Nonpharmacological therapies in Alzheimer’s disease: a systematic review of efficacy
Open accessAbstract
INTRODUCTION: Nonpharmacological therapies (NPTs) can improve the quality of life (QoL) of people with Alzheimer's disease (AD) and their carers. The objective of this study was to evaluate the best evidence on the effects of NPTs in AD and related disorders (ADRD) by performing a systematic review and meta-analysis of the entire field. METHODS: Existing reviews and major electronic databases were searched for randomized controlled trials (RCTs). The deadline for study inclusion was September 15, 2008. Intervention categories and outcome domains were predefined by consensus. Two researchers working together detected 1,313 candidate studies of which 179 RCTs belonging to 26 intervention categories were selected. Cognitive deterioration had to be documented in all participants, and degenerative etiology (indicating dementia) had to be present or presumed in at least 80% of the subjects. Evidence tables, meta-analysis and summaries of results were elaborated by the first author and reviewed by author subgroups. Methods for rating level of evidence and grading practice recommendations were adapted from the Oxford Center for Evidence-Based Medicine. RESULTS: Grade A treatment recommendation was achieved for institutionalization delay (multicomponent interventions for the caregiver, CG). Grade B recommendation was reached for the person with dementia (PWD) for: improvement in cognition (cognitive training, cognitive stimulation, multicomponent interventions for the PWD); activities of daily living (ADL) (ADL training, multicomponent interventions for the PWD); behavior (cognitive stimulation, multicomponent interventions for the PWD, behavioral interventions, professional CG training); mood (multicomponent interventions for the PWD); QoL (multicomponent interventions for PWD and CG) and restraint prevention (professional CG training); for the CG, grade B was also reached for: CG mood (CG education, CG support, multicomponent interventions for the CG); CG psychological well-being (cognitive stimulation, multicomponent interventions for the CG); CG QoL (multicomponent interventions for PWD and CG). CONCLUSION: NPTs emerge as a useful, versatile and potentially cost-effective approach to improve outcomes and QoL in ADRD for both the PWD and CG.
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Research shows a positive correlation between increased physical activity, cognitive training, improved nutrition, and slowing cognitive and functional decline and intensity of BPSD.
“Indeed, research shows a positive correlation between increased physical activity, cognitive training, improved nutrition, and slowing cognitive and functional decline and intensity of BPSD.”
From Alzheimer's Disease: Treatment Strategies and Their Limitations. (2022) · cites this paper as [170]
Only multicomponent interventions have been shown to be effective in preventing institutionalisation.
“Only multicomponent interventions have been shown to be effective in preventing institutionalisation.11,12”
Preliminary results indicate that cognitive stimulation may improve quality of life and well-being of caregivers of people with AD and dementia.
“However, preliminary results indicate that CS may improve QoL and well-being of caregivers of people with AD and dementia (69, 70, 74).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [70]
Most randomized controlled trials showed no effect of cognitive training on outcomes other than trained tasks, but their low quality impedes any solid conclusion.
“Most RCTs showed no effect of CT on other outcomes, but their low quality impede any solid conclusion (70–72, 74, 77).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [70]
Cognitive stimulation improves general cognitive functioning in patients with mild-to-moderate dementia.
“Several studies reported an improvement of general cognitive functioning in patients with mild-to-moderate dementia after CS sessions of variable length (69–74).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [70]
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 [70]
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 [70]
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 [70]
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 [70]
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 [70]
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 [70]
Some systematic reviews demonstrated that multicomponent interventions were more effective than single activities in improving general well-being of both persons with dementia and their caregivers, and in hospitalized older adults with cognitive impairment.
“Actually, some systematic reviews demonstrated that multicomponent interventions were more effective than single activities in improving general well-being of both persons with dementia and their caregivers (70, 175), and in hospitalized older adults with cognitive impairment (176, 177).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [70]
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Cognitive Stimulation in Patients with Dementia: Randomized Controlled Trial
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“However, of the high-quality studies reviewed, cognitive training, cognitive stimulation, and training in ADLs appeared most successful in reaching the aims of the interventions [112].”
Cognitive stimulation to improve cognitive functioning in people with dementia
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“Olazarán et al in 2010 138 (AMSTAR=4) identi fi ed 179 RCTs of diverse types of non-pharmacological interventions for AD patients and examined problem behaviour, mood, QoL, cognition, ADLs, mechanical restraint and institutionalisation of patients and mood, psychological well-being and QoL of CGs.”
BackgroundBabulal, G. M., Quiroz, Y. T., Albensi, B. C., Arenaza‐Urquijo, E., Astell, A. J., Babiloni, C., Bahar‐Fuchs, A., Bell, J., Bowman, G. L., Brickman, A. M., et al. (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2018.09.009 · Cited by 528 · see citing works
“, counseling or meditation), to delay and/or prevent the onset of ADRD symptoms or remediate their impact [117,118].”
BackgroundBahar-Fuchs, A., Clare, L., & Woods, B. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003260.pub2 · Cited by 507 · see citing works
Särkämö, T., Tervaniemi, M. H., Laitinen, S., Numminen, A., Kurki, M., Johnson, J. K., & Rantanen, P. (2013) · The Gerontologist · doi:10.1093/geront/gnt100 · Cited by 490 · see citing works
“In order to alleviate the cognitive, emotional, and social impairments associated with dementia and to reduce the strain of caring for PWDs, many nonpharmacological interventions, such as various multicomponent interventions and cognitive stimulation and training programs, have been developed and shown to be beneficia…”
BackgroundBoots, L. M. M., de Vugt, M. E., van Knippenberg, R. J. M., Kempen, G. I. J. M., & Verhey, F. R. J. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4016 · Cited by 449 · see citing works
“Olazaran et al. (2010) found that these interventions can delay institutionalization for up to 1.5 years.”
BackgroundInfluentialTan, C.-C., Yu, J.-T., Wang, H.-F., Tan, M.-S., Meng, X.-F., Wang, C., Jiang, T., Zhu, X.-C., & Tan, L. (2014) · Journal of Alzheimer s Disease · doi:10.3233/jad-132690 · Cited by 484 · see citing works
“Non-pharmacologic therapy primarily includes physical exercise, social support, cognitive rehabilitation, assistance with activities of daily living, multidisciplinary programs, and providing support to caregivers [4].”
World Alzheimer Report 2011 : The benefits of early diagnosis and intervention
Prince, M. J., Bryce, R., & Ferri, C. P. (2018) · Cited by 448 · see citing works
Lin, J. S., O’Connor, E., Rossom, R. C., Perdue, L. A., & Eckstrom, E. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-159-9-201311050-00730 · Cited by 412 · see citing works
A meta-review of stress, coping and interventions in dementia and dementia caregiving
Gilhooly, K. J., Gilhooly, M. L. M., Sullivan, M. P., McIntyre, A., Wilson, L., Harding, E., Woodbridge, R., & Crutch, S. (2016) · BMC Geriatrics · doi:10.1186/s12877-016-0280-8 · Cited by 410 · see citing works
“[16*] Olazaran et al., 2010 [13*] Selwood et al., 2007.”
Neuropsychiatric signs and symptoms of Alzheimer's disease: New treatment paradigms
Lanctôt, K. L., Amatniek, J., Ancoli‐Israel, S., Arnold, S. E., Ballard, C., Cohen‐Mansfield, J., Ismail, Z., Lyketsos, C., Miller, D. S., Musiek, E., et al. (2017) · Alzheimer's & Dementia: Translational Research & Clinical Interventions · doi:10.1016/j.trci.2017.07.001 · Cited by 395 · see citing works
“[86] Olazaran J, Reisberg B, Clare L, Cruz I, Pena-Casanova J, Del Ser T, et al.”
BackgroundHoffmann, K., Sobol, N. A., Frederiksen, K. S., Beyer, N., Vogel, A., Vestergaard, K., Brændgaard, H., Gottrup, H., Lolk, A., Wermuth, L., et al. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-150817 · Cited by 356 · see citing works
“Interventions combining social interaction with specific training programs may be optimal, especially for diseases with complex symptomatology such as AD [44].”
BackgroundCognitive training for people with mild to moderate dementia
Bahar-Fuchs, A., Martyr, A., Goh, A. M., Sabates, J., & Clare, L. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013069.pub2 · Cited by 342 · see citing works
Self-citationHuhn, M., Tardy, M., Spineli, L. M., Kissling, W., Förstl, H., Pitschel-Walz, G., Leucht, C., Samara, M., Dold, M., Davis, J. M., et al. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.112 · Cited by 333 · see citing works
Effects of the Finnish Alzheimer Disease Exercise Trial (FINALEX): A Randomized Controlled Trial
Pitkälä, K. H., Pöysti, M. M., Laakkonen, M.-L., Tilvis, R. S., Savikko, N., Kautiainen, H., & Strandberg, T. E. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.359 · Cited by 304 · see citing works
Psychosocial interventions for people with dementia: a synthesis of systematic reviews
McDermott, O., Charlesworth, G. M., Hogervorst, E., Stoner, C. R., Moniz-Cook, E. D., Spector, A. E., Csipke, E., & Orrell, M. W. (2018) · Aging & Mental Health · doi:10.1080/13607863.2017.1423031 · Cited by 300 · see citing works
Zucchella, C., Sinforiani, E., Tamburin, S., Federico, A., Mantovani, E., Bernini, S., Casale, R., & Bartolo, M. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.01058 · Cited by 297 · see citing works
“Actually, some systematic reviews demonstrated that multicomponent interventions were more effective than single activities in improving general well-being of both persons with dementia and their caregivers (70, 175), and in hospitalized older adults with cognitive impairment (176, 177).”
BackgroundResultImproving dementia care: The role of screening and detection of cognitive impairment
Soo Borson, B., Frank, L. B., Bayley, P. J., Boustani, M. A., Dean, M., Lin, P., McCarten, J. R., Morris, J. C., Salmon, D. P., Schmitt, F. A., et al. (2013) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2012.08.008 · Cited by 287 · see citing works
“16/j.jalz.2012.08.008”
InfluentialThe impact of early dementia diagnosis and intervention on informal caregivers
de Vugt, M. E., & Verhey, F. R. J. (2013) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2013.04.005 · Cited by 275 · see citing works
Aguirre, E., Woods, B. T., Spector, A. E., & Orrell, M. W. (2012) · Ageing Research Reviews · doi:10.1016/j.arr.2012.07.001 · Cited by 252 · see citing works
Cognitive Reserve and Alzheimer’s Disease
Xu, W., Yu, J., Tan, M., & Tan, L. (2014) · Molecular Neurobiology · doi:10.1007/s12035-014-8720-y · Cited by 240 · see citing works
Bahar-Fuchs, A., Clare, L., & Woods, B. (2013) · Alzheimer's Research & Therapy · doi:10.1186/alzrt189 · Cited by 239 · see citing works
“More recently, Olazarán and colleagues [72] reviewed the general literature on the effi cacy of 26 categories of non-pharmacological interventions for people with dementia.”
BackgroundSelf-citationDröes, R., Chattat, R., Diaz, A., Gove, D., Graff, M. J. L., Murphy, K. E., Verbeek, H., Vernooij-Dassen, M. J. F. J., Clare, L., Johannessen, A., et al. (2016) · Aging & Mental Health · doi:10.1080/13607863.2016.1254596 · Cited by 243 · see citing works
The future of Alzheimer's disease: The next 10 years
Hampel, H. J., Prvulovic, D., Teipel, S. J., Jessen, F., Luckhaus, C., Frölich, L., Riepe, M. W., Dodel, R. C., Leyhe, T., Bertram, L., et al. (2011) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2011.11.008 · Cited by 233 · see citing works
Therapeutic Implications of Caffeic Acid in Cancer and Neurological Diseases
Alam, M., Ahmed, S., Elasbali, A. M., Adnan, M., Alam, S., Hassan, M. I., & Pasupuleti, V. R. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.860508 · Cited by 234 · see citing works
Music Therapy in the Treatment of Dementia: A Systematic Review and Meta-Analysis
Moreno-Morales, C., Calero, R., Moreno-Morales, P., & Pintado, C. (2020) · Frontiers in Medicine · doi:10.3389/fmed.2020.00160 · Cited by 231 · see citing works
Reminiscence therapy in dementia: A review
Cotelli, M., Manenti, R., & Zanetti, O. O. (2012) · Maturitas · doi:10.1016/j.maturitas.2012.04.008 · Cited by 230 · see citing works
Tsoi, K. K. F., Chan, J. Y. C., Ng, Y., Lee, M. M. Y., Kwok, T. C. Y., & Wong, S. Y. S. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.12.009 · Cited by 222 · see citing works
Caregiver Health: Health of Caregivers of Alzheimer’s and Other Dementia Patients
Richardson, T. J., Lee, S. J., Berg‐Weger, M., & Grossberg, G. T. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-013-0367-2 · Cited by 219 · see citing works
World Alzheimer Report 2013: Journey of Caring: An analysis of long-term care for dementia
Guerchet, M., Prince, M. J., & Prina, M. A. (2013) · Cited by 210 · see citing works
Orgeta, V., Qazi, A., Spector, A. E., & Orrell, M. W. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.148130 · Cited by 210 · see citing works
Psychological treatments for depression and anxiety in dementia and mild cognitive impairment
Orgeta, V., Qazi, A., Spector, A. E., & Orrell, M. W. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009125.pub2 · Cited by 208 · see citing works
Leven, N. V., Prick, A.-E. J. C., Groenewoud, J. G., Roelofs, P. D. D. M., de Lange, J., & Pot, A. M. (2013) · International Psychogeriatrics · doi:10.1017/s1041610213000860 · Cited by 200 · see citing works
Cooper, C., Mukadam, N., Katona, C., Lyketsos, C. G., Ames, D. J., Rabins, P. V., Engedal, K., Lima, C. D. M., Blazer, D. G., Teri, L. L., et al. (2012) · International Psychogeriatrics · doi:10.1017/s1041610211002614 · Cited by 200 · see citing works
Livingston, G., Barber, J., Rapaport, P., Knapp, M., Griffin, M., Romeo, R., King, D., Livingston, D., Lewis-Holmes, E., Mummery, C., et al. (2014) · Health Technology Assessment · doi:10.3310/hta18610 · Cited by 192 · see citing works
Music therapy and Alzheimer's disease: Cognitive, psychological, and behavioural effects
Gallego, M. G., & García, J. G. (2017) · Neurología (English Edition) · doi:10.1016/j.nrleng.2015.12.001 · Cited by 188 · see citing works
Using virtual reality for cognitive training of the elderly
García-Betances, R. I., Jiménez-Mixco, V., Arredondo, M. T., & Cabrera-Umpiérrez, M. F. (2015) · American Journal of Alzheimer's Disease & Other Dementias® · doi:10.1177/1533317514545866 · Cited by 187 · see citing works
Dickinson, C., Dow, J., Gibson, G., Hayes, L., Robalino, S., & Robinson, L. A. (2016) · International Psychogeriatrics · doi:10.1017/s1041610216001447 · Cited by 182 · see citing works
“Four reviews, all rated as moderate quality, reviewed multi-component interventions (Pinquart and Sorensen, 2006; Parker et al. , 2008; Olazaran et al. , 2010; Elvish et al. , 2013).”
InfluentialPsychosocial interventions in dementia care research: The INTERDEM manifesto
Moniz-Cook, E. D., Vernooij-Dassen, M. J. F. J., Woods, B. T., Orrell, M. W., & Interdem Network (2011) · Aging & Mental Health · doi:10.1080/13607863.2010.543665 · Cited by 174 · see citing works
“Much has been achieved over the last decade in demonstrating that psychosocial interventions can be as effective as pharmacological therapies (Olazaran et al., 2010).”
BackgroundEgan, K. J., Pinto-Bruno, Á. C., Bighelli, I., Berg‐Weger, M., van Straten, A., Albanese, E., & Pot, A. M. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.10.023 · Cited by 167 · see citing works
Cheng, S.-T., & Zhang, F. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01547-2 · Cited by 166 · see citing works
A common challenge in older adults: Classification, overlap, and therapy of depression and dementia
Leyhe, T., Reynolds, C. F., Melcher, T., Linnemann, C., Klöppel, S., Blennow, K., Zetterberg, H., Dubois, B., Lista, S., & Hampel, H. J. (2016) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2016.08.007 · Cited by 168 · see citing works
Testad, I., Corbett, A., Aarsland, D., Lexow, K. O., Fossey, J., Woods, B. T., & Ballard, C. G. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214000131 · Cited by 166 · see citing works
García-Casal, J. A., Loizeau, A., Csipke, E., Franco, M., Bartolomé, M. V. P., & Orrell, M. W. (2016) · Aging & Mental Health · doi:10.1080/13607863.2015.1132677 · Cited by 160 · see citing works
“Non pharmacological interventions have been shown as a realistic and affordable contribution to the provision of care for PWD (Olazar (cid:1) an et al., 2010).”
BackgroundA claims data-based comparison of comorbidity in individuals with and without dementia
Bauer, K., Schwarzkopf, L., Graessel, E., & Holle, R. (2014) · BMC Geriatrics · doi:10.1186/1471-2318-14-10 · Cited by 157 · see citing works
“Additionally, studies from various settings suggest that non-pharmacological, multicomponent interventions have the potential to slow down the decline in cognitive function and support the capacity to carry out Activities of Daily Living [48,49].”
BackgroundRelationship between Exercise and Alzheimer’s Disease: A Narrative Literature Review
Meng, Q., Lin, M.-S., & Tzeng, I.-S. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00131 · Cited by 158 · see citing works
“) have been used and have varied ineffectiveness (Olazarán et al., 2010; Ballard et al., 2011).”
MethodLök, N., Bademli̇, K., & Tosun, A. S. (2018) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4980 · Cited by 157 · see citing works
“Cognitive practices include cognitive training, cognitive stimulation, daily activities, and reality orientation therapy; behavioral practices include multifactorial behavioral interventions; affective practices include aromatherapy, massage, therapeutic touch, and music; and psychosocial practices include reminiscenc…”
BackgroundKajiyama, B., Thompson, L. W., Eto-Iwase, T., Yamashita, M., Mario, J. D., Tzuang, M., & Gallagher-Thompson, D. E. (2013) · Aging & Mental Health · doi:10.1080/13607863.2013.775641 · Cited by 157 · see citing works
“Other research has suggested that psychoeducational programs can be effective with racially and ethnically diverse CGs (Au et al., 2010; Belle et al., 2006; Burgio et al., 2009; Gallagher-Thompson et al., 2003, 2007; Gallagher-Thompson, Gray, Dupart, Jimenez, & Thompson, 2008; Gallagher-Thompson, and Wang et al., 2010…”
BackgroundSikkes, S. A. M., Tang, Y., Jutten, R. J., Wesselman, L. M. P., Turkstra, L. S., Brodaty, H., Clare, L., Cassidy‐Eagle, E. L., Cox, K. L., Chételat, G., et al. (2020) · Alzheimer s & Dementia · doi:10.1002/alz.12188 · Cited by 154 · see citing works
Woods, B. T., Bruce, E., Edwards, R., Elvish, R., Hoare, Z., Hounsome, B., Keady, J. D., Moniz-Cook, E. D., Orgeta, V., Orrell, M. W., et al. (2012) · Health Technology Assessment · doi:10.3310/hta16480 · Cited by 153 · see citing works
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Wiegelmann, H., Speller, S., Verhaert, L.-M., Schirra-Weirich, L., & Wolf‐Ostermann, K. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02020-4 · Cited by 151 · see citing works
Effect of meditation on cognitive functions in context of aging and neurodegenerative diseases.
Marciniak, R., Sheardova, K., Čermáková, P., Hudeček, D., Šumec, R., & Hort, J. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00017 · Cited by 142 · see citing works
“They seem to be more efficient in motivated patients in early or intermediate stages of dementia (2, 3).”
BackgroundInfluentialBaruah, U., Varghese, M., Loganathan, S., Mehta, K. M., Gallagher-Thompson, D. E., Zandi, D., Dua, T., & Pot, A. M. (2021) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5502 · Cited by 142 · see citing works
Nonpharmacological enhancement of cognitive function in Parkinson's disease: A systematic review
Hindle, J. V., Petrelli, A., Clare, L., & Kalbe, E. (2013) · Movement Disorders · doi:10.1002/mds.25377 · Cited by 141 · see citing works
“It is possible that the search terms missed more obscure nonpharmacological interventions, although the terms were based on the best available published evidence in AD.1 The exclusion of deep brain simulation or surgery may have missed significant treatment effects, but these treatments require separate review.”
BackgroundInfluentialMusicoterapia en la enfermedad de Alzheimer: efectos cognitivos, psicológicos y conductuales
Gallego, M. G., & García, J. G. (2016) · Neurología · doi:10.1016/j.nrl.2015.12.003 · Cited by 138 · see citing works
Pathophysiology and management of alzheimer’s disease: an overview
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Bennett, S. H., Laver, K., Voigt-Radloff, S., Letts, L. J., Clemson, L. M., Graff, M. J. L., Wiseman, J., & Gitlin, L. N. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026308 · Cited by 142 · see citing works
“Therefore, this review reports on the results of the 15 studies presented across 19 articles.(11) 15 17 31–46 All but one study were peer- reviewed articles published in English.”
BackgroundVink, A. C., Zuidersma, M., Boersma, F., de Jonge, P., Zuidema, S. U., & Slaets, J. P. J. (2012) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3924 · Cited by 135 · see citing works
Clinical practice guidelines for dementia in Australia
Laver, K., Cumming, R. G., Dyer, S. M., Agar, M. R., Anstey, K. J., Beattie, E., Brodaty, H., Broe, T., Clemson, L. M., Crotty, M., et al. (2016) · The Medical Journal of Australia · doi:10.5694/mja15.01339 · Cited by 134 · see citing works
Cornelis, E., Gorus, E., Beyer, I., Bautmans, I., & De Vriendt, P. (2017) · PLoS Medicine · doi:10.1371/journal.pmed.1002250 · Cited by 133 · see citing works
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“, [11, 12, 30, 33, 99], can still be explained by the heterogeneous nature of supportive strategies caused by differences in content, duration, and intensity; the methodological quality of studies; the variety in outcome measures; and the different characteristics of the caregivers and the care-recipients.”
BackgroundKamiya, M., Sakurai, T., Ogama, N., Maki, Y., & Toba, K. (2014) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12260 · Cited by 130 · see citing works
Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia
Nowrangi, M. A., Lyketsos, C. G., & Rosenberg, P. B. (2015) · Alzheimer s Research & Therapy · doi:10.1186/s13195-015-0096-3 · Cited by 129 · see citing works
“In a metaanalysis by Olazarán and colleagues [108], the majority of the studies (randomized controlled trials) reviewed showed positive effects for improvements in mood, behavior, and quality of life of persons with dementia while delaying institutionalization.”
BackgroundDassel, K. B., Carr, D. C., & Vitaliano, P. (2017) · The Gerontologist · doi:10.1093/geront/gnv148 · Cited by 127 · see citing works
Gallagher-Thompson, D., Tzuang, Y. M., Au, A., Brodaty, H., Charlesworth, G., Gupta, R., Lee, S. E., Losada, A., & Shyu, Y.-I. (2012) · Clinical Gerontologist · doi:10.1080/07317115.2012.678190 · Cited by 128 · see citing works
Self-citationLaver, K., Milte, R., Dyer, S. M., & Crotty, M. (2016) · Journal of Aging and Health · doi:10.1177/0898264316660414 · Cited by 128 · see citing works
“This review supports the findings of other reviews of caregiver interventions (Brodaty & Arasaratnam, 2012; Olazarán et al., 2010; Van’t Leven et al., 2013) but adds to the body of literature by examining effect on a number of outcomes, including meta-analysis and comparing different forms of multicomponent interventi…”
BackgroundMethodResultInfluentialde Medeiros, K., & Basting, A. D. (2013) · The Gerontologist · doi:10.1093/geront/gnt055 · Cited by 127 · see citing works
Exercise Intervention Associated with Cognitive Improvement in Alzheimer’s Disease
Cui, M. Y., Lin, Y., Sheng, J. Y., Zhang, X., & Cui, R. (2018) · Neural Plasticity · doi:10.1155/2018/9234105 · Cited by 128 · see citing works
“Research on nondrug therapies has produced promising cost-effective strategies for dementia [81, 82], which improve behavior, mood, and the quality of life for families of patients with AD [82].”
BackgroundKurz, A., Thöne-Otto, A. I. T., Cramer, B., Egert, S., Frölich, L., Gertz, H., Kehl, V., Wagenpfeil, S., & Werheid, K. (2011) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e318231e46e · Cited by 126 · see citing works
Dawson, A. S. F., Bowes, A. M., Kelly, F., Velzke, K., & Ward, R. (2015) · BMC Geriatrics · doi:10.1186/s12877-015-0053-9 · Cited by 124 · see citing works
“Non-pharmacological interventions have been shown to be more cost-effective than technological interventions or medication in allowing people with dementia to be cared for at home for longer [61] and to have additional beneficial consequences for carers [81].”
BackgroundCaregiver Burden and Psychoeducational Interventions in Alzheimer’s Disease: A Review
Beinart, N., Weinman, J., Wade, D., & Brady, R. (2012) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000345777 · Cited by 124 · see citing works
Woods, B. T., Orrell, M. W., Bruce, E., Edwards, R. T., Hoare, Z., Hounsome, B., Keady, J. D., Moniz-Cook, E. D., Orgeta, V., Rees, J., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0152843 · Cited by 126 · see citing works
“Introduction There is increasing recognition that in dementia care psychosocial interventions may have comparable value to pharmacological approaches [1,2] and may be preferable in some contexts, e.”
BackgroundGraessel, E., Stemmer, R., Eichenseer, B., Pickel, S., Donath, C., Kornhuber, J., & Luttenberger, K. (2011) · BMC Medicine · doi:10.1186/1741-7015-9-129 · Cited by 124 · see citing works
“This has been underscored by a recent systematic review, which demonstrated the efficacy of multicomponent interventions for dementia patients in achieving a range of outcomes [18].”
BackgroundHessler, J. B., Schäufele, M., Hendlmeier, I., Junge, M. N., Leonhardt, S., Weber, J., & Bickel, H. (2017) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796016001098 · Cited by 123 · see citing works
Treatment of Psychosis and Dementia in Parkinson’s Disease
Goldman, J. G., & Holden, S. K. (2014) · Current Treatment Options in Neurology · doi:10.1007/s11940-013-0281-2 · Cited by 121 · see citing works
“While there is Level B evidence for the use of these methods in AD [81], only a few studies in PD have been conducted.”
BackgroundEska, K., Graessel, E., Donath, C., Schwarzkopf, L., Lauterberg, J., & Holle, R. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000355079 · Cited by 119 · see citing works
Magierski, R., Sobów, T., Schwertner, E., & Religa, D. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.01168 · Cited by 121 · see citing works
“Moreover, symptoms of depression and anxiety can be reduced by psychological interventions added to usual care (Orgeta et al., 2014; Orgeta et al., 2015).”
BackgroundCognition-Oriented Treatments for Older Adults: a Systematic Overview of Systematic Reviews
Gavelin, H. M., Lampit, A., Hallock, H., Sabatés, J., & Bahar‐Fuchs, A. (2020) · Neuropsychology Review · doi:10.1007/s11065-020-09434-8 · Cited by 122 · see citing works
Clements-Cortés, A., Ahonen, H., Evans, M., Freedman, M., & Bartel, L. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-160081 · Cited by 116 · see citing works
Bakker, C., de Vugt, M. E., van Vliet, D., Verhey, F. R. J., Pijnenburg, Y. A. L., Vernooij-Dassen, M. J. F. J., & Koopmans, R. T. C. M. (2012) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2012.09.011 · Cited by 114 · see citing works
Zwijsen, S. A., Smalbrugge, M., Eefsting, J. A., Twisk, J. W. R., Gerritsen, D. L., Pot, A. M., & Hertogh, C. M. P. M. (2014) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2014.04.007 · Cited by 114 · see citing works
“46 This is a 7-point scale that describes 7 stages from ‘no global impairment’ (1) to ‘very severe global impairment’ (7).”
BackgroundCognitive training in Parkinson disease
Zimmermann, R., Gschwandtner, U., Benz, N., Hatz, F., Schindler, C., Taub, E., & Fuhr, P. (2014) · Neurology · doi:10.1212/wnl.0000000000000287 · Cited by 109 · see citing works
Laakkonen, M., Kautiainen, H., Hölttä, E., Savikko, N. M., Tilvis, R. S., Strandberg, T. E., & Pitkälä, K. H. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14055 · Cited by 110 · see citing works
Serino, S., Pedroli, E., Tuena, C., Leo, G. D., Stramba‐Badiale, M., Goulene, K., Mariotti, N. G., & Riva, G. (2017) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2017.00240 · Cited by 110 · see citing works
Quintana-Hernández, D. J., Miró-Barrachina, M. T., Ibáñez-Fernández, I. J., Pino, A. S.-D., Quintana-Montesdeoca, M. P., Rodríguez-de Vera, B., Morales-Casanova, D., Pérez-Vieitez, M. D. C., Rodríguez-García, J., & Bravo-Caraduje, N. (2016) · Journal of Alzheimer's Disease · doi:10.3233/jad-143009 · Cited by 107 · see citing works
“However,nosignificantdifferences were found between NPTs in severe-moderate-stage AD.”
InfluentialWaldorff, F. B., Buss, D. V., Eckermann, A., Rasmussen, M. L. H., Keiding, N., Rishoj, S., Siersma, V., Sorensen, J., Sorensen, L. V., Vogel, A., et al. (2012) · BMJ · doi:10.1136/bmj.e4693 · Cited by 106 · see citing works
Aşiret, G. D., & Kapucu, S. (2015) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988715598233 · Cited by 105 · see citing works
“Nonpharmacological applications are patient centered and geared toward supporting the individuals rather than forcing them or focusing on their deficiencies.(4) Reminiscence therapy is the most commonly used nonpharmacological application in AD and other types of dementia.”
BackgroundCognitive Training Program to Improve Working Memory in Older Adults with MCI
Hyer, L. A., Scott, C. V., Atkinson, M. M., Mullen, C. M., Lee, A., Johnson, J. A., & McKenzie, L. (2015) · Clinical Gerontologist · doi:10.1080/07317115.2015.1120257 · Cited by 104 · see citing works
“Accumulating research continues to demonstrate that older adults who are impaired benefit from CT (e.g., Belleville et al., 2011; Jean, Bergeron, Thivierge, & Simard, 2010; Loewenstein, Acevedo, Czaja, & Duara, 2004; Olazarán et al., 2010).”
BackgroundRaising the standard of applied dementia care research: addressing the implementation error
Vernooij-Dassen, M. J. F. J., & Moniz-Cook, E. D. (2014) · Aging & Mental Health · doi:10.1080/13607863.2014.899977 · Cited by 104 · see citing works
“However, many studies fail to report positive outcomes (Olazaran et al., 2010).”
BackgroundInfluentialHome is where the future is: The BrightFocus Foundation consensus panel on dementia care
Samus, Q. M., Black, B. S., Bovenkamp, D. E., Buckley, M. J., Callahan, C. M., Davis, K. C., Gitlin, L. N., Hodgson, N. A., Johnston, D. M., Kales, H. C., et al. (2017) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2017.10.006 · Cited by 102 · see citing works
Barban, F., Annicchiarico, R., Pantelopoulos, S. A., Federici, A., Perri, R., Fadda, L., Carlesimo, G. A., Ricci, C., Giuli, S., Scalici, F., et al. (2015) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4328 · Cited by 100 · see citing works
Boots, L. M. M., de Vugt, M. E., Kempen, G. I. J. M., & Verhey, F. R. J. (2018) · Journal of Medical Internet Research · doi:10.2196/10017 · Cited by 101 · see citing works
“Many caregiver support interventions have been developed to ameliorate negative caregiver consequences with promising results [4].”
Background
- Authors
- Olazarán, J., Reisberg, B., Clare, L., Cruz, I., Peña-Casanova, J., del Ser, T., Woods, B., Beck, C., Auer, S., Lai, C., Spector, A., Fazio, S., Bond, J., Kivipelto, M., Brodaty, H., Rojo, J. M., Collins, H., Teri, L., Mittelman, M., Orrell, M., Feldman, H. H., & Muñiz, R.
- Affiliations
- NYU Langone Health (US)
- Bangor University (GB)
- University of Arkansas for Medical Sciences (US)
- MAS Alzheimerhilfe (AT)
- Hong Kong Polytechnic University (HK)
- University College London (GB)
- Alzheimer's Association (US)
- Newcastle University (GB)
- Karolinska Institutet (SE)
- UNSW Sydney (AU)
- Consejo Superior de Investigaciones Científicas (ES)
- Cochrane (GB)
- University of Washington (US)
- University of British Columbia (CA)
- ORCID
- Venue
- Dementia and Geriatric Cognitive Disorders
- Publisher
- S. Karger AG
- Published
- 2010
- Volume
- 30
- Issue
- 2
- Pages
- 161-178
- ISSN
- 1420-8008 (ISSN-L)
- 1421-9824
- OpenAlex
- W2116861306
- Cited by
- 937
- References
- 229
- Citations by year
- 2026: 24 · 2025: 26 · 2024: 41 · 2023: 48 · 2022: 50 · 2021: 51 · 2020: 94 · 2019: 62 · 2018: 76 · 2017: 87 · 2016: 81 · 2015: 61 · 2014: 76 · 2013: 68 · 2012: 65
- FWCI
- 7.13
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Dementia and Geriatric Cognitive Disorders (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- Alzheimer's disease, non-pharmacological treatment, dementia, quality of life, caregivers, cognitive training, cognitive stimulation, multicomponent intervention, activities of daily living, mood, restraint prevention, caregiver education, treatment guidelines
- MeSH terms
- Activities of Daily Living, Aged, Complementary Therapies, Alzheimer Disease, Cost-Benefit Analysis, Humans, Institutionalization, Quality of Life, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Caregivers, Disease Progression, Evidence-Based Medicine, Neurodegenerative Diseases, Learning Curve
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