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Effectiveness of interventions for dementia in low- and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis
  1. Maximilian Salcher-Konrad1,
  2. Huseyin Naci2,
  3. David McDaid1,
  4. Suvarna Alladi3,
  5. Deborah Oliveira4,5,
  6. Andra Fry6,
  7. Shereen Hussein7,
  8. Martin Knapp1,
  9. Christine Wayua Musyimi8,
  10. David Musyimi Ndetei8,9,
  11. Mariana Lopez-Ortega10,
  12. Adelina Comas-Herrera1
  1. 1 Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science, London, UK
  2. 2 Department of Health Policy, London School of Economics and Political Science, London, UK
  3. 3 NIMHANS, Bangalore, India
  4. 4 Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
  5. 5 University of Nottingham Institute of Mental Health, Nottingham, UK
  6. 6 Library, London School of Economics and Political Science, London, UK
  7. 7 Personal Social Services Research Unit (PSSRU), University of Kent, Canterbury, UK
  8. 8 Africa Mental Health Foundation, Nairobi, Kenya
  9. 9 University of Nairobi, Nairobi, Kenya
  10. 10 National Institute of Geriatrics, National Institutes of Health, Mexico City, Mexico
  1. Correspondence to Maximilian Salcher-Konrad; m.salcher{at}


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.

Prospero registration number CRD42018106206.

  • dementia
  • low and middle income countries
  • developing countries
  • Alzheimer disease
  • lamics
  • systematic review

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  • Contributors AC-H, DMD, HN and MS-K defined the scope of the review and review question. DMD, HN and MS-K developed inclusion/exclusion criteria. AF consulted on the databases to be searched and search terms used. MS-K drafted the protocol. MS-K, HN, DMD, SA, DO, AF, SH, MK, CM, DN, ML-O and AC-H reviewed the draft protocol along with the search strategy and contributed to a revised version. MS-K acts as the guarantor of the manuscript.

  • Funding This work is conducted as part of the ‘Strengthening responses to dementia in developing countries’ (STRiDE) project, supported by the UK Research and Innovation’s Global Challenges Research Fund (ES/P010938/1). The funder was not involved in the development of this protocol at any stage.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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