Development and acceptability of a brief, evidence-based Dementia Awareness for Caregivers course in low- and middle-income countries

Abstract

Background Knowledge of and attitudes towards dementia vary across countries, and for caregivers in low- and middle-income countries (LMICs), access to information can be challenging. There is an urgent need for brief, easily accessible and culturally appropriate educational courses for caregivers of persons with dementia, providing much needed information whilst addressing important psychological concepts such as stigma. Methods An international and multidisciplinary team developed Dementia Awareness for Caregivers (DAC) courses in four stages: (1) scoping review and module agreement, (2) development of an International template (DAC-International) containing a standardised process for adding information, (3) development of local DACs using a standardised format and (4) acceptability of courses in Brazil, India and Tanzania. Findings The DAC-International was developed, comprising three modules: ‘What is dementia?’; ‘Positive engagement’ and ‘Caring for someone with dementia’. Three local versions were developed from this (DAC-Brazil, DAC-India and DAC-Tanzania), where additions of country-specific information included prevalent stereotypes and the addition of culturally relevant case studies. An initial field test was conducted in each country ( n = 85), which indicated acceptability to participants. Conclusions The methods used here resulted in culturally valid and acceptable educational courses for carers of people with dementia. Future work will consist of large-scale, formal evaluations and the development of additional local courses.

A Systematic Review of Educational Interventions for Informal Caregivers of People Living with Dementia in Low and Middle-Income Countries

“…In terms of online intervention delivery, whilst in its infancy in LMICS, feasibility should capture access to technology and availability of digital skills among caregivers. A culturally adaptable Dementia Awareness for Caregivers course template was recently designed [ 66 ] that can be delivered to caregivers in LMICs in a one half-day session. Although yet to be formally evaluated, this study provides one of the first examples of a brief intervention for caregivers, which may be more easily disseminated into public health services than the more intensive interventions evaluated in this review.…”

Longitudinal change in cognition in older adults in Uganda: a prospective population study

“…[27] Strain among carers of people with dementia has been welldocumented in the SSA setting, including in Uganda, [28] and carer support packages relevant to African settings may help to address this. [29] The relationship between cognition and mortality rates was largely explained by SEP and education. These findings contrast with worldwide evidence that dementia is a risk factor for death, including from sub-Saharan Africa.…”

“…[27] Strain among carers of people with dementia has been well-documented in the SSA setting, including in Uganda,[28] and carer support packages relevant to African settings may help to address this. [29]…”

Cognition in older adults in Uganda: Correlates, trends over time and association with mortality in prospective population study

“…These results are comparable to other studies in the continent: in a study of middle-aged and older adults in South Africa, around 20-40% of people in the lowest group of cognition score had an ADL impairment [26], and in Tanzania, 41% of people with dementia had moderate or severe disability [27]. Strain among carers of people with dementia has been well-documented in the SSA setting, including in Uganda [28], and carer support packages relevant to African settings may help to address this issue [29].…”