Toward a theory‐based specification of non‐pharmacological treatments in aging and dementia: Focused reviews and methodological recommendations

Abstract

Introduction Non‐pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks methodological rigor and continues to produce mixed results. Methods In the current position paper, experts in NPT research have specified treatment targets, aims, and ingredients using an umbrella framework, the Rehabilitation Treatment Specification System. Results Experts provided a snapshot and an authoritative summary of the evidence for different NPTs based on the best synthesis efforts, identified main gaps in knowledge and relevant barriers, and provided directions for future research. Experts in trial methodology provide best practice principles and recommendations for those working in this area, underscoring the importance of prespecified protocols. Discussion We conclude that the evidence strongly supports various NPTs in relation to their primary targets, and discuss opportunities and challenges associated with a unifying theoretical framework to guide future efforts in this area.

Personalized treatment interventions: nonpharmacological and natural treatment strategies in Alzheimer’s disease

“…Nonpharmacological treatment of AD has gained attention in recent years, primarily as an alternative first-line approach, or an additional intervention to treat behavioral symptoms [12], but some interventions may exert beneficial effects on cognition. The umbrella term "nonpharmacological treatment" covers numerous treatment approaches [13], starting from simple activities such as walking or puzzle-solving, to implementation of high technology-assistance, such as computer-assisted training and robots. A validated taxonomy of these interventions is lacking in the literature [12].…”

“…The aim of such interventions is to postpone patient deterioration, including cognitive decline, alleviate psychiatric symptoms, and improve overall health and quality of life. The largest body of evidence exists for cognitive training, physical exercise, and music-based therapy [13].…”

“…Cognitive training interventions are designed to attenuate cognitive decline in dementia, while training basic functions using standardized tasks, to improve or maintain non-verbal and verbal memories, language, visual-spatial skills, concept formation, and reasoning [46]. In general, cognitive training induced at least moderate improvement in cognitive test performance in both MCI and patients with mild to moderate AD, and this achievement was maintained over a short or medium period [13]. This method also prevented cognitive decline among older people at risk for dementia, in terms of reducing the incidence of MCI or dementia [47].…”

“…Cognitive interventions in general had benefits on cognition, but did not improve activities of daily living [18]. Cognitive rehabilitation is a problem-solving behavioral therapy, aimed to improve functional disability [13].…”

Effectiveness of the Validation Method in Work Satisfaction and Motivation of Nursing Home Care Professionals: A Literature Review

“…The increase in life expectancy and the higher prevalence of neurocognitive disorders means there is a need to improve and innovate non-pharmacological strategies in order to ensure the quality of life and well-being of older people and their caregivers [ 1 , 2 , 3 ]. As a neurocognitive disorder progresses, one of the challenges is to be able to maintain effective channels of communication to identify the needs and emotions of older people with dementia and therefore be able to offer optimal, quality and humanising care [ 4 , 5 , 6 , 7 ].…”