Impact of Antipsychotic Review and Nonpharmacological Intervention on Antipsychotic Use, Neuropsychiatric Symptoms, and Mortality in People With Dementia Living in Nursing Homes: A Factorial Cluster-Randomized Controlled Trial by the Well-Being and Health for People With Dementia (WHELD) Program

Abstract

While reductions in antipsychotic use can be achieved by using a "real world" intervention, this may not be of benefit to people with dementia in the current climate of more judicious prescribing unless nonpharmacological interventions such as social interaction or exercise are provided in parallel.

Communication training interventions for family and professional carers of people living with dementia: a systematic review of effectiveness, acceptability and conceptual basis

“…Performance bias was present in all of the quantitative studies due to the impossibility of blinding patients and trainers to the intervention being delivered. However, most studies were also subject to detection bias; only seven studies used comprehensive assessor blinding (Ballard et al, 2016;Broughton et al, 2011;Chenoweth et al, 2014;De Rotrou et al, 2011;Gitlin, Winter, & Dennis, 2010;Livingston et al, 2013;Orgeta et al, 2015).…”

“…Eight studies reported adequate randomisation processes and allocation procedures, and therefore reduced selection bias (Ballard et al, 2016;Chenoweth et al, 2014;De Rotrou et al, 2011;Gitlin et al, 2010;Livingston et al, 2013;Orgeta et al, 2015;Prick, De Lange, Twisk, & Pot, 2015;van der Ploeg et al, 2013). However, attrition levels were often high and rarely reported for each treatment group.…”

“…Effectiveness: Knowledge, communication skills and strategies Four RCTs reported effectiveness data on a training-intervention (Ballard et al, 2016;Chenoweth et al, 2014;van der Kooij et al, 2013;van der Ploeg et al, 2013). The results of two RCTs and two case control studies indicated that those receiving training-interventions demonstrated significant improvements in knowledge and communication skills (Broughton et al, 2011;Chenoweth et al, 2014;Sprangers, Dijkstra, & Romijn-Luijten, 2015;van der Kooij et al, 2013).…”

Aromatherapy and Aromatic Plants for the Treatment of Behavioural and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease: Clinical Evidence and Possible Mechanisms

“…Alzheimer's Disease (AD), originally described by Alzheimer in 1907 [1], is the most common cause of dementia in the elderly: 35 million people all over the world are affected by dementia [2] and, according to the survey made by the World Health Organization (WHO) in 2012, 54% of all the cases of dementia are AD-related. These data account for the social burden of AD worldwide.…”

A preclinical screen to evaluate pharmacotherapies for the treatment of agitation in dementia

“…Basically, there are no officially approved pharmacotherapies for agitation in dementia, and few if any safe and effective pharmacotherapies (Antonsdottir et al, 2015;Cummings et al, 2015;Panza et al, 2015;Soto et al, 2015;Kales et al, 2014;. Also, non-pharmaceutical approaches have been shown to be of very limited value (Ballard et al, 2016;Steinberg, 2016;Kales et al, 2014). Of the pharmacological treatments used for the management of agitation in dementia, benzodiazepines (anxiolytics) have weak effects (Defrancesco et al, 2015;Ngo and Holroyd-Leduc, 2015;Kales et al, 2014;Wilson et al, 2012;Salzman et al, 2008) and have been found to accelerate cognitive deterioration (Defrancesco et al, 2015), the antidepressants citalopram (Pollock et al, 2002) and sertraline (Lyketsos et al, 2003) have been suggested to have some effects (Sink et al, 2005), however the trial using citalopram had a high dropout rate due to lack of efficacy and sertraline had no benefit with respect to neuropsychiatric symptoms.…”