Effectiveness of interventions for dementia in low- and middle-income countries

Introduction There are more people living with dementia in low- and middle-income countries (LMICs) than in high-income countries. Evidence-based interventions to improve the lives of people living with dementia and their carers are needed, but a systematic mapping of methodologically robust studies in LMICs and synthesis of the effectiveness of dementia interventions in these settings is missing.

Methods and analysis A systematic review and meta-analysis will be conducted to answer the question: Which dementia interventions were shown to be effective in LMICs and how do they compare to each other? Electronic database searches (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit, Cochrane Database of Systematic Reviews) will be complemented by hand searching of reference lists and local knowledge of existing studies from an international network of researchers in dementia from LMICs. Studies will be eligible for inclusion if they were published between 2008 and 2018, conducted in LMICs and evaluated the effectiveness of a dementia intervention using a study design that supports causal inference of the treatment effect. We will include both randomised and non-randomised studies due to an anticipated low number of well-conducted randomised trials in LMICs and potentially greater external validity of non-randomised studies conducted in routine care settings. In addition to narrative synthesis of the interventions, feasibility of pairwise and network meta-analyses will be explored to obtain pooled effects of relative treatment effects.

Ethics and dissemination Secondary analysis of published studies, therefore no ethics approval required. Planned dissemination channels include a peer-reviewed publication as well as a website, DVD and evidence summaries.

Salcher-Konrad, M., Naci, H., McDaid, D., Alladi, S., Oliveira, D., Fry, A., Hussein, S., Knapp, M., Musyimi, C., Ndetei, D., Lopez-Ortega, M. and Comas-Herrera, A. (2019) Effectiveness of interventions for dementia in low- and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis. BMJ Open.

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Founder and Director
Shereen Hussein is a Health and Social Care Policy professor at the London School of Hygiene and Tropical Medicine (LSHTM), United Kingdom.
Shereen Founded the MENARAH Network in 2019, through an initial grant from the Global Challenge Research Fund, UKRI. She is a medical demographer with expertise in ageing, family dynamics, migration and long-term care systems. Shereen regularly collaborates with the United Nations, the World Health Organisation and the World Bank in policy and research focused on ageing in the Middle East and North Africa Region.
Shereen received her undergraduate degree in statistics and a postgraduate degree in computer science at Cairo University. She completed an MSc in medical demography at the London School of Hygiene and a PhD in quantitative demography and population studies at the London School of Economics and Political Science, United Kingdom.

Co-lead at Strengthening Responses to Dementia in Developing Countries (STRiDE) | + posts

Assistant Professor, London School of Economics, Co-lead STRiDE-Dementia, United Kingdom

Adelina Comas-Herrera is co-lead of the Strengthening Responses to Dementia in Developing Countries (STRiDE) project, a multi-national research project funded by the Research Councils UK’s Global Challenges Research Fund involving Brazil, India, Indonesia, Jamaica, Kenya, Mexico, and South Africa. The project aims to build capacity to generate research to support the development of policy responses to dementia. She is the curator of LTCcovid.org, a website that has played a key role in generating and sharing evidence on the impacts of COVID-19 on people who use and provide Long-Term Care and measures adopted to mitigate these impacts.