Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series

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dc.contributor.authorAbraha, Iosief
dc.contributor.authorRimland, Joseph M.
dc.contributor.authorTrotta, Fabiana Mirella
dc.contributor.authorDell'Aquila, Giuseppina
dc.contributor.authorCruz-Jentoft, Alfonso
dc.contributor.authorPetrovic, Mirko
dc.contributor.authorGudmundsson, Adalsteinn
dc.contributor.authorSoiza, Roy
dc.contributor.authorO'Mahony, Denis
dc.contributor.authorGuaita, Antonio
dc.contributor.funderSeventh Framework Programmeen
dc.date.accessioned2017-04-27T09:00:30Z
dc.date.available2017-04-27T09:00:30Z
dc.date.issued2017-03-16
dc.date.updated2017-04-27T08:44:58Z
dc.description.abstractObjective: To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). Design: Systematic overview of reviews. Data sources: PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009–March 2015). Eligibility criteria: Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD. Data extraction: Eligible studies were selected and data extracted independently by 2 reviewers. The AMSTAR checklist was used to assess the quality of the SRs. Data analysis: Extracted data were synthesised using a narrative approach. Results: 38 SRs and 142 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (12 SRs, 27 primary studies) that encompassed: acupressure, aromatherapy, massage/touch therapy, light therapy and sensory garden; (2) cognitive/emotion-oriented interventions (33 SRs; 70 primary studies) that included cognitive stimulation, music/dance therapy, dance therapy, snoezelen, transcutaneous electrical nerve stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 32 primary studies) and (4) other therapies (5 SRs, 12 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions. Music therapy was effective in reducing agitation (SMD, −0.49; 95% CI −0.82 to −0.17; p=0.003), and anxiety (SMD, −0.64; 95% CI −1.05 to −0.24; p=0.002). Home-based behavioural management techniques, caregiver-based interventions or staff training in communication skills, person-centred care or dementia care mapping with supervision during implementation were found to be effective for symptomatic and severe agitation. Conclusions: A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide012759
dc.identifier.citationAbraha, I., Rimland, J. M., Trotta, F. M., Dell'Aquila, G., Cruz-Jentoft, A., Petrovic, M., Gudmundsson, A., Soiza, R., O'Mahony, D. and Guaita, A. (2017) 'Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series', BMJ Open, 7, e012759 (29pp). doi:10.1136/bmjopen-2016-012759en
dc.identifier.doi10.1136/bmjopen-2016- 012759
dc.identifier.endpage29en
dc.identifier.issn2044-6055
dc.identifier.journaltitleBMJ Openen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/3892
dc.identifier.volume7en
dc.language.isoenen
dc.publisherBMJ Publishing Group Limiteden
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/305930/EU/Development and clinical trials of a new Software ENgine for the Assessment & Optimization of drug and non-drug Therapy in Older peRsons/SENATORen
dc.rights© 2017, the Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.en
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectMusic therapyen
dc.subjectBehaviouralen
dc.subjectPsychologicalen
dc.subjectTherapyen
dc.titleSystematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop seriesen
dc.typeArticle (peer-reviewed)en
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