Systematic Review of Psychological Approaches to the Management of Neuropsychiatric Symptoms of Dementia
Open accessAbstract
OBJECTIVE: The authors systematically reviewed the literature on psychological approaches to treating the neuropsychiatric symptoms of dementia. METHOD: Reports of studies that examined effects of any therapy derived from a psychological approach that satisfied prespecified criteria were reviewed. Data were extracted, the quality of each study was rated, and an overall rating was given to each study by using the Oxford Centre for Evidence-Based Medicine criteria. RESULTS: A total of 1,632 studies were identified, and 162 satisfied the inclusion criteria for the review. Specific types of psychoeducation for caregivers about managing neuropsychiatric symptoms were effective treatments whose benefits lasted for months, but other caregiver interventions were not. Behavioral management techniques that are centered on individual patients' behavior or on caregiver behavior had similar benefits, as did cognitive stimulation. Music therapy and Snoezelen, and possibly sensory stimulation, were useful during the treatment session but had no longer-term effects; interventions that changed the visual environment looked promising, but more research is needed. CONCLUSIONS: Only behavior management therapies, specific types of caregiver and residential care staff education, and possibly cognitive stimulation appear to have lasting effectiveness for the management of dementia-associated neuropsychiatric symptoms. Lack of evidence regarding other therapies is not evidence of lack of efficacy. Conclusions are limited because of the paucity of high-quality research (only nine level-1 studies were identified). More high-quality investigation is needed.
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According to Livingston et al., agitation in dementia is associated with poorer quality of life and impairs the engagement in daily activities and relationships.
“According to Livingston et al. [45], agitation in dementia is associated with poorer quality of life and impairs the engagement in daily activities and relationships.”
From Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review (2015) · cites this paper as [45]
The Background (page unavailable) says neuropsychiatric symptoms of dementia contribute to decreased quality of life, supporting that part of the claim at a broader level than agitation specifically. The passages on therapeutic activities and social interaction discuss interventions and agitation outcomes, but do not say that agitation impairs engagement in daily activities or relationships. (LLM, conf=0.84)
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Dementia prevention, intervention, and care
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31363-6 · Cited by 6,072 · see citing works
Self-citationDefeating Alzheimer's disease and other dementias: a priority for European science and society
Winblad, B., Amouyel, P., Andrieu, S., Ballard, C., Brayne, C., Brodaty, H., Cedazo-Minguez, A., Dubois, B., Edvardsson, D., Feldman, H., et al. (2016) · The Lancet Neurology · doi:10.1016/s1474-4422(16)00062-4 · Cited by 1,676 · see citing works
Behavioral and psychological symptoms of dementia
Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012) · Frontiers in Neurology · doi:10.3389/fneur.2012.00073 · Cited by 1,425 · see citing works
Neuropsychiatric symptoms in Alzheimer's disease
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“However, most such studies have been of short duration with small sample and effect sizes [42].”
BackgroundSelf-citationNonpharmacological therapies in Alzheimer’s disease: a systematic review of efficacy
Olazarán, J., Reisberg, B., Clare, L., Cruz, I., Peña-Casanova, J., del Ser, T., Woods, B., Beck, C., Auer, S., Lai, C., et al. (2010) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000316119 · Cited by 937 · see citing works
Cognitive stimulation to improve cognitive functioning in people with dementia
Woods, B., Aguirre, E., Spector, A. E., & Orrell, M. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005562.pub2 · Cited by 855 · see citing works
Antipsychotic Drug Use and Mortality in Older Adults with Dementia
Gill, S. S., Bronskill, S. E., Normand, S.-L. T., Anderson, G. M., Sykora, K., Lam, K., Bell, C. M., Lee, P. E., Fischer, H. D., Herrmann, N., et al. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-11-200706050-00006 · Cited by 624 · see citing works
“Nonpharmacologic treatments for neuropsychiatric symptoms of dementia have been reviewed (62).”
BackgroundHusebo, B. S., Ballard, C., Sandvik, R., Nilsen, O. B., & Aarsland, D. (2011) · BMJ · doi:10.1136/bmj.d4065 · Cited by 571 · see citing works
Boots, 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
“The grading system is widely accepted and often used to apply weights to individual studies according to their methodological quality (Petrowsky et al., 2004; Livingston et al., 2005; Visser et al., 2009).”
MethodMeta-Analysis of Nonpharmacological Interventions for Neuropsychiatric Symptoms of Dementia
Brodaty, H., & Arasaratnam, C. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.11101529 · Cited by 479 · see citing works
Livingston, G., Kelly, L., Lewis-Holmes, E., Baio, G., Morris, S., Patel, N., Omar, R. Z., Katona, C., & Cooper, C. (2014) · British Journal of Psychiatry · doi:10.1192/bjp.bp.113.141119 · Cited by 426 · see citing works
Self-citationManagement of agitation and aggression associated with Alzheimer disease
Ballard, C. G., Gauthier, S., Cummings, J. L., Brodaty, H., Grossberg, G. T., Robert, P., & Lyketsos, C. G. (2009) · Nature Reviews Neurology · doi:10.1038/nrneurol.2009.39 · Cited by 404 · see citing works
Self-citationA European consensus on outcome measures for psychosocial intervention research in dementia care
Moniz-Cook, E. D., Vernooij-Dassen, M. J. F. J., Woods, B. T., Verhey, F. R. J., Chattat, R., de Vugt, M. E., Mountain, G. A., O’connell, M., Harrison, J., Vasse, E., et al. (2008) · Aging & Mental Health · doi:10.1080/13607860801919850 · Cited by 392 · see citing works
“Caregivers can act as proxy reporters (Logsdon & Teri, 1995 ) but the advantage of CSDD is its reliance on the perspective of both the person with dementia and the caregiver.”
BackgroundACNP White Paper: Update on Use of Antipsychotic Drugs in Elderly Persons with Dementia
Jeste, D. V., Blazer, D. G., Casey, D. E., Meeks, T. W., Salzman, C., Schneider, L. S. S., Tariot, P. N., & Yaffe, K. S. (2007) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301492 · Cited by 366 · see citing works
“Unfortunately, the evidence base for the efficacy of most psychosocial interventions in dementia patients is limited (Cohen-Mansfield, 2001; Livingston et al, 2005).”
BackgroundManagement of behavioral problems in Alzheimer's disease
Gauthier, S. G., Cummings, J. L., Ballard, C. G., Brodaty, H., Grossberg, G. T., Robert, P. H., & Lyketsos, C. G. (2010) · International Psychogeriatrics · doi:10.1017/s1041610209991505 · Cited by 360 · see citing works
“A review of 162 studies concerned with psychological management approaches to NPS concluded that psycho-education for caregivers was effective, with benefits lasting for months, especially when delivered individually (Livingston et al., 2005).”
BackgroundInfluentialSelf-citationSelwood, A., Johnston, K., Katona, C., Lyketsos, C., & Livingston, G. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.10.025 · Cited by 342 · see citing works
“This does however accord with our earlier systematic review showing that teaching principles of dementia care does not seem to be efficacious in reducing the neuropsychiatric symptoms of dementia (Livingston et al., 2005).”
BackgroundResultInfluentialSelf-citationMusic therapy in dementia: a narrative synthesis systematic review
McDermott, O., Crellin, N., Ridder, H. M., & Orrell, M. (2013) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3895 · Cited by 310 · see citing works
“, 2003, 2011; Ridder, 2005) have found short-term reductions in behavioural disturbance and improved mood, but evidence for long-term benefits is lacking (Livingston et al., 2005).”
BackgroundResultBest practice in the management of behavioural and psychological symptoms of dementia
Tible, O., Riese, F., Savaskan, E., & von Gunten, A. (2017) · Therapeutic Advances in Neurological Disorders · doi:10.1177/1756285617712979 · Cited by 302 · see citing works
Scales, K., Zimmerman, S. I., & Miller, S. (2017) · The Gerontologist · doi:10.1093/geront/gnx167 · Cited by 297 · see citing works
“However, several other reviews found insufficient evidence for the efficacy of validation therapy in reducing BPSDs (Livingston et al., 2005; O’Connor et al., 2009; O’Neil et al., 2011).”
Lyketsos, C. G., Colenda, C. C., Beck, C. M., Blank, K., Doraiswamy, M. P., Kalunian, D. A., & Yaffe, K. S. (2006) · American Journal of Geriatric Psychiatry · doi:10.1097/01.jgp.0000221334.65330.55 · Cited by 275 · see citing works
“A recent systematic review of the literature identified several specific nonpharmacologic interventions that appear to be effective based on controlled trials for the NPS of dementia.(34) Cognitive stimulation, improved socialization (perhaps through the use of “adult day care”), or behavioral management techniques ce…”
BackgroundSelf-citationHarmer, B. J., & Orrell, M. W. (2008) · Aging & Mental Health · doi:10.1080/13607860802343019 · Cited by 268 · see citing works
“However, there is a lack of quality research to support its benefits (Livingston, Johnston, Katona, Paton, & Lyketsos, 2005 ; Woods et al, 2006 ) and it can be seen to be an ‘easy option’, used to distract older people from their present concerns (Coleman, 2005 ).”
Sultzer, D. L., Davis, S. M., Tariot, P. N., Dagerman, K. S., Lebowitz, B. D., Lyketsos, C. G., Rosenheck, R. A., Hsiao, J. K., Lieberman, J. A., Schneider, L. S., et al. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07111779 · Cited by 321 · see citing works
Self-citationAntipsychotic use in dementia: a systematic review of benefits and risks from meta-analyses
Tampi, R. R., Tampi, D. J., Balachandran, S., & Srinivasan, S. (2016) · Therapeutic Advances in Chronic Disease · doi:10.1177/2040622316658463 · Cited by 267 · see citing works
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“Livingston and colleagues [22] in a comprehensive systematic review examined the benefits of a range of sensory, psychological, and behavioural interventions in the treatment of agitation.”
BackgroundOliveira, A. M. D., Radanovic, M., Mello, P. C. H. D., Buchain, P. C., Vizzotto, A. D. B., Celestino, D. L., Stella, F., Piersol, C. V., & Forlenza, O. V. (2015) · BioMed Research International · doi:10.1155/2015/218980 · Cited by 247 · see citing works
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Case management approaches to home support for people with dementia
Reilly, S., Miranda‐Castillo, C., Malouf, R. S., Hoe, J., Toot, S., Challis, D., & Orrell, M. W. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008345.pub2 · Cited by 250 · see citing works
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Self-citationO'Connor, D. W., Ames, D., Gardner, B., & King, M. (2009) · International Psychogeriatrics · doi:10.1017/s1041610208007588 · Cited by 239 · see citing works
“Previous reviewers agreed that studies of socalled psychosocial treatments are often too small, loosely designed and poorly reported to warrant clear conclusions (Opie et al., 1999; CohenMansfield, 2001; Livingston et al., 2005).”
BackgroundInfluentialArt Therapy for Alzheimer's Disease and Other Dementias
Chancellor, B., Duncan, A. C., & Chatterjee, A. K. (2014) · Journal of Alzheimer s Disease · doi:10.3233/jad-131295 · Cited by 228 · see citing works
“Music and dance may also provide benefits [33] [34].”
Review of brief cognitive tests for patients with suspected dementia
Velayudhan, L., Ryu, S., Raczek, M., Philpot, M. P., Lindesay, J. E. B., Critchfield, M., & Livingston, G. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214000416 · Cited by 223 · see citing works
“It was carried out using similar methods as earlier systematic reviews from our group (Cooper et al., 2011; Livingston et al., 2005).”
MethodSelf-citationRodda, J. E., Morgan, S., & Walker, Z. (2009) · International Psychogeriatrics · doi:10.1017/s1041610209990354 · Cited by 218 · see citing works
Ayalon, L. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.20.2182 · Cited by 212 · see citing works
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“42,43 These reviews do suggest that non-pharmacological interventions can be useful, and potentially cost-effective, in terms of improving psychological outcomes.”
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
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“This is part of a series of systematic reviews by the Old Age Task Force of the World Federation of Biological Psychiatry (Livingston et al., 2005; Selwood et al., 2007; Cooper et al., 2011).”
BackgroundSelf-citationPrevalence and Predictors of Neuropsychiatric Symptoms in Cognitively Impaired Nursing Home Patients
Zuidema, S. U., Koopmans, R. T. C. M., & Verhey, F. R. J. (2007) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988706292762 · Cited by 197 · see citing works
Determinants of Quality of Life in Nursing Home Residents with Dementia
Wetzels, R. B., Zuidema, S. U., de Jonghe, J. F. M., Verhey, F. R. J., & Koopmans, R. T. C. M. (2010) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000280437 · Cited by 178 · see citing works
“Comorbidity (recuperation from an acute illness) can also influence QoL and was not considered as an independent variable. Additionally, although NPI-NH factors were believed to be independent from each other, some of the explained variance might be due to a moderate correlation between them. Notably, correlations bet…”
BackgroundA Systematic Review of Treatments for Refractory Depression in Older People
Cooper, C., Katona, C., Lyketsos, K., Blazer, D., Brodaty, H., Rabins, P., de Mendonça Lima, C. A., & Livingston, G. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10081165 · Cited by 176 · see citing works
Self-citationDementia of the Alzheimer Type
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“Studies of patient-centered behavioral interventions such as sensory stimulation or music therapy have reported positive, but short-lived effects on agitation and other symptoms (216).”
BackgroundFox, C., Crugel, M., Maidment, I., Auestad, B. H., Coulton, S., Treloar, A., Ballard, C., Boustani, M., Katona, C., & Livingston, G. (2012) · PLoS ONE · doi:10.1371/journal.pone.0035185 · Cited by 173 · see citing works
“The evidence for non-pharmacological treatments is predominantly for people with mild-to-moderate symptoms [7,8] and their use is often impractical in severe agitation, which carries the greatest distress and risk.”
Self-citationSubjective needs of people with dementia: a review of the literature
van der Roest, H. G., Meiland, F. J. M., Maroccini, R., Comijs, H. C., Jonker, C., & Dröes, R. (2007) · International Psychogeriatrics · doi:10.1017/s1041610206004716 · Cited by 172 · see citing works
“Following recommendation by the American Psychiatric Association (1997), studies of this type of care have become increasingly more common (Finnema et al., 2000; Livingston et al., 2005).”
MethodSeitz, D. P., Brisbin, S., Herrmann, N., Rapoport, M. J., Wilson, K., Gill, S. S., Rines, J., LeClair, K., & Conn, D. K. (2012) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2011.12.059 · Cited by 169 · see citing works
“21 [27] Livingston G, Johnston K, Katona C, et al.”
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
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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
“In the 10-year period from 1993–2003 Livingston and colleagues (Livingston et al., 2005) identified 1,632 studies and included 162 studies in their review of psychological approaches to the management of neuropsychiatric symptoms of dementia, and only nine of these were high quality studies with control conditions.”
BackgroundNonpharmacological Management of Apathy in Dementia: A Systematic Review
Brodaty, H., & Burns, K. A. (2011) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e31822be242 · Cited by 164 · see citing works
Vasse, E., Vernooij-Dassen, M., Spijker, A., Rikkert, M. O., & Koopmans, R. (2010) · International Psychogeriatrics · doi:10.1017/s1041610209990615 · Cited by 155 · see citing works
“Several reviews about the use of nonpharmacological interventions in dementia care have recently been published (Brodaty et al., 2003b; Livingston et al., 2005; Verkaik et al., 2005), but these do not focus on people with dementia in institutional care or the effects of communication strategies on neuropsychiatric sym…”
BackgroundHsu, M., Flowerdew, R., Parker, M. J., Fachner, J. C., & Odell‐Miller, H. (2015) · BMC Geriatrics · doi:10.1186/s12877-015-0082-4 · Cited by 154 · see citing works
“Significantly, our findings echo the importance of staff education and training which may be the most effective method in managing symptoms of dementia [23], and music therapists can play a valuable role in this context.”
BackgroundWoods, 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
“HADS (depression) – carer ≥ 8 Mild disturbance 60/483 (12) 28/266 (11) 32/217 (15) ≥ 11 Moderate disturbance 24/483 (5) 14/266 (5) 10/217 (5) ≥ 15 Severe disturbance 4/483 (1) 4/266 (2) 0/217 (0) HADS (anxiety) – carer ≥ 8 Mild disturbance 92/483 (19) 53/266 (20) 39/217 (18) ≥ 11 Moderate disturbance 72/483 (15) 42/26…”
BackgroundInfluentialNeuropsychiatric symptoms in dementia: Importance and treatment considerations
Ballard, C. G., Day, S., Sharp, S. I., Wing, G., & Sorensen, S. (2008) · International Review of Psychiatry · doi:10.1080/09540260802099968 · Cited by 150 · see citing works
Management of Neuropsychiatric Symptoms in People with Dementia
Ballard, C., & Corbett, A. (2010) · CNS Drugs · doi:10.2165/11319240-000000000-00000 · Cited by 147 · see citing works
“A systematic review conducted by Livingston and colleagues([15]) identified 162 studies of specific psychological interventions that were of sufficient quality to meet their inclusion criteria, although the majority were small and the evidence base for each specific intervention was modest.”
BackgroundEvidence-based psychological treatments for disruptive behaviors in individuals with dementia.
Logsdon, R. G., McCurry, S. M., & Teri, L. L. (2007) · Psychology and Aging · doi:10.1037/0882-7974.22.1.28 · Cited by 140 · see citing works
Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease
Herrmann, N., & Gauthier, S. (2008) · Canadian Medical Association Journal · doi:10.1503/cmaj.070804 · Cited by 140 · see citing works
“Education and support programs for staff and caregivers are also effective.(19) One benefit of support groups and counselling made available through the Alzheimer Society of Canada is that many creative strategies devised by individual caregivers can be shared with others.”
BackgroundInfluentialInterventions targeting pain or behaviour in dementia: A systematic review
Pieper, M. J. C., van Dalen‐Kok, A. H., Francke, A. L., van der Steen, J. T., Scherder, E., Husebo, B. S., & Achterberg, W. P. (2013) · Ageing Research Reviews · doi:10.1016/j.arr.2013.05.002 · Cited by 140 · see citing works
Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R., & Livingston, G. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.05.001 · Cited by 136 · see citing works
Self-citationDementia Screening in Primary Care
Brayne, C., Fox, C., & Boustani, M. A. (2007) · JAMA · doi:10.1001/jama.298.20.2409 · Cited by 135 · see citing works
Functional analysis-based interventions for challenging behaviour in dementia
Moniz-Cook, E. D., Swift, K., James, I. A., Malouf, R. S., de Vugt, M. E., & Verhey, F. R. J. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006929.pub2 · Cited by 136 · see citing works
Nonpharmacological intervention for agitation in dementia: A systematic review and meta-analysis
Kong, E.-H., Evans, L. K., & Guevara, J. P. (2009) · Aging & Mental Health · doi:10.1080/13607860902774394 · Cited by 132 · see citing works
“Therefore, increased attention has been paid to nonpharmacological interventions which are associated with fewer risks (Livingston, Johnston, Katona, Paton, & Lyketsos, 2005 ).”
BackgroundDancing as a psychosocial intervention in care homes: a systematic review of the literature
Guzmán, A., Hughes, J. C., James, I. A., & Rochester, L. (2012) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3913 · Cited by 131 · see citing works
“We have identified that a broad range of activity based interventions are emerging (Livingston et al., 2005; James and Fossey, 2008).”
BackgroundAntidepressants for agitation and psychosis in dementia
Seitz, D. P., Adunuri, N., Gill, S. S., Gruneir, A., Herrmann, N., & Rochon, P. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008191.pub2 · Cited by 304 · 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
“Behavior therapy using antecedentbehavior-consequence (ABC) diary assessment has provided good sustained improvements in behavior [106,107].”
BackgroundMethodSelf-citationChoi, A., Lee, M. S., & Lim, H. (2008) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2008.0006 · Cited by 128 · see citing works
Psychosocial interventions for dementia patients in long-term care
Vernooij-Dassen, M. J. F. J., Vasse, E., Zuidema, S. U., Cohen‐Mansfield, J., & Moyle, W. (2010) · International Psychogeriatrics · doi:10.1017/s1041610210001365 · Cited by 127 · see citing works
“, 2003) and the positive effects of cognitive stimulation (Livingston et al., 2005).”
InfluentialMultisensory Stimulation for People With Dementia
Sánchez, A., Millán-Calentí, J. C., Lorenzo‐López, L., & Maseda, A. (2012) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317512466693 · Cited by 127 · see citing works
de Medeiros, K., & Basting, A. D. (2013) · The Gerontologist · doi:10.1093/geront/gnt055 · Cited by 127 · see citing works
O'Connor, D. W., Ames, D., Gardner, B., & King, M. (2009) · International Psychogeriatrics · doi:10.1017/s1041610208008223 · Cited by 126 · see citing works
Robinson, L. A., Iliffe, S., Brayne, C., Goodman, C. M., Rait, G., Manthorpe, J., Ashley, P., & Moniz-Cook, E. D. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2405 · Cited by 126 · see citing works
Evidence-Based Interventions to Improve Quality of Life for Individuals with Dementia.
Logsdon, R. G., McCurry, S. M., & Teri, L. L. (2007) · PubMed · Cited by 125 · see citing works
Orgeta, V., Leung, P., Yates, L., Kang, S., Hoare, Z., Henderson, C., Whitaker, C. J., Burns, A. S., Knapp, M. R. J., Leroi, I., et al. (2015) · Health Technology Assessment · doi:10.3310/hta19640 · Cited by 125 · see citing works
“Reason Total, n (%) Does not wish to take part 320 (24) iCST exclusion criteria apply 295 (22) Dyad has not responded 215 (16) Could not make contact/reason not known 53 (4) Not available owing to holiday/family/work commitments 33 (2) Health problems for dyad 21 (2) Subtotals 937 (70) Other Prefers group activities/d…”
MethodInfluentialMaidment, I. D., Fox, C., Boustani, M. A., Menés, J. R., Brown, R. C., & Katona, C. (2007) · Annals of Pharmacotherapy · doi:10.1345/aph.1k372 · Cited by 121 · see citing works
Self-citationHulme, C. T., Wright, J. M., Crocker, T. F., Oluboyede, Y., & House, A. O. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2429 · Cited by 118 · see citing works
“The final review (Livingston et al., 2005) reported on 25 papers but judged them of low quality.”
BackgroundInfluentialBallard, C. G., Corbett, A., Chitramohan, R., & Aarsland, D. (2009) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32833111f9 · Cited by 113 · 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
Frontotemporal Dementias: A Review
Weder, N. D., Aziz, R., Wilkins, K. M., & Tampi, R. R. (2007) · Annals of General Psychiatry · doi:10.1186/1744-859x-6-15 · Cited by 110 · see citing works
Satoh, M., Yuba, T., Tabei, K., Okubo, Y., Kida, H., Sakuma, H., & Tomimoto, H. (2015) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000436960 · Cited by 108 · see citing works
Waldorff, 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
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Azcurra, D. S. (2012) · Brazilian Journal of Psychiatry · doi:10.1016/j.rbp.2012.05.008 · Cited by 105 · see citing works
Depression in Alzheimer's disease: Phenomenology, clinical correlates and treatment
STARKSTEIN, S. E., Mizrahi, R., & Power, B. (2008) · International Review of Psychiatry · doi:10.1080/09540260802094480 · Cited by 104 · see citing works
White, N., Leurent, B., Lord, K., Scott, S., Jones, L., & Sampson, E. L. (2017) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4463 · Cited by 103 · see citing works
“Patients who were prescribed antipsychotics, after adjusting for end of life medication, age and dementia severity, were significantly more likely to die (adjusted hazard ratio 5.78, 95% CI 1.57, 21.26, p=0.008).”
BackgroundInfluentialNon‐pharmacological management of behavioural symptoms in nursing homes
Deudon, A., Maubourguet, N., Gervais, X., Leone, E., Brocker, P., Carcaillon, L., Riff, S., Lavallart, B., & Robert, P. H. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2275 · Cited by 102 · see citing works
“Livingston et al. (2005) identified a total of 1632 studies and only 162 satisfied the inclusion criteria for the review.”
BackgroundDiagnosing and Treating Depression in Patients with Alzheimer’s Disease
Burke, A. D., Goldfarb, D., Bollam, P., & Khokher, S. (2019) · Neurology and Therapy · doi:10.1007/s40120-019-00148-5 · Cited by 115 · see citing works
A model for streamlining psychotherapy in the RDoC era: the example of ‘Engage’
Alexopoulos, G. S., & Arean, P. (2014) · Molecular Psychiatry · doi:10.1038/mp.2013.150 · Cited by 95 · see citing works
Effects of Person-Centered Care Approaches to Dementia Care on Staff
Barbosa, A., de Sousa, L. X. M., Nolan, M., & de Figueiredo, D. M. P. (2014) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317513520213 · Cited by 100 · see citing works
Ihl, R., Frölich, L., Winblad, B. G., Schneider, L. S. S., Burns, A. S., Möller, H., & WFSBP Task Force on Treatment Guidelines for Alzheimer's Disease and other Dementias (2011) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2010.538083 · Cited by 97 · see citing works
“Nevertheless, several studies investigated these aspects (see Livingston et al. 2005; O ’ Connor et al. 2009a,b; Gauthier et al. 2010, for reviews).”
BackgroundO'Neil, M. E., Freeman, M., Christensen, V., Telerant, R., Addleman, A., & Kansagara, D. L. (2011) · Cited by 96 · see citing works
Kiosses, D. N., Leon, A. C., & Areán, P. A. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2011.03.001 · Cited by 91 · see citing works
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Lyketsos, C. G. (2007) · International Psychogeriatrics · doi:10.1017/s104161020700484x · Cited by 92 · see citing works
“Consequently, NPS are a significant focus of treatment with a wide range of treatments having been investigated, both pharmacological (Sink et al., 2005; Weintraub and Katz, 2005) and non-pharmacological (Livingston et al., 2005).”
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Impact of Adult Day Services on Behavioral and Psychological Symptoms of Dementia
Femia, E. E., Zarit, S. H., Stephens, M. A. P., & Greene, R. (2007) · The Gerontologist · doi:10.1093/geront/47.6.775 · Cited by 89 · see citing works
Brief Psychosocial Therapy for the Treatment of Agitation in Alzheimer Disease (The CALM-AD Trial)
Ballard, C. G., Brown, R. G., Fossey, J., Douglas, S., Bradley, P., Hancock, J., James, I. A., Juszczak, E., Bentham, P., Burns, A. S., et al. (2009) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181b0f8c0 · Cited by 85 · see citing works
“Other studies of nonpharmacologic interventions have been encouraging(19) but are generally small scale and underpowered.(20) The two most substantial trials so far undertaken have focused on either generic agitation(21) or the specific agitation symptom of abnormal vocalizations,(22) demonstrating significant benefit…”
Management of mild to moderate Alzheimer's disease and dementia
Hogan, D. B., Bailey, P., Carswell, A., Clarke, B., Cohen, C. A., Forbes, D. A., Man‐Son‐Hing, M., Lanctôt, K. L., Morgan, D., & Thorpe, L. (2007) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2007.07.006 · Cited by 84 · see citing works
Personalized dementia care: proven effectiveness of psychosocial interventions in subgroups.
van Mierlo, L. V., der Roest, H. G. V., Meiland, F., & Dröes, R. (2010) · Ageing Research Reviews · doi:10.1016/j.arr.2009.09.002 · Cited by 77 · see citing works
“Many reviews in the past (e.g. Eggermont and Scherder, 2006; Livingston et al., 2005; Smits et al., 2007) have tried to give an overview of effective psychosocial interventions, but failed to systematically provide information concerning characteristics of the subgroups for which those…”
BackgroundKurz, A. F., Leucht, S., & Lautenschlager, N. T. (2011) · International Psychogeriatrics · doi:10.1017/s1041610211001001 · Cited by 82 · see citing works
“Within the variety of interventions that have been developed (Livingston et al., 2005; Forbes et al., 2008; Blankevoort et al., 2010; Olazarán et al., 2010) cognitionfocused approaches aim at restoring memory and other cognitive abilities or at compensating impairments in order to preserve functioning in the everyday…”
BackgroundTestad, I., Ballard, C. G., Brønnick, K., & Aarsland, D. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05486oli · Cited by 82 · see citing works
Mental health care for the elderly in low-income countries: a health systems approach.
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Self-citation
- Authors
- Livingston, G., Johnston, K., Katona, C., Paton, J., Lyketsos, C. G., & Old Age Task Force of the World Federation of Biological Psychiatry
- Affiliations
- University College London (GB)
- Corresponding author
- Livingston, Gill
- Venue
- American Journal of Psychiatry
- Published
- 2005-11-01
- Volume
- 162
- Issue
- 11
- Pages
- 1996-2021
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2150798548
- Cited by
- 591
- References
- 172
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 14 · 2023: 8 · 2022: 17 · 2021: 16 · 2020: 10 · 2019: 28 · 2018: 21 · 2017: 39 · 2016: 38 · 2015: 28 · 2014: 46 · 2013: 47 · 2012: 56
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Kent Academic Repository (University of Kent) (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 › Arts and Humanities › Conservation › Art Therapy and Mental Health
- Keywords
- psychological intervention, caregiver interventions, cognitive stimulation therapy, music therapy, Snoezelen, sensory stimulation, long-term treatment effectiveness
- MeSH terms
- Behavior Therapy, Dementia, Humans, Person-Centered Psychotherapy, Patient Education as Topic, Psychotherapy, Research Design, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Caregivers, Guidelines as Topic, Evidence-Based Medicine
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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