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Systematic review of the current psychosocial interventions for people with moderate to severe dementia
Author(s) -
Hui Esther K,
Tischler Victoria,
Wong Gloria HY,
Lau WY Tiffany,
Spector Aimee E
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.051247
Subject(s) - psychosocial , dementia , psychological intervention , quality of life (healthcare) , medicine , randomized controlled trial , cognition , systematic review , medline , clinical psychology , gerontology , disease , physical therapy , psychology , psychiatry , nursing , surgery , pathology , political science , law
Background Dementia, a global epidemic, currently affects 40 to 50 million individuals worldwide. There are currently limited effective treatments for moderate to severe dementia, and most treatments focus on reducing symptoms rather than improving positive factors. It is unclear if improvements are not possible due to disease severity. This review examines the efficacy of the current psychosocial interventions for people with moderate to severe dementia, focusing on improving cognition and quality of life to evaluate what treatments are working and whether improvements are possible. Method A systematic search was conducted using six key databases to identify psychosocial interventions for people with moderate to severe dementia, measuring cognition or quality of life in randomized controlled trials (RCTs), published between 2000 and 2020. Result The search identified 4193 studies, and 74 articles were assessed for full‐text review. Fourteen RCTs were included and appraised with the Physiotherapy Evidence Database Scale. The included RCTs were moderate in quality. Conclusion Aromatherapy and reminiscence therapy showed the strongest evidence in improving quality of life. There was some evidence that aerobic exercise enhanced cognition, and a multi‐component study improved quality of life. However, a quality assessment, using pre‐specified criteria, indicated many methodological weaknesses. While we found improvements in cognition and quality of life for moderate to severe dementia, results must be interpreted with caution. Future interventions with rigorous study designs are a pressing need and required before we can recommend specific interventions.