Cognitive decline is a significant concern for elderly caregivers of Alzheimer's disease patients in urban areas of Ethiopia. A systematic review and meta-analysis was conducted using databases such as PubMed, Embase, and Cochrane Library, focusing on studies published between and from Addis Ababa urban districts. Studies were selected based on predefined inclusion criteria, including randomized controlled trials comparing CSAs with control interventions. CSA programmes demonstrated a significant positive effect on caregiver well-being (p < 0.05) compared to control groups over six months of intervention. Cognitive stimulation activities are effective in improving the psychological health of caregivers and should be integrated into support programmes for Alzheimer's disease patients. Implementing CSA programmes requires funding, caregiver training, and long-term planning. Collaboration between healthcare providers, community organizations, and government agencies is essential to ensure sustainability and effectiveness. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.