Developing primary care psychiatry in the Asia‐Pacific

Non-pharmacological interventions for Lewy body dementia: a systematic review

“…1 ). The included studies consisted of 12 case studies (Kung & O'Connor, 2002 ; Loher et al 2002 ; Graff et al 2006 ; Cheston et al 2007 ; Huh et al 2008 ; Freund et al 2009 ; Ciro et al 2013 ; Gil-Ruiz et al 2013 ; Tabak et al 2013 ; Dawley, 2015 ; Hsu et al 2015 ; Ricciardi et al 2015 ), seven case series (Rasmussen et al 2003 ; Rochester et al 2009 ; Takahashi et al 2009 ; Ota et al 2012 ; Elder et al 2016 ; Yamaguchi et al 2016 ) – two of which were reported in the same paper (Takahashi et al 2009 ) – and two randomised controlled trials (Logemann et al 2008 ; Telenius et al 2015 ). Both randomised trials focused on the broader conditions of dementia and/or Parkinson's disease but had separate results for a Lewy body dementia subgroup available.…”

“…A further case report on electroconvulsive therapy was excluded (Fujiwara et al 2004 ) because of a concurrent pharmacological intervention. Twelve studies focused on dementia with Lewy bodies (Kung & O'Connor, 2002 ; Rasmussen et al 2003 ; Cheston et al 2007 ; Huh et al 2008 ; Takahashi et al 2009 ; Ota et al 2012 ; Ciro et al 2013 ; Gil-Ruiz et al 2013 ; Hsu et al 2015 ; Telenius et al 2015 ; Yamaguchi et al 2016 ), eight focused on Parkinson's disease dementia (Loher et al 2002 ; Graff et al 2006 ; Logemann et al 2008 ; Freund et al 2009 ; Rochester et al 2009 ; Tabak et al 2013 ; Dawley, 2015 ; Ricciardi et al 2015 ), and one included patients from both groups (Elder et al 2016 ). A summary of studies is shown in Table 1 .…”

“…Demographic information was not consistently reported. It was not provided for the subgroup of 132 patients with Parkinson's disease dementia in the largest study (Logemann et al 2008 ) and for two case series (Ota et al 2012 ; Yamaguchi et al 2016 ) – altogether 140 participants. Of the data available ( n = 55), the mean age of participants was 70.6 years ( s.d.…”

“…Interventions included carer education (Huh et al 2008 ), psychological interventions (for visual hallucinations) (Ota et al 2012 ), physical exercise (Tabak et al 2013 ; Telenius et al 2015 ), gait cueing (Rochester et al 2009 ), environmental modification (Gil-Ruiz et al 2013 ) (for mirrored self-misidentification, a delusion that usually occurs in the context of dementia; Connors & Coltheart, 2011 ; Connors et al 2015 ), music (Hsu et al 2015 ), simulated presence (Cheston et al 2007 ), occupational therapy (Graff et al 2006 ; Ciro et al 2013 ), physical therapy (Dawley, 2015 ), dietary fluid and postural interventions to prevent aspiration (Logemann et al 2008 ), electroconvulsive therapy (Kung & O'Connor, 2002 ; Rasmussen et al 2003 ; Takahashi et al 2009 ; Yamaguchi et al 2016 ), transcranial magnetic stimulation (Takahashi et al 2009 ), transcranial direct current stimulation (Elder et al 2016 ), and deep brain stimulation (Loher et al 2002 ; Freund et al 2009 ; Ricciardi et al 2015 ). The most studied interventions were electroconvulsive therapy (four studies) and deep brain stimulation (three studies).…”

“…Other individual studies variously reported benefits of carer education for reducing agitation (Huh et al 2008 ); psychological interventions for reducing distress around visual hallucinations (Ota et al 2012 ); physical exercise to improve gait and function (Tabak et al 2013 ; Telenius et al 2015 ); gait cueing to improve gait speed (Rochester et al 2009 ); environmental modification to reduce the distress associated with mirrored self-misidentification delusion (Gil-Ruiz et al 2013 ); music therapy to reduce agitation (Hsu et al 2015 ); simulated presence to reduce distress (Cheston et al 2007 ); occupational therapy interventions to improve functional ability (Graff et al 2006 ; Ciro et al 2013 ); physical therapy to improve gait (Dawley, 2015 ); dietary fluid and postural interventions to prevent aspiration (Logemann et al 2008 ); transcranial magnetic stimulation to reduce depression (Takahashi et al 2009 ); and transcranial direct current stimulation to improve attention (Elder et al 2016 ) (see Table 1 ). For all these studies, however, limitations in their design, including small sample sizes, lack of blinding, and lack of adequate controls, mean that it is not possible to rule out confounding, selection bias, experimenter expectancy, publication bias, and other causes for the reported effects.…”