Efficacy of cognitive-behavioural therapy interventions on reducing burden for caregivers of older adults with a neurocognitive disorder: a systematic review and meta-analysis

Cogn Behav Ther. 2021 Jan;50(1):19-46. doi: 10.1080/16506073.2020.1819867. Epub 2020 Oct 30.


By 2025, 34 million people worldwide will be living with Alzheimer's disease or another form of dementia (i.e., neurocognitive disorders). Symptoms of neurocognitive disorders have functional repercussions on daily activities. People with neurocognitive disorders often rely on a caregiver to alleviate the impact of their symptoms, but this help has consequences for the caregiver. Indeed, caregivers report subjective burden, depressive symptoms, stress, anxiety and a lower quality of life than non-caregivers. Multiple cognitive-behavioral therapy (CBT) trials have been conducted to reduce these symptoms for caregivers. No meta-analysis has been conducted to evaluate the efficacy of this type of intervention on reducing subjective burden. Articles were selected from PsycNet, MEDLINE, AgeLine and ProQuest Dissertation and Theses for the period from 2000 to 2017. Article selection, data extraction and bias analysis for individual studies were completed by two independent authors who used a consensus procedure when discrepancies occurred. A total of 20 articles were included in the systematic review. Ten studies evaluated the efficacy of CBT in reducing subjective burden, and the meta-analysis suggested a significant reduction in subjective burden following CBT. Additionally, 17 studies evaluated the efficacy in reducing depressive symptoms, and the meta-analysis revealed a significant reduction for these caregivers following CBT. CBT for caregivers of individuals with a neurocognitive disorder had no impact on stress, anxiety, or quality of life.

Keywords: Caregivers; burden; cognitive-behavioral therapy intervention; dementia; mild cognitive impairment; non-pharmacological intervention; psychological symptoms; quality of life.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Aged
  • Caregiver Burden / prevention & control*
  • Cognitive Behavioral Therapy*
  • Humans
  • Neurocognitive Disorders / psychology*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome