The DOI matches its Crossref record; 228 of the 229 references it cites were found in a registry or an index.
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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“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]
In the citing paper
“Only multicomponent interventions have been shown to be effective in preventing institutionalisation.11,12”
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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“They seem to be more efficient in motivated patients in early or intermediate stages of dementia (2, 3).”
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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 151
“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
Pathophysiology and management of alzheimer’s disease: an overview
Thakur, A. K., Kamboj, P., Goswami, K., & Ahuja, K. (2018) · Journal of Analytical & Pharmaceutical Research · doi:10.15406/japlr.2018.07.00230 · Cited by 144
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
“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
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 136
Cornelis, E., Gorus, E., Beyer, I., Bautmans, I., & De Vriendt, P. (2017) · PLoS Medicine · doi:10.1371/journal.pmed.1002250 · Cited by 133
Vandepitte, S., Noortgate, N. V. D., Putman, K. D., Verhaeghe, S. T. L., Faes, K., & Annemans, L. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-151011 · Cited by 132
“, [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
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 138
“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
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
Self-citationLaver, K., Milte, R., Dyer, S. M., & Crotty, M. (2016) · Journal of Aging and Health · doi:10.1177/0898264316660414 · Cited by 138
“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 141
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 139
“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
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
“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
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
“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
“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
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
“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
Magierski, R., Sobów, T., Schwertner, E., & Religa, D. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.01168 · Cited by 129
“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
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
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
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
“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
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 126
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 119
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
“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
Aşiret, G. D., & Kapucu, S. (2015) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988715598233 · Cited by 105
“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 121
“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
“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 107
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
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 109
“Many caregiver support interventions have been developed to ameliorate negative caregiver consequences with promising results [4].”
Background
Metadata
- 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
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Geriatrics and Gerontology › 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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