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Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series.
Abraha, Iosief Rimland, Joseph M Trotta, Fabiana Mirella Dell'Aquila, Giuseppina Cruz-Jentoft, Alfonso Petrovic, Mirko Gudmundsson, Adalsteinn Soiza, Roy O'Mahony, Denis Guaita, Antonio
Abraha, Iosief
Rimland, Joseph M
Trotta, Fabiana Mirella
Dell'Aquila, Giuseppina
Cruz-Jentoft, Alfonso
Petrovic, Mirko
Gudmundsson, Adalsteinn
Soiza, Roy
O'Mahony, Denis
Guaita, Antonio
Advisors
Editors
Other Contributors
Departments
Date
2017-03-16
Date Submitted
Keywords
DEMENTIA
BEHAVIOURAL CHANGE
BEHAVIOURAL CHANGE
Other Subjects
systematic review
Subject Mesh
Aged
Aged, 80 and over
Anxiety
Cognitive Therapy
Complementary Therapies
Dementia
Home Care Services
Humans
Phototherapy
Physical Therapy Modalities
Psychomotor Agitation
Review Literature as Topic
Aged, 80 and over
Anxiety
Cognitive Therapy
Complementary Therapies
Dementia
Home Care Services
Humans
Phototherapy
Physical Therapy Modalities
Psychomotor Agitation
Review Literature as Topic
Planned Date
Start Date
Collaborators
Principal Investigators
Files
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Main Article
Adobe PDF, 2.22 MB
Alternative Titles
Publisher
Abstract
To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD).
Systematic overview of reviews.
PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015).
Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD.
Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs.
Extracted data were synthesised using a narrative approach.
38 SRs and 142 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (12 SRs, 27 primary studies) that encompassed: acupressure, aromatherapy, massage/touch therapy, light therapy and sensory garden; (2) cognitive/emotion-oriented interventions (33 SRs; 70 primary studies) that included cognitive stimulation, music/dance therapy, dance therapy, snoezelen, transcutaneous electrical nerve stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 32 primary studies) and (4) other therapies (5 SRs, 12 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. Music therapy was effective in reducing agitation (SMD, -0.49; 95% CI -0.82 to -0.17; p=0.003), and anxiety (SMD, -0.64; 95% CI -1.05 to -0.24; p=0.002). Home-based behavioural management techniques, caregiver-based interventions or staff training in communication skills, person-centred care or dementia care mapping with supervision during implementation were found to be effective for symptomatic and severe agitation.
A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.
Systematic overview of reviews.
PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015).
Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD.
Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs.
Extracted data were synthesised using a narrative approach.
38 SRs and 142 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (12 SRs, 27 primary studies) that encompassed: acupressure, aromatherapy, massage/touch therapy, light therapy and sensory garden; (2) cognitive/emotion-oriented interventions (33 SRs; 70 primary studies) that included cognitive stimulation, music/dance therapy, dance therapy, snoezelen, transcutaneous electrical nerve stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 32 primary studies) and (4) other therapies (5 SRs, 12 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. Music therapy was effective in reducing agitation (SMD, -0.49; 95% CI -0.82 to -0.17; p=0.003), and anxiety (SMD, -0.64; 95% CI -1.05 to -0.24; p=0.002). Home-based behavioural management techniques, caregiver-based interventions or staff training in communication skills, person-centred care or dementia care mapping with supervision during implementation were found to be effective for symptomatic and severe agitation.
A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.
Language
en
ISSN
2044-6055
eISSN
ISBN
DOI
10.1136/bmjopen-2016-012759
PMID
28302633