Psychiatry Investig.  2019 May;16(5):325-335. 10.30773/pi.2019.02.11.2.

A Systematic Review and Meta-Analysis of Nonpharmacological Interventions for Moderate to Severe Dementia

• Na R
• Yang JH
• Yeom Y
• Kim YJ
• Byun S
• Kim K
• Kim KW

• KMID: 2449904
• DOI: http://doi.org/10.30773/pi.2019.02.11.2

Abstract

OBJECTIVE
Due to limited efficacy of medications, non-pharmacological interventions (NPI) are frequently co-administered to people with moderate to severe dementia (PWMSD). This systematic review and meta-analysis investigated the effects of NPI on activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD), and cognition and quality of life (QoL) of PWMSD.
METHODS
A literature search was conducted in the following databases: Cochrane CENTRAL, EMBASE, Medline, CIHNAL, PsycINFO, KoreaMED, KMbase, and KISS. We conducted a meta-analysis on randomized controlled trials and used the generic inverse variance method with a fixed-effects model to calculate the standardized mean difference (SMD). The protocol had been registered (CRD42017058020).
RESULTS
Ten randomized controlled trials met the inclusion criteria of the current meta-analysis. NPI were effective in improving ADL [SMD=0.28, 95% confidence interval (CI)=0.11-0.45] and reducing depression (SMD=-0.44, 95% CI=-0.70- -0.19). However, NPI were not effective in reducing agitation, anxiety, or overall, or improving cognitive function. In a subgroup analysis, music therapy was effective in reducing overall BPSD (SMD=-0.52, 95% CI=-0.90- -0.13).
CONCLUSION
Albeit the number of studies was limited, NPI improved ADL and depression in PWMSD.

Keyword

Dementia; Nonpharmacological intervention; Activities of daily living; Depression; Behavioral and psychological symptoms of dementia

MeSH Terms

Activities of Daily Living
Anxiety
Cognition
Dementia*
Depression
Dihydroergotamine
Methods
Music Therapy
Quality of Life
Dihydroergotamine