Determining the efficacy of non‐pharmacological interventions to manage neuropsychiatric symptoms of dementia in residential aged care settings: A systematic review of systematic reviews. (December 2021)

• Record Type: Journal Article
• Authors: Koch, Jana; Amos, Jessica; Mortby, Moyra E
• Is Part Of: Alzheimer's & dementia. Volume 17(2021)Supplement 7
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.055376
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Non‐pharmacological interventions such as music, physical activity, and reminiscence provide a cost‐effective and safe approach to managing neuropsychiatric symptoms in neurocognitive disorders. While much research has focused on evaluating the efficacy of individual non‐pharmacological interventions used to manage neuropsychiatric symptoms and inform best practice, they have struggled to provide clear results and recommendations. A possible explanation for the lack of clear results may be the failure of previous studies to examine the efficacy in specific population settings (e.g. residential aged care vs. community settings). This systematic review of systematic reviews evaluates the efficacy of non‐pharmacological interventions used to manage neuropsychiatric symptoms in the context of residential aged care settings only. Method: A systematic review of systematic reviews was conducted. PubMed/Medline, Embase, Cochrane Library and Web of Science were searched for eligible reviews in December 2019 and February 2020. Two authors independently screened title and abstracts, and assessed full‐text reviews for eligibility. The quality of systematic reviews was appraised with 'AMSTAR‐2: A Measurement tool to assess systematic reviews'. Narrative summaries were created to group findings by intervention domains. Result: From 1362 systematic reviews identified, 26 met the inclusion criteria and were included. Of these, 10 focused on person tailored interventions, six on sensory stimulation interventions, three on environmental interventions, three on exercise interventions and four on other interventions. Quality ratings identified reviews to be of mostly moderate quality (73%). The majority of reviews report positive results, but effects were not always statistically significant. Tailored interventions that included music and social elements appeared to be most beneficial for depressive symptoms and mood. Furthermore, outcome measures and intervention protocols were highly heterogenetic across interventions. Conclusion: This systematic review of systematic review highlights the importance of considering intervention settings when evaluating the efficacy of non‐pharmacological interventions in neurocognitive disorders across studies. The findings suggest that in this setting, combining different types of interventions and tailoring them to the personal experiences of the resident is recommended. Use of a more standardized approach for outcome measures is vital in order to accurately assess intervention efficacy and allow for comparison of intervention approaches.