (LMICs) and minority ethnic groups. In high‐income countries (HICs), evidence‐based psychosocial interventions can improve outcomes for people with dementia and family carers. To consider their efficacy in other settings, we investigated whether there are culturally tailored interventions for LMIC populations and minority ethnic groups, with tested acceptability, feasibility and efficacy. Method We systematically reviewed the literature on culturally tailored dementia interventions in LMICs and minority ethnic groups. We searched 11 databases for terms relating to dementia, interventions and cultural tailoring. We identified eligible papers using predefined inclusion criteria. We rated study quality using a quality checklist and prioritised those with less risk of bias when reporting results (PROSPERO: CRD42019133090). Result We found 22 studies out of 22,221 unique references that met criteria for inclusion. Most studies targeted family carers (n = 15) and LMICs (n = 14). Studies of interventions for family carers had mixed quality and there were no higher quality studies of people with dementia. Only three studies reported whether the adapted outcome measures used had been validated in their sample. Culturally tailored, group interventions involving a therapeutic and educational component were associated with improvements in family carers’ depressive symptoms in Egypt and Columbia, and in Latino carers in the US, reflecting findings in HICs and non‐minority groups. An individually delivered, multicomponent intervention improved carer mental health in India but not in Peru or Russia. An adapted Cognitive Stimulation Therapy appeared to be acceptable and feasible in sub‐Saharan Africa, with a full trial planned. Conclusion Culturally tailored interventions for family carers appear to be acceptable and feasible in some LMICs and minority ethnic groups as they are in HICs. Although research in these groups is increasing, studies of culturally tailored interventions were only published for 11 out of 142 LMICs, and studies of interventions for people with dementia are few and of low quality. To improve reliability and validity of future studies of culturally tailored interventions, researchers should ascertain psychometric properties of adapted and translated outcome measures before using them in a new setting.

Care needs assessment of older adults with dementia in a semi‐rural district in Vietnam: A community‐based cross‐sectional study

“…As the prevalence of dementia in Vietnam is anticipated to rise significantly in the coming years, nonpharmacological interventions, such as physical activity, cognitive stimulation, and person-centred care, [39][40][41][42][43] may hold particular relevance in a setting where access to dementia medications may be limited and cultural and social factors can significantly impact dementia management. 44,45 Moreover, interventions that promote social engagement may also be effective in addressing social isolation and stigma associated with dementia, 46 which can pose substantial barriers to care and support. Nevertheless, implementing these interventions in Vietnam could be hindered by challenges such as a lack of trained healthcare professionals, limited resources, and cultural barriers.…”