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 found that NPTs emerge as a useful, versatile, and potentially cost-effective approach to improve outcomes and quality of life in AD and related disorders for both the person with dementia and the caregiver [27].”
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“Nonpharmacological interventions provide a promising alternative approach and can delay institutionalization (Olazarán et al., 2010).”
BackgroundRobinson, A. L., & Moghaddam, N. G. (2022) · Mental Health Review Journal · doi:10.1108/mhrj-05-2021-0043 · Cited by 17
Hashim, A. H. A., Ismail, A. N., Rias, R. M., & Mohamed, A. (2015) · International Symposium on Technology Management and Emerging Technologies (ISTMET) · doi:10.1109/istmet.2015.7359034 · Cited by 17
Richtlijn diagnostiek en behandeling van dementie
Rikkert, M. G. M. O., van Exel, E. R., Knol, W. G., Lemstra, A. W., Roks, G., & Verhey, F. R. J. (2015) · Research Publications (Maastricht University) · Cited by 17
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“There is evidence that neuropsychiatric symptoms can be prevented or diminished by behavioral interventions [9].”
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“people with dementia [9] and their caregivers [10].”
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Activities of Daily Living and Dementia
Yang, Y., Yang, H. D., Hong, Y.-J., Kim, J. E., Park, M. H., Na, H. R., Han, I.-W., & Kim, S. (2012) · Dementia and Neurocognitive Disorders · doi:10.12779/dnd.2012.11.2.29 · Cited by 17
“비약물적 치료로는 ADL 훈련, 인지치료, 그리고 신 체적인 재활/물리 치료 및 운동 요법을 할 수 있다[41].”
Jeyagurunathan, A., Yuan, Q., Samari, E., Zhang, Y., Goveas, R. R., Ng, L. L., & Subramaniam, M. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1396056 · Cited by 16
“Receiving the diagnosis can be a shock or a relief to patients, and disclosure is an important part of management; earlier diagnosis seems to be associated with easier transitions and might delay the need for a move from home (17).”
BackgroundPsychotherapeutic Interventions for Dementia: a Systematic Review
Sukhawathanakul, P., Crizzle, A. M., Tuokko, H. A., Naglie, G., & Rapoport, M. J. (2021) · Canadian Geriatrics Journal · doi:10.5770/cgj.24.447 · Cited by 26
Pharmacogenomics of Dementia: Personalizing the Treatment of Cognitive and Neuropsychiatric Symptoms
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“These types of interventions have been found to be useful in improving outcomes and quality of life in patients with dementia [183].”
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NHG-Standaard Dementie (derde herziening)+
van Charante, E. P. M., Perry, M., Vernooij-Dassen, M. J. F. J., Boswijk, D., Stoffels, J., Achthoven, L., & Luning-Koster, M. N. (2012) · Cited by 16
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“Therefore, there has been a growing interest in non-pharmacological therapies (NPTs) for dealing with ADRD related symptoms (Alves et al., 2013; Brodaty & Ara-saratnam, 2012; Olazarán et al., 2010).”
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“Discussion Although the intervention was based on multicomponent strategies that have shown the best results on health and well-being, quality of life, and mood [30, 31], there were no significant differences between the intervention and control groups regarding the caregivers’ perceived relationship.”
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Gambella, E., Margaritini, A., Benadduci, M., Rossi, L., D’Ascoli, P., Riccardi, G. R., Pasquini, S., Civerchia, P., Pelliccioni, G., Bevilacqua, R., et al. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.964454 · Cited by 16
Group Intensive Cognitive Activation in Patients with Major or Mild Neurocognitive Disorder
Panerai, S., Tasca, D., Musso, S., Catania, V., Ruggeri, F., Raggi, A., Muratore, S., Prestianni, G., Bonforte, C., & Ferri, R. (2016) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2016.00034 · Cited by 16
Management of Behavioral and Psychological Symptoms of Dementia
Cankurtaran, E. Ş. (2014) · Nöro Psikiyatri Arşivi · doi:10.5152/npa.2014.7405 · Cited by 20
“There have been many different types of non-pharmacological interventions for the BPSD, which are listed in Table 2 (22,23,24).”
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“care costs in the long term if institutionalization can be postponed [3].”
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The Diagnostic Pathway From Cognitive Impairment to Dementia in Japan
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Kooijmans, E. C. M., Hoogendijk, E., Drapała, N., Antonenko, O., Burchell, G., Barańska, I., Pokladníková, J., Szczerbińska, K., Fialová, D., van Hout, H. V., et al. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.105306 · Cited by 15
Ottoboni, G., Chirico, I., Povolná, P., Dostálová, V., Holmerová, I., Janssen, N., Dassen, F. C. M., de Vugt, M. E., Gómez, M. C. S., García‐Peñalvo, F. J., et al. (2021) · Nurse Education Today · doi:10.1016/j.nedt.2021.104977 · Cited by 15
Asistencia sanitaria en las demencias: satisfacción y necesidades del cuidador
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Fernández‐Calvo, B., Contador, I., Campos, F. R., Carvalho, V. Â. M. D. L. E., da Silva, J. C., & Alves, N. T. (2016) · Estudos de Psicologia (Natal) · doi:10.5935/1678-4669.20160013 · Cited by 16
“In contrast, a more recent meta-analysis showed that multicomponent intervention is the most effective among all programs applied to caregivers to improve their quality of life (Olazarán et al., 2010).”
BackgroundResult
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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