A critique of research on the use of activities with persons with Alzheimer’s disease: a systematic literature review

Marshall, Melody J.; Hutchinson, Sally A.

doi:10.1046/j.1365-2648.2001.01887.x

Cited by 137 publications

(66 citation statements)

References 55 publications

(114 reference statements)

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“…Numerous methodological problems in psychosocial studies have been noted by reviewers (e.g., Finnema et al, 2000;Marshall and Hutchinson, 2001): sampling problems such as unclear selection criteria and diagnostic difficulties, design and measurement problems such as the lack of rigor, the use of instruments without reporting reliability and validity in the populations of concern, and the inadequate description of interventions and measurement of outcomes. The contribution of our study is that it was an RCT that addressed many of the methodological issues mentioned in the literature.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of a specific reminiscence approach to promote the well-being of nursing home residents with dementia

Lai

Chi

Kayser‐Jones

2004

Int. Psychogeriatr.

125

119

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Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of a specific reminiscence approach to promote the well-being of nursing home residents with dementia

Lai

Chi

Kayser‐Jones

2004

Int. Psychogeriatr.

125

119

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“…Research shows that purposeful activity results in reduced depressive and agitated behaviors. (18,19) However, studies have focused exclusively on nursing home residents, involved small sample sizes, used non-experimental designs, or have not tested systematic approaches to developing activities. Lack of research on communityliving patients is significant given that the home is the primary care setting for this population.…”

Section: Objectivesmentioning

confidence: 99%

Tailored Activities to Manage Neuropsychiatric Behaviors in Persons With Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

Gitlin

Winter

Burke

et al. 2008

American Journal of Geriatric Psychiatry

144

216

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Objective-To test whether the Tailored Activity Program for at-home dementia patients reduces neuropsychiatric behaviors and caregiver burden.Method-A prospective, two-group controlled pilot study with 60 dyads randomized to treatment or wait-list control. Dyads were interviewed at baseline and 4 months (trial endpoint); control participants then received intervention and were reassessed 4 months later. The 8-session occupational therapy intervention involved neuropsychological and functional testing from which activities were customized and instruction in use provided to caregivers. Conclusions-Results suggest clinically-relevant benefits for both dementia patients and caregivers, with treatment minimizing the occurrence of behaviors that commonly trigger nursing home placement. (1) Neuropsychiatric behaviors such as apathy, depressed affect, lability, agitation, and aggressiveness are common occurrences, with most patients manifesting these behaviors over the course of the disease. (2,3,4) Behaviors are the most challenging aspect of caregiving, contributing to caregiver distress, depression, increased care costs, and risk for nursing home placement. (5,6,7,8) There are few tested interventions to minimize behavioral occurrences. Recent research has shown that pharmacological approaches may not be effective and may cause harm (9,10,11). A few caregiver intervention studies report minimal behavioral benefits (12,13,14,15), with most studies not examining patient symptom reduction. Thus, developing and testing nonpharmacological approaches to address behaviors is an important public health priority as articulated in recent position statements by the American Association for Geriatric Psychiatry (16) and Annals of Internal Medicine. (17) One promising approach is activity. Research shows that purposeful activity results in reduced depressive and agitated behaviors. (18,19) However, studies have focused exclusively on nursing home residents, involved small sample sizes, used non-experimental designs, or have not tested systematic approaches to developing activities. Lack of research on communityliving patients is significant given that the home is the primary care setting for this population. Results-At KeywordsThis pilot controlled study evaluates an activity-based intervention, the Tailored Activity Program (TAP) that seeks to reduce behavioral disturbances by identifying patients' preserved capabilities and devising activities that build on them. The trial tested whether tailored activities reduced behavioral occurrences in dementia patients and caregiver burden and enhanced patient engagement, caregiver mastery, self-efficacy, and use of simplification strategies to manage behaviors. Also, because the intervention required caregiver involvement, we evaluated whether caregiver depressive symptoms moderated dementia patient and caregiver outcomes.Using a two-group randomized, parallel design, 60 dyads (dementia patients and their caregivers) were assigned to treatment or wait-list control. Treatment grou...

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“…These therapies often still lack empirical evidence relating to their effectiveness (Marshall & Hutchinson, 2001), but this issue is gradually being addressed. A review of some of the most popular forms of alternative therapy is provided below.…”

Section: Alternative Non-pharmacological Therapiesmentioning

confidence: 99%

Non-pharmacological interventions in dementia

Douglas¹,

James²,

Ballard³

2004

Adv. psychiatr. treat

233

172

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It is increasingly recognised that pharmacological treatments for dementia should be used as a second-line approach and that non-pharmacological options should, in best practice, be pursued first. This review examines current non-pharmacological approaches. It highlights the more traditional treatments such as behavioural therapy, reality orientation and validation therapy, and also examines the potential of interesting new alternative options such as cognitive therapy, aromatherapy and multisensory therapies. The current literature is explored with particular reference to recent research, especially randomised controlled trials in the area. Although many non-pharmacological treatments have reported benefits in multiple research studies, there is a need for further reliable and valid data before the efficacy of these approaches is more widely recognised.

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A critique of research on the use of activities with persons with Alzheimer’s disease: a systematic literature review

Cited by 137 publications

References 55 publications

A randomized controlled trial of a specific reminiscence approach to promote the well-being of nursing home residents with dementia

A randomized controlled trial of a specific reminiscence approach to promote the well-being of nursing home residents with dementia

Tailored Activities to Manage Neuropsychiatric Behaviors in Persons With Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

Non-pharmacological interventions in dementia

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