Systematic review of non-pharmacologic interventions to delay functional decline in community-dwelling patients with dementia
Open accessAbstract
OBJECTIVES: Older adults with dementia experience progressive functional decline, which contributes to caregiver burden and nursing home placement. The goal of this systematic review was to determine if any non-pharmacologic interventions have delayed functional decline among community-dwelling dementia patients. METHOD: We completed a systematic literature review to identify controlled clinical trials reporting the impact of non-pharmacologic interventions on any measure of functional impairment or disability among community-dwelling dementia patients. We included studies that reported any proxy-respondent, self-reported, or performance-based standardized assessments. RESULTS: We identified 18 published clinical trials that met inclusion criteria and found that study interventions fell into three different groups: occupational therapy, exercise, and multi-faceted ("other") interventions. The three groups of studies tended to vary systematically regarding the conceptual framework for the disabling process, target of intervention, and type of outcome measure. Approximately half the studies were conducted in the United States with mean sample size of 99 (from 27 to 1131) and follow-up periods between three months and two years. Instruments used to measure functional impairment or disability varied widely with 55 instruments across 18 studies. Nine studies reported a statistically significant improvement in functional decline in the intervention group. CONCLUSION: The current literature provides clinical trial evidence that non-pharmacologic interventions can delay progression of functional impairment or disability among community-dwelling dementia patients. The clinical significance of this early evidence is uncertain. These early studies provide rationale for larger and longer-term studies to determine if these interventions are sufficiently potent to delay institutionalization.
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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 [105]
Occupational therapy interventions may maintain physical function and activities of daily living in community-dwelling persons with dementia.
“A review including seven RCTs showed that OT interventions may maintain physical function and ADL in community-dwelling persons with dementia (105, 122).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [105]
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- Authors
- McLaren, A. N., LaMantia, M. A., & Callahan, C. M.
- Affiliations
- Indiana University School of Medicine (US)
- Regenstrief Institute (US)
- Venue
- Aging & Mental Health
- Publisher
- Informa UK Limited
- Published
- 2013-04-23
- Volume
- 17
- Issue
- 6
- Pages
- 655-666
- ISSN
- 1360-7863 (ISSN-L)
- 1364-6915
- PMC
- PMC3723698
- OpenAlex
- W2039890884
- Cited by
- 103
- References
- 56
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 2 · 2022: 2 · 2021: 7 · 2020: 6 · 2019: 12 · 2018: 16 · 2017: 16 · 2016: 8 · 2015: 15 · 2014: 5
- FWCI
- 1.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Aging & Mental Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Institute on Aging (K24AG024078, R01AG034946)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
- Keywords
- dementia, functional decline, non-pharmacological treatment, community-dwelling older adults, occupational therapy, exercise intervention, multicomponent intervention, functional disability, disability, nursing home admission, caregiver burden
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Alzheimer Disease, Dementia, Exercise Therapy, Humans, Middle Aged, Occupational Therapy, Residence Characteristics, Disease Progression
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