Modality therapy for Dementia Management: A Systematic Review (original) (raw)
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Cognitive Psychosocial Intervention in Dementia: A Systematic Review
Background: The evolution of dementia depends on the underlying pathology, early diagnosis and the availability of effective treatment for some of the symptoms that interfere with the patients' or caregivers' quality of life. Even though there is no specific treatment to reverse dementia, some interventions such as reality orientation and skills training can retard cognitive impairment. Aim: To review existing scientific evidence regarding the efficacy of therapies included in the category of cognition-oriented approaches for people suffering from dementia. Methods: Papers were retrieved from several bibliographic databases (last publication date: 2009) with pre-specified selection criteria, data extraction and methodological quality assessment. Results: Nine reality orientation and 8 skills training trials were identified as meeting the inclusion criteria. Conclusions: Stimulation of cognitive functions, especially by means of reality orientation, improves overall cognitive function in patients suffering from dementia.
Objective: To establish a robust understanding of the state of the evidence on the effectiveness and/or efficacy of art therapy (AT) as a non-pharmacological treatment (NPT) modality for persons living with dementia (PLWD). Introduction: Over the past decade, AT has received increased attention from health care professionals and researchers as having a potential role to play within treatment plans for PLWD.(1-4) Inclusion criteria: This scoping review will include systematic reviews from health-related disciplines conducted within the last 20 years that report the effectiveness and/or efficacy of AT as an NPT modality for PLWD and Mild Cognitive Impairment (MCI) as their primary outcome. Study outcomes must include cognition, quality of life, emotional and psychological well-being, and/or neuropsychiatric symptoms (NPS). Methods: A scoping review of systematic reviews was selected to outline different types of evidence and to identify gaps in the literature. The proposed review will...
The effectiveness of alternative treaments for Dementia
The increasing prevalence of dementia and lack of cure or effective pharmacological treatment highlights the importance of investigating alternative treatments as they could offer a non-invasive, person-centred alternative. The aim of this paper is to evaluate the effectiveness of music therapy, animal assisted therapy and aromatherapy in treating the symptoms of dementia and investigating the possible explanations for why these treatments may be effective. Music therapy and animal assisted therapy were both found to be effective in treating the behavioural symptoms of dementia but there was a lack of consensus as to whether they were effective in addressing the cognitive symptoms. There seemed to be general disagreement as to whether aromatherapy was effective in treating any of the symptoms of dementia. Whether alternative treatments can provide an effective alternative to the use of multiple medications for dementia is still under debate. Future research should focus on tackling the cognitive symptoms of dementia rather than the behavioural symptoms as it may be more beneficial to slow the cognitive decline to allow people to cope independently for longer.
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Psychiatry Investigation
scribed for behavioral and psychological symptoms of dementia (BPSD), are associated with serious adverse effects, including pneumonia, cardiovascular events, stroke, fractures, and kidney failure. 7,8 Above all, pharmacological interventions cannot fulfill the needs of PWD and their caregivers, including relief of pain and discomfort, the need for social contact, and alleviation of boredom. 9 For these reasons, a combination of pharmacological and nonpharmacological interventions (NPI) is strongly recommended for PWD. 10-13 Recent systematic reviews have identified the effects of various NPI on cognitive decline, 14-16 BPSD, 12-17 activities of daily living (ADL) 14,16,18 and quality of life (QoL) 14 of PWD. However, most analyses in previous systematic reviews did not take into account the severity of dementia. 17,19-23 Although there have been several systematic reviews focused on the effects of NPI in people with moderate to severe dementia (PWMSD), they did not conduct meta-analyses 24,25 or con
Psychological Management of Dementia: An Update
2007
Received, May 12, 2007 Acepted, May 28, 2007 It is increasingly recognized that pharmacological treatments for dementia should be used as a second line approach and that non-pharmacological options should, in best practice, be pursued first. This review examines current non-pharmacological approaches. It highlights the more traditional treatments such as behavioral therapy, reality orientation and validation therapy, and also examines the potential of interesting new alternative options such as cognitive therapy, aromatherapy and music therapies. Although many non-pharmacological treatments have reported benefits in multiple research studies, there is a need for further reliable and valid data before the efficacy of these approaches is more widely recognized.
Dementia, 2018
ObjectiveMultimodal non-pharmacological interventions have been argued to have the potential to complement current pharmacological approaches to improving quality of life for people living with dementia. The aim of this review was to identify, synthesise and appraise the evidence for the effectiveness of multimodal non-pharmacological interventions for improving cognitive function specifically.MethodAfter a comprehensive search strategy including grey literature, 26 studies were reviewed. The inclusion criteria concerned adults with a primary diagnosis of dementia. Studies used two or more different modes of intervention, and measured a cognitive outcome. Due to differences in the conceptualisations of the term ‘multimodal’, a typology of modes and methods was developed to facilitate classification of candidate studies.ResultsTwenty-one group studies and five case studies were found. Group studies used two or three modes of intervention and multiple methods to implement them. Interv...
This is an independent report commissioned and funded by the Department of Health. The views expressed are not necessarily those of the Department. We are not aware of conflicts of interest amongst members of the review team. Non-drug treatments for symptoms in dementia Summary 1. Introduction 2. Background 2.1 The condition 2.2 The social burden 2.3 The use of antipsychotic medication 3. Objectives of this overview 4. Review methods 4.1 Review type 4.2 User involvement 4.3 Consultation with stakeholders 4.4 Identification of relevant systematic reviews 4.4.1 Definitions 4.4.2 Outcomes 4.4.3 Inclusion and exclusion criteria for systematic reviews 4.4.4 Search strategy 4.5 Selecting reviews 4.6 Quality assessment and data extraction 4.6.1 Quality assessment 4.6.2 Data extraction 4.7 Synthesising the findings across intervention categories 5. Results 5.1 Flow of studies through the review 5.2 Characteristics of included studies 5.2.1 Description of broad reviews 5.2.2 Description of narrow reviews 5.3 Summary of evidence across intervention categories 5.3.1 Evidence summary-Reduction in use of antipsychotics 5.3.2 Evidence summary-Effective management of 5.3.2 neuropsychiatric symptoms and challenging behaviours 5.4 Reviews of reviews and guidelines 6. Discussion and summary 6.1 Discussion 6.2 Summary of the evidence 7. References and included reviews* Appendix 1 Search strategy Appendix 2 Assessing the quality of systematic reviews Appendix 3 Characteristics of systematic reviews with a broad focus Appendix 4 Characteristics of systematic reviews with a narrow focus Appendix 5 Characteristics of other review of reviews and practice guidelines Appendix 6 Overall summary table: evidence by type of intervention Contents There was promising evidence for four other alternative treatments-physical activity/exercise; massage/touch therapies; multi-sensory stimulation (e.g. snoezlen, aromatherapy) and music therapy-although the evidence for these was not as robust, either because the primary studies were not as rigorous, the results were more mixed or the evidence available was limited. Only one treatment appeared to be ineffective-validation therapy. For the vast majority of treatments, however, the evidence was inconclusive, either because it was inconsistent across primary studies, or these studies were of poor quality, or the evidence was almost totally lacking. This general lack of high quality evidence meant that the systematic reviews included in our overview refrained from making policy and practice recommendations. It also leads to the conclusion that more and better research is needed on these alternative interventions in order to inform future policy and practice.