Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews

Legere, Laura; McNeill, Susan; Martin, Lori Schindel; Acorn, Michelle; An, Diana

doi:10.1111/jocn.14007

Cited by 54 publications

(53 citation statements)

References 25 publications

(93 reference statements)

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“…Momentarily, different pharmacological and non-pharmacological therapies are recommended to reduce the frequency and severity of BPSD, that have been shown to be effective in slowing down the impairment, especially with regard to the cognitive symptoms that are inherent to dementia [14]. In general, non-pharmacological interventions are considered as a preferable alternative to pharmacotherapy, mainly because of the adverse effects that are found in pharmacological therapies [15,16].…”

Section: Introductionmentioning

confidence: 99%

“…The American Psychiatric Association [17] distinguishes non-pharmacological therapies that are conducted to treat dementia into four different categories: (1) cognition-oriented treatments (e.g., reality orientation, skills training), (2) emotion-oriented treatments (e.g., supportive therapy, validation/integrated emotion-oriented care, Snoezelen, reminiscence), (3) behaviororiented treatments (behavior therapy), and (4) stimulation-oriented treatments (e.g., activity or recreational therapy, art therapy, music therapy, exercise, psychomotor therapy). There is conflicting evidence with regard to the effectiveness of non-pharmacological interventions to improve BPSD [14], which makes it necessary to have a clear overview of the existing evidence.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Therapy for Dementia Patients: A Systematic Review

Carrión

Folkvord

Anastasiadou

et al. 2018

Dement Geriatr Cogn Disord

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Background: Cognitive therapy is a well-established intervention for treating elderly suffering from dementia. In particular, reality orientation and skills training seem to be effective interventions for reversing cognitive impairment among elderly, although findings are inconclusive. Therefore, a systematic update of the existing evidence of cognitive therapy for people suffering from dementia is needed. Aim: To review existing scientific evidence regarding the efficacy of cognitive therapies for elderly suffering from dementia. Methods: Studies were retrieved from several bibliographic databases (January 2009 to December 2017) with prespecified selection criteria, data extraction, and methodological quality assessment. Results: In total, 10 reality orientation, 25 skills training, and 12 mixed trials were identified as meeting the inclusion criteria and were systematically reviewed. Results from reality orientation trials showed minor effects for cognitive assessments, while skills training trials and mixed trials showed contradicting effects on cognition. Effects on other outcomes (e.g., daily functioning, depression, language) were limited or not found. Conclusions: Skills training trials and mixed trials seem to affect cognitive impairment in a positive way, although the results are inconclusive. Comparison between studies was difficult due to differences in form of intervention. Because findings are inconclusive, more structuralized and comparable randomized controlled trials are needed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cognitive Therapy for Dementia Patients: A Systematic Review

Carrión

Folkvord

Anastasiadou

et al. 2018

Dement Geriatr Cogn Disord

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“…Existing pharmacological options in NPS treatment include atypical antipsychotics, benzodiazepines, and other drugs (eg, mood stabilizers), which may, however, increase the risk of cognitive decline, cerebrovascular events, or mortality . Differently, systematic reviews have demonstrated the effectiveness of nonpharmacological treatments (NPTs) for NPS as well as the increase in perceived quality of life in PwD and their caregivers . Consequently, the National Institute for Health and Care Excellence dementia guidelines recommend NPTs as first‐line treatments in the management of noncognitive behavioral disturbances in PwD.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17] Differently, systematic reviews have demonstrated the effectiveness of nonpharmacological treatments (NPTs) for NPS as well as the increase in perceived quality of life in PwD and their caregivers. 14,[18][19][20] Consequently, the National Institute for Health and Care Excellence dementia guidelines 21 focused on NPTs such as cognitive stimulation, pet therapy, doll therapy, and caregiver training in problem solving 18,22,23 to reduce NPS.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the efficacy of gesture‐verbal treatment and doll therapy for managing neuropsychiatric symptoms in older patients with dementia

Balzotti

Filograsso²,

Altamura

et al. 2018

Int J Geriat Psychiatry

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Background The prevalence of neuropsychiatric symptoms (NPS) diminishes the quality of life and increases the care burden in patients with dementia. Despite the clinical importance of dementia‐associated NPS, no protocols for treating NPS are already well established. Attention has turned to the effectiveness of nonpharmacological treatments for NPS since their potential safe alternative to pharmacotherapy. Objective This study is aimed to compare the effects in older individuals with dementia living in a residential care, of two intervention programs, the gesture‐verbal treatment (GVT), a treatment implemented by us on a previous method for word retrieval in individuals with aphasia, and the better‐known doll therapy (DT). The GVT would act on both receptive and expressive language skills, the DT on attachment and emotional connections. Methods We evaluated NPS by the neuropsychiatric inventory in a total of 30 patients divided into 3 groups, the GVT, the DT, and control groups, using a pre‐post design. The treatment groups completed 12‐week nonpharmacological interventions in addition to standard rehabilitative therapies, while the control group participated only in standard rehabilitative therapies. Results The DT group showed significant improvements in agitation, irritability, apathy, depression, and delusions relative to controls. The GVT group showed significant improvements in apathy and depression with respect to controls. The DT intervention ameliorated symptoms of agitation compared to the GVT intervention whereas the GVT intervention improved apathy compared to the DT intervention. Conclusion Improved understanding of the potential therapeutic benefits of different treatments for neuropsychiatric symptoms is crucial for establishing nonpharmacological interventions in dementia.

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“…Further, a number of studies have demonstrated the benefits of nonpharmacological interventions on behavioural and psychological symptoms of dementia (BPSD; Legere et al . ; Logsdon et al . ; Scales et al .…”

Section: Introductionmentioning

confidence: 99%

Psychotherapeutic skills training for nurses on an acute aged mental health unit: A mixed‐method design

Kelly

Jayaram

Bhar

et al. 2018

Int J Mental Health Nurs

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This study examines the need for, and outcomes of, a psychotherapeutic skills training programme, within an acute psychogeriatric unit. Nursing staff were surveyed to explore their training needs in psychotherapeutic skills with inpatients diagnosed with depressive, anxiety, or neurocognitive disorders. Staff were then invited to participate in a focus group (n = 6) to identify content of such training, possible barriers, and an implementation strategy. Next, to ascertain the feasibility and acceptability of such training, materials and schedules were developed and piloted with a small group of nurses (n = 8), before being administered to nurses across the unit (n = 23). Impacts of training on the confidence and competence of nurses to use such skills were investigated. Of nurses surveyed (n = 20), 80% wanted to use psychotherapeutic skills in routine practice, but only 35% had received training in such skills in the last 5 years. Focus group results identified that nurses wanted training in skills related to engaging patients, responding to resistance from patients, problem solving, reminiscence, relaxation, and cognitive behaviour therapy. Nurses who underwent the pilot training reported increases in confidence and competence in using such skills. These findings were replicated in the unit‐wide training programme and were found to be durable across a 3‐month follow‐up period. This study highlighted the training needs of nurses working in an inpatient psychogeriatric setting, approaches to implementing new skills, and benefits of training for nurses’ levels of confidence and competence in using psychotherapeutic skills.

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Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews

Cited by 54 publications

References 25 publications

Cognitive Therapy for Dementia Patients: A Systematic Review

Cognitive Therapy for Dementia Patients: A Systematic Review

Comparison of the efficacy of gesture‐verbal treatment and doll therapy for managing neuropsychiatric symptoms in older patients with dementia

Psychotherapeutic skills training for nurses on an acute aged mental health unit: A mixed‐method design

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