Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Cotelli et al., 2019 | Systematic review | 2005–2016 | Persons living with mild cognitive impairment, Alzheimer’s disease, or frontotemporal dementia | 5 | Randomized controlled trial |
Tay et al., 2019 | Systematic review | 1998–2017 | Persons living with dementia | 11 |
|
Lim et al., 2019 | Systematic review | 2009–2017 | Persons in the early stages of dementia or mild cognitive impairment | 9 |
|
Bahar-Fuchs et al., 2019 | Systematic review and meta-analysis | 1988–2018 | Persons living with mild to moderate dementia | 33 (32 included in meta-analysis) | Randomized controlled trial |
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Cognitive telerehabilitation | Cognitive ability |
|
Cognitive-behavioral therapy |
|
|
Tai chi |
|
Tai chi has the potential to improve short-term cognitive function in the early stages of dementia. |
Cognitive training |
|
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Yen and Lin, 2018 | Systematic review | 2004–2010 | Older adults living with and without dementia | 16 |
|
van der Steen et al., 2018 | Systematic review and meta-analysis | 1993–2016 | Persons living with dementia | 22 (21 included in meta-analysis) | Randomized controlled trial |
van den Berg et al., 2018 | Systematic review | 1991–2017 | Persons living with dementia | 17 |
|
Spencer et al., 2018 | Systematic review | 2009 | Persons living with dementia | 1 | Cluster randomized controlled study |
Russell-Williams et al., 2018 | Review | 2010–2016 | Persons living with dementia, mild cognitive impairment, or subjective cognitive decline | 10 |
|
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Reminiscence therapy |
|
|
Music therapy |
|
|
Electroconvulsive therapy | Agitation and aggression | Clinical improvements were observed in most of the studies, but the lack of randomized controlled trials limits inference. |
De-escalation techniques for managing aggression |
|
A single study with high risk of bias found no difference in change in overall behavior. |
Meditation:
|
|
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Peluso et al., 2018 | Review | 1995–2016 | Persons living with dementia and/or psychiatric disorders | 16 |
|
Oltra-Cucarella et al., 2018 | Systematic review and meta-analysis | 1993–2016 | Persons living with Alzheimer’s disease or mixed dementias | 33 |
|
Mohler et al., 2018 | Systematic review and meta-analysis | 2000–2015 | Persons living with dementia | 8 (7 included in meta-analysis) |
|
Lorusso and Bosch, 2018 | Systematic review | 2001–2014 | Persons living with dementia | 12 |
|
Liang et al., 2018 | Systematic review and network meta-analysis | 2004–2016 | Persons living with Alzheimer’s disease or mild cognitive impairment | 17 | Randomized controlled trial |
Hu et al., 2018 | Systematic review and meta-analysis | 1999–2016 | Persons living with cognitive impairment, including dementia and mild cognitive impairment | 10 |
|
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Animal-assisted therapy |
|
Preliminary evidence from studies of low quality indicates that in persons with dementia, animal-assisted therapy may decrease problem behaviors and improve quality of life and social skills. |
Cognition-focused interventions:
|
|
Cognition-focused interventions have limited effects on cognition or function compared with non–cognition focused interventions. |
Tailored activities |
|
|
Multisensory environments |
|
|
|
|
|
Animal-assisted intervention |
|
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Herke et al., 2018 | Systematic review | 1986–2015 | Persons living with dementia | 9 | Randomized controlled trial |
Fusar-Poli et al., 2018 | Systematic review and meta-analysis | 2009–2014 | Persons living with dementia | 6 | Randomized controlled trial |
Frederiksen et al., 2018 | Systematic review | 2006–2017 | Persons living with no cognitive impairment (6 studies) Individuals with subjective memory complaints, mild cognitive impairment, or Alzheimer’s disease (2 studies) | 8 | Randomized controlled trial |
Duan et al., 2018 | Systematic review and network meta-analysis | 2006–2016 | Persons living with dementia | 10 | Randomized controlled trial |
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Environmental or behavior modifications for food and fluid intake |
|
Conclusions could not be made due to heterogeneity in interventions and poor study design. |
Music therapy |
|
|
Physical exercise |
|
For persons with dementia, two small studies found physical exercise had no effect on biomarker outcomes. |
|
|
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Deshmukh et al., 2018 | Systematic review | 2006–2011 | Persons living with dementia | 2 | Randomized controlled trial |
Theleritis et al., 2018 | Systematic review | 1998–2016 | Persons living with dementia | 43 |
|
Wu et al., 2017 | Systematic review and meta-analysis | 2005–2015 | Persons living with dementia | 11 |
|
Wood et al., 2017 | Systematic mapping review | 2001–2015 | Persons living with dementia | 10 |
|
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
|
||
Art therapy |
|
Evidence is insufficient to draw conclusions regarding the effect of art therapy on outcomes. |
Nonpharmacologic:
|
Apathy |
|
|
Behaviors | Low-quality evidence is insufficient to draw conclusions. |
Animal-assisted therapies incorporating dogs | Quality of life |
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Theleritis et al., 2017 | Systematic review and meta-analysis | 2004–2016 | Persons living with Alzheimer’s disease | 22 |
|
Streater et al., 2017 | Systematic and scoping review | 1982–2013 | Persons living with dementia | 7 |
|
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Nonpharmacologic:
|
Apathy |
|
Crisis management:
|
|
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Smallfield and Heckenlaible, 2017 | Systematic review | 2006–2014 | Persons living with Alzheimer’s disease and related neurocognitive disorders | 52 |
|
Lewis et al., 2017 | Systematic review | 2008–2015 | Persons living with cognitive impairment | 7 (6 included in meta-analysis) | Randomized controlled trial |
Karssemeijer et al., 2017 | Systematic review and meta-analysis | 2008–2017 | Persons living with mild cognitive impairment or dementia | 10 | Randomized controlled trial |
Karkou and Meekums, 2017 | Systematic review | N/A | Persons living with dementia | 0 | Randomized controlled trial |
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Interventions to maintain self-care and leisure:
|
|
|
Supervised home- or community-based exercise programs longer than 3 months |
|
|
Combined cognitive-physical interventions |
|
|
Dance movement therapy |
|
No studies met the inclusion criteria. |
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Ijaopo, 2017 | Systematic review | 2008–2017 | Persons living with dementia | 10 |
|
Garrido et al., 2017 | Critical synthesis | 2006–2016 | Persons living with dementia | 28 |
|
Dimitriou and Tsolaki, 2017 | Systematic review | 1998–2013 | Persons living with dementia | 11 | Randomized controlled trial |
Anderson et al., 2017 | Systematic review | 2008–2015 | Persons living with dementia | 7 | Randomized controlled trial |
Abraha et al., 2017 | Systematic review | 1997–2007 | Persons living with dementia | 3 |
|
Charry-Sanchez et al., 2018 | Systematic review | 2000–2017 | Persons living with dementia, depression, and other conditions | 23 (8 on dementia) |
|
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
|
|
Evidence is limited on the effect of nonpharmacologic interventions on reducing severe agitation. |
Prerecorded music alone or in combination with other musical activities | Behaviors | For persons with dementia, prerecorded music can be effective in reducing behavioral symptoms, including agitation. |
Sensory stimulation interventions:
|
Sleep disturbances | Bright light therapy may help reduce sleeping problems compared with usual care. |
Complementary and alternative medicine:
|
|
Complementary and alternative medicine may reduce behavioral symptoms compared with control conditions. |
Simulated presence therapy (audio or video recording) |
|
Low quality evidence indicates the effects of simulated presence on behavioral outcomes is uncertain. |
Animal-assisted therapies |
|
For persons living with dementia, animal–assisted therapy shows promise in short-term management of behaviors, but study designs limit inferences. |
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Chiu et al., 2018 | Systematic review and meta-analysis | 1981–2016 | Persons living with dementia | 11 | Randomized controlled trial |
Creighton et al., 2013 | Systematic review | 1989–2012 | Persons living with dementia | 34 |
|
Fakhoury et al., 2017 | Literature review | 2000–2015 | Persons living with dementia | 6 | Randomized controlled trial |
Fleiner et al., 2017 | Systematic review | 1994–2009 | Persons living with dementia | 5 |
|
Folkerts et al., 2017 | Systematic review and meta-analysis | 1981–2016 | Persons living with dementia | 27 (15 included in meta-analysis) |
|
Garcia-Casal et al., 2017 | Systematic review and meta-analysis | 2003–2014 | Persons living with dementia | 12 |
|
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Reality orientation therapy alone or combined with reminiscence therapy or cognitive training |
|
|
Spaced retrieval:
|
|
Spaced-retrieval interventions are viable and may be effective in improving recall and reducing problem behaviors, but more rigorous study designs are needed. |
Music therapy | Behavior | Findings across studies are mixed. |
Short-term structured exercise | Behavior | Structured exercise may reduce problem behaviors. Larger and more rigorous study designs are needed. |
Cognitive intervention:
|
|
|
Computer-based cognitive training:
|
Cognition |
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Jutkowitz et al., 2016 | Systematic review and meta-analysis | 1999–2014 | Persons living with dementia | 19 | Randomized controlled trial |
Klimova et al., 2017 | Literature review | 2010–2014 | Persons living with dementia | 6 |
|
Woods et al., 2018 | Systematic review and meta-analysis | 1987–2016 | Persons with dementia | 22 (16 included in meta-analysis) | Randomized controlled trial |
Levy et al., 2017 | Systematic review | 1995–2015 | Older adults | 40 (39 on dementia) |
|
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Care-delivery interventions:
|
|
Evidence was insufficient to draw conclusions on the effect of care-delivery interventions on agitation/aggression or problem behaviors. |
Dancing therapy | Any outcomes | Limited data suggest dancing therapy may positively impact cognition, physical function, and mood. |
Reminiscence therapy |
|
Heterogeneity of study designs makes inferences challenging, but overall, effects are small and inconsistent. |
Complementary and alternative medicine:
|
|
|
Author | Method | Dates of Studies Reviewed | Population | No. of Studies Included | Included Study Designs |
---|---|---|---|---|---|
Morrin et al., 2018 | Systematic review | 1995–2017 | Persons living with Lewy body dementia | 15 | Quasi-experiential |
Nyman et al., 2018 | Systematic review | 2003–2015 | Persons living with dementia | 9 (reported in 19 articles) | Randomized controlled trial |
O’Caoimh et al., 2019 | Systematic review and meta-analysis | 1992–2018 | Persons living with mild cognitive impairment or dementia | 48 |
|
Zhang et al., 2017 | Systematic review and meta-analysis | 1987–2016 | Persons living with dementia | 34 |
|
SOURCE: Adapted from Gaugler et al., 2020. [commissioned paper]
Types of Interventions | Outcomes Examined for Persons Living with Dementia | Key Findings |
---|---|---|
Nonpharmacologic interventions:
|
|
|
Behavior change (e.g., goal setting, social support, credible source) to promote physical activity |
|
|
Nonpharmacologic interventions:
|
|
|
Music therapy |
|
|
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