The Impact of Social Support on Delaying the Rate of Cognitive Decline and Promoting the Quality of Life for Individuals Living with Alzheimer’s: A Systematic Review

Abstract

Objective: Unlike institutionalisation, care provided by an informal carer to an individual with Alzheimer’s Disease (AD) living at home, is preferred by the family and the healthcare system, and may have an impact on easing the individual’s symptoms and improving their well-being. This systematic review aims to evaluate the effects of social support on the improvement of QoL and a potential delay in cognitive decline by identifying and assessing interventions aimed at individuals with AD and factors influencing QoL. Method: The studies deemed eligible were peer-reviewed and published in English from 2005 to 2020. Of 4,091 articles identified with the use of PRISMA from PubMed, Cochrane, Web of Science and EMBASE, eight observational cohort, cross-sectional or interventional RCT studies were selected and rated as good quality with CASP. Results: Psychosocial interventions were found to be largely ineffective in improving QoL and delaying the rate of progression in individuals with AD. RCT studies reported no discernible differences between the intervention and the control group. The main factors negatively affecting the QoL were: living alone, with a younger or anxious caregiver, having a restricted social network and experiencing behavioural and psychological problems. The use of active coping strategies by the caregiver, e.g. acceptance of the situation and seeking solutions to the problem may positively affect the rate of cognitive decline. Discrepancies between QoL rated by the person with AD/dementia and the caregiver by proxy, were indicative of the quality of the relationship in the dyad. Conclusion: A coordinated interdisciplinary management of AD is necessary, where psychosocial needs of the dyad are prioritised. Future interventions should focus on educating caregivers about coping strategies and improving their mental health, as this affects the QoL of the individual with AD. Reducing depressive symptoms and unmet needs, particularly with respect to widening social interactions in the individual with AD is another priority intervention.