Dementia caregiver intervention research: In search of clinical significance

Richard Schulz, Alison O’ Brien, Sara Czaja, Marcia Ory, Rachel Norris, Lynn M. Martire, Steven H. Belle, Lou Burgio, Laura Gitlin, David Coon, Robert Burns, Dolores Gallagher-Thompson, Alan Stevens

Research output: Contribution to journalReview articlepeer-review

338 Scopus citations


Purpose: We reviewed intervention studies that reported dementia caregiver outcomes published since 1996, including psychosocial interventions for caregivers and environmental and pharmacological interventions for care recipients. Our goal was to focus on issues of clinical significance in caregiver intervention research in order to move the field toward a greater emphasis on achieving reliable and clinically meaningful outcomes. Design and Methods: MEDLINE, PsyclNFO, and Cumulative Index to Nursing and Allied Health databases from 1996 through 2001 were searched to identify articles and book chapters mapping to two medical subject headings: caregivers and either dementia or Alzheimer's disease. Articles were evaluated on two dimensions, outcomes in four domains thought to be important to the individual or society and the magnitude of reported effects for these outcomes in order to determine if they were large enough to be clinically meaningful. Results: Although many studies have reported small to moderate statistically significant effects on a broad range of outcomes, only a small proportion of these studies achieved clinically meaningful outcomes. Nevertheless, caregiving intervention studies have increasingly shown promise of affecting important public health outcomes in areas such as service utilization, including delayed institutionalization; psychiatric symptomatology, including the successful treatment of major and minor depression; and providing services that are highly valued by caregivers. Implications: Assessment of clinical significance in addition to statistical significance is needed in this research area. Specific recommendations on design, measurement, and conceptual issues are made to enhance the clinical significance of future research.

Original languageEnglish (US)
Pages (from-to)589-602
Number of pages14
Issue number5
StatePublished - Oct 1 2002

All Science Journal Classification (ASJC) codes

  • General Medicine


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