Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards
Open accessAbstract
OBJECTIVE: To provide a systematic review of selected experimental studies of psychosocial treatments of behavioral disturbances in dementia. Psychosocial treatments are defined here as strategies derived from one of three psychologically oriented paradigms (learning theory, unmet needs and altered stress thresholds). METHOD: English language reports published or in press by December 2006 were identified by means of database searches, checks of previous reviews and contact with recognized experts. Papers were appraised with respect to study design, participants' characteristics and reporting details. Because people with dementia often respond positively to personal contact, studies were included only if control conditions entailed similar levels of social attention or if one treatment was compared with another. RESULTS: Only 25 of 118 relevant studies met every specification. Treatment proved more effective than an attention control condition in reducing behavioral symptoms in only 11 of the 25 studies. Effect sizes were mostly small or moderate. Treatments with moderate or large effect sizes included aromatherapy, ability-focused carer education, bed baths, preferred music and muscle relaxation training. CONCLUSIONS: Some psychosocial interventions appear to have specific therapeutic properties, over and above those due to the benefits of participating in a clinical trial. Their effects were mostly small to moderate with a short duration of action. This limited action means that treatments will work best in specific, time-limited situations. In the few studies that addressed within-group differences, there were marked variations in response. Some participants benefited greatly from a treatment, while others did not. Interventions proved more effective when tailored to individuals' preferences.
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The application of the interventions to home-based support remains uncertain.
“their application to home-based support remains uncertain”
From Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review (2015) · cites this paper as [46]
No effect has been documented for acupuncture and transcutaneous electrical nerve stimulation on behavioral and psychological symptoms of dementia.
“No effect has been documented for acupuncture and transcutaneous electrical nerve stimulation.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [99]
There are no conclusive results for validation and reminiscence therapy, the effectiveness of light therapy is not clear, and aromatherapy is better than no treatment for behavioral and psychological symptoms of dementia.
“In particular, there are no conclusive results for validation and reminiscence therapy, the effectiveness of light therapy is not clear, aromatherapy is better than no treatment.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [99]
All guidelines agree that individualized and person-centered non-pharmacological treatments are the first-line treatment for behavioral and psychological symptoms of dementia, and that pharmacological strategy should be considered only later, using the least harmful drug for the shortest time.
“Considering the limited evidence and concerns on the safety of drug treatment (94–99), all guidelines agree that individualized and person-centered NPT are the first-line treatment for BPDS and the use of a pharmacological strategy should be considered only later, using the least harmful drug for the shortest time.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [99]
Music therapy and behavioral management techniques seem to cause a short-term reduction of behavioral and psychological symptoms of dementia, but long-term efficacy is unclear.
“Music therapy and behavioral management techniques seem to cause a short-term reduction of BPSD, but long-term efficacy is unclear.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [99]
The small body of evidence for massage and touch therapy suggests they could be viable treatment options, especially given the ease of implementation and minimal training involved.
“The small body of evidence for other sensory interventions, such as massage and touch therapy, suggests they could be viable treatment options, especially given the ease of implementation and minimal training involved.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [99]
Potential benefits of non-pharmacological treatments for behavioral and psychological symptoms of dementia have been documented, but the strength of evidence is overall low and heterogeneity in intervention type, follow-up duration, and outcome measures hampers comparison across studies.
“Potential benefits of these interventions have been documented, but the strength of evidence is overall low and the great heterogeneity in terms of type of intervention, follow-up duration, type of outcome measures hamper comparison across studies.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [99]
Some reports indicate that non-pharmacological treatments for behavioral and psychological symptoms of dementia are potentially cost-effective.
“Some reports indicate the NPT to BPSD to be potentially cost-effective (70, 99, 106), but further research is needed on this point.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [99]
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- Authors
- O'Connor, D. W., Ames, D., Gardner, B., & King, M.
- Affiliations
- The University of Melbourne (AU)
- Monash University (AU)
- University of Technology Sydney (AU)
- Venue
- International Psychogeriatrics
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 21
- Issue
- 2
- Pages
- 225-240
- ISSN
- 1041-6102 (ISSN-L)
- OpenAlex
- W2141280598
- Cited by
- 239
- References
- 69
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 9 · 2021: 11 · 2020: 7 · 2019: 8 · 2018: 11 · 2017: 12 · 2016: 22 · 2015: 13 · 2014: 21 · 2013: 28 · 2012: 29
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Psychogeriatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- dementia, behavioral symptoms, psychosocial interventions, behavioral problems, aromatherapy, caregiver education, music therapy, muscle relaxation training, bed bath, treatment response variability, personalized treatment
- MeSH terms
- Activities of Daily Living, Aged, Alzheimer Disease, Behavior Therapy, Mental Disorders, Dementia, Homes for the Aged, Humans, Music Therapy, Nurse-Patient Relations, Nursing Homes, Outcome and Process Assessment, Health Care, Relaxation Therapy, Socioenvironmental Therapy, Randomized Controlled Trials as Topic, Caregivers, Cost of Illness, Aromatherapy, Needs Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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