Relationship quality and subjective well-being of persons with dementia and partners: A systematic review using a resilience framework

OBJECTIVE: This review aimed to explore changes in relationship quality between persons with dementia and their partners and examine the association of relationship quality with subjective well-being. METHODS: Eleven databases were systematically searched from inception to November 2024, along with manual screening of reference lists. Selected studies were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Convergent integrated approach was used to synthesize findings based on the resilience framework. The GRADE-CERQual approach was applied to assess confidence in the synthesised qualitative evidence. RESULTS: This synthesis included 10 qualitative, 10 quantitative, and 4 mixed-method studies. Within a resilience framework, 18 initial categories were distilled into three themes and nine subthemes. Relationship quality changes between persons with dementia and their partners unfold across three empirically derived stages: maintenance, adjustment, and redefinition. Influencing factors encompass individual factors such as disease knowledge and initiative, family factors such as beliefs, reciprocity, and communication, and social factors, such as social support services and neighbourhood context. Overall, higher relationship quality is associated with higher subjective well-being. CONCLUSION: Dyadic relationship quality is significantly associated with the subjective well-being of both persons with dementia and their partners. Resilience factors should be integrated into interventions to enhance relationship quality and promote mutual subjective well-being.