A Systematic Review and Meta-Analysis of Nonpharmacological Interventions for Moderate to Severe Dementia
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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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Memantine can be administered in combination with an acetylcholinesterase inhibitor because they have complementary mechanisms of action.
“Memantine can be administered in combination with an AChEI, as they have complementary mechanisms of action.”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [14]
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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
- Publisher
- Korean Neuropsychiatric Association
- Published
- 2019-05-25
- Volume
- 16
- Issue
- 5
- Pages
- 325-335
- ISSN
- 1738-3684 (ISSN-L)
- 1976-3026
- PMC
- PMC6539264
- 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
- diamond
- doi.org
- Licence
- 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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