Effectiveness of psychosocial interventions for anticipatory grief in informal caregivers for people living with dementia: A systematic review and meta-analysis

Abstract Background and Objectives Psychosocial interventions support informal caregivers of people with dementia, but their impact on anticipatory grief and related health outcomes remains unclear. This review examines the effectiveness of different psychosocial approaches in addressing these outcomes. Research Design and Methods A systematic review and meta-analysis were conducted following PRISMA guidelines and registered in PROSPERO (CRD42024629388). Eight databases were searched from inception to 10th Jan 2025. Two reviewers independently screened studies, assessed bias, and extracted data. Leave-one-out sensitivity and subgroup analyses addressed heterogeneity. Evidence quality was assessed using the GRADEpro Guideline Development Tool. Results Eleven interventional studies were included. Psychosocial interventions (n = 6) had no significant short-term (< 1 month: SMD = -0.57, 95% CI:[-1.14, 0.01], p = 0.05, I2 = 85%) or medium-term (1-6 months; SMD = -0.76, 95% CI:[-1.99, 0.46], p = 0.22, I2 = 88%, n = 3) effect on anticipatory grief but showed improvement in long-term (≥ 6 months; MD = -0.41, 95% CI:[-0.62, -0.20], p = 0.0001, I2 = 0%, n = 2). Short-term reductions in depression were also observed, with no significant effects in other outcomes. Subgroup analyses did not identify frameworks or delivery methods linked to better outcomes. The GRADEpro rated the evidence as ‘Low’ to ‘Very Low’. Discussion and Implications Overall, psychosocial interventions have limited short- and medium-term impact on anticipatory grief. Individual, technology-mediated cognitive-behavioural approaches may improve anticipatory grief in long-term, but evidence is limited. Further research should clarify the concept of anticipatory grief and evaluate interventions in large, rigorous RCTs.