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BMJ Open. 2017 Mar 16;7(3):e012759. doi: 10.1136/bmjopen-2016-012759.

Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series.

Author information

1
Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy.
2
Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Madrid, Spain.
3
Department of Internal Medicine (Geriatrics), Ghent University, Ghent, Belgium.
4
Landspitali University Hospital Reykjavik, Reykjavik, Iceland.
5
Department of Medicine for the Elderly, Woodend Hospital, Aberdeen, UK.
6
Department of Medicine, University College Cork, Cork, Ireland.
7
'Golgi Cenci' Foundation, Milan, Italy.

Abstract

OBJECTIVE:

To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD).

DESIGN:

Systematic overview of reviews.

DATA SOURCES:

PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015).

ELIGIBILITY CRITERIA:

Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD.

DATA EXTRACTION:

Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs.

DATA ANALYSIS:

Extracted data were synthesised using a narrative approach.

RESULTS:

38 SRs and 129 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (25 SRs, 66 primary studies) that encompassed: shiatsu and acupressure, aromatherapy, massage/touch therapy, light therapy, sensory garden and horticultural activities, music/dance therapy, dance therapy, snoezelen multisensory stimulation therapy, transcutaneous electrical nerve stimulation; (2) cognitive/emotion-oriented interventions (13 SRs; 26 primary studies) that included cognitive stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 22 primary studies); (4) Multicomponent interventions (3 SR; four primary studies); (5) other therapies (5 SRs, 15 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions.

CONCLUSIONS:

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.

KEYWORDS:

Alzheimer's disease; BPSD; Behavioral and psychological symptoms in dementia; Non-pharmacological intervention

PMID:
28302633
PMCID:
PMC5372076
DOI:
10.1136/bmjopen-2016-012759
[Indexed for MEDLINE]
Free PMC Article

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