Cited by 70Dementia and Cognitive Impairment ResearchGeriatric Care and Nursing HomesAlzheimer's disease research and treatments

A Systematic Review and Meta-Analysis of Nonpharmacological Interventions for Moderate to Severe Dementia

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Na, Riyoung, Yang, Ji-hye, Yeom, Yusung, Kim, You Joung, Byun, Seonjeong, Kim, Kiwon, Kim, Ki Woong·2019·Psychiatry Investigation

Abstract

OBJECTIVE: Due to limited efficacy of medications, non-pharmacological interventions (NPI) are frequently co-administered to people with moderate to severe dementia (PWMSD). This systematic review and meta-analysis investigated the effects of NPI on activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD), and cognition and quality of life (QoL) of PWMSD. METHODS: A literature search was conducted in the following databases: Cochrane CENTRAL, EMBASE, Medline, CIHNAL, PsycINFO, KoreaMED, KMbase, and KISS. We conducted a meta-analysis on randomized controlled trials and used the generic inverse variance method with a fixed-effects model to calculate the standardized mean difference (SMD). The protocol had been registered (CRD42017058020). RESULTS: Ten randomized controlled trials met the inclusion criteria of the current meta-analysis. NPI were effective in improving ADL [SMD=0.28, 95% confidence interval (CI)=0.11-0.45] and reducing depression (SMD=-0.44, 95% CI=-0.70- -0.19). However, NPI were not effective in reducing agitation, anxiety, or overall, or improving cognitive function. In a subgroup analysis, music therapy was effective in reducing overall BPSD (SMD=-0.52, 95% CI=-0.90- -0.13). CONCLUSION: Albeit the number of studies was limited, NPI improved ADL and depression in PWMSD.

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  1. [19]Brasure M Jutkowitz E Fuchs E Nelson VA Kane RA Shippee T Nonpharmacologic Interventions for Agitation and Aggression in Dementia Comparative Effectiveness Review No. 177 Minnesota AHRQ Publication 2016 27099894
  2. [41]Rabins PV Blacker D Rovner BW Rummans T Schneider LS Tariot PN American Psychiatric Association practice guideline for the treatment of patients with Alzheimer’s disease and other dementias Second edition Am J Psychiatry 2007 164 12 Suppl 5 56 18340692
  3. [71]Spielberger CD Gorsuch RL Lushene R Vagg PR Jacobs GA Manual for the State-Trait Anxiety Inventory Palo Alto, CA Consulting Psychologists Press 1983

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Authors
Na, R., Yang, J.-H., Yeom, Y., Kim, Y. J., Byun, S., Kim, K., & Kim, K. W.
Affiliations
Seoul National University (KR)
Corresponding author
Kim, Ki Woong
Venue
Psychiatry Investigation
Published
2019-05-25
Volume
16
Issue
5
Pages
325-335
ISSN
  • 1738-3684 (ISSN-L)
  • 1976-3026
OpenAlex
W2945084355
Cited by
70
References
83
Citations by year
2026: 6 · 2025: 4 · 2024: 13 · 2023: 10 · 2022: 12 · 2021: 17 · 2020: 6 · 2019: 2
FWCI
1.55
Type
journal article
Language
en
Open access
Locations
  • Psychiatry Investigation (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • National Institute of Dementia of Korea (1703-0018)
  • Ministry of Health and Welfare (HI09C1379)
  • Kyungpook National University
  • Ministry of Science and ICT
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
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
non-pharmacological treatment, moderate to severe dementia, activities of daily living, behavioral and psychological symptoms of dementia, depression, agitation, anxiety, music therapy, cognitive function, quality of life

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