Non-pharmacological interventions for neuropsychiatric symptoms of dementia in residential aged care settings: An umbrella review

Jana Koch; Jessica G Amos; Elizabeth Beattie; Nicola T Lautenschlager; Coleen Doyle; Kaarin J Anstey; Moyra E Mortby

doi:10.1016/j.ijnurstu.2022.104187

Non-pharmacological interventions for neuropsychiatric symptoms of dementia in residential aged care settings: An umbrella review

Int J Nurs Stud. 2022 Apr:128:104187. doi: 10.1016/j.ijnurstu.2022.104187. Epub 2022 Jan 29.

Authors

Jana Koch¹, Jessica G Amos¹, Elizabeth Beattie², Nicola T Lautenschlager³, Coleen Doyle⁴, Kaarin J Anstey¹, Moyra E Mortby⁵

Affiliations

¹ School of Psychology, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, 139 Baker Street, Randwick, Sydney, NSW, Australia.
² Dementia Centre for Research Collaboration, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia.
³ Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Building 5, 34-54 Poplar Rd, Parkville, VIC, Australia; NorthWestern Mental Health, Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, Australia.
⁴ National Aging Research Institute, 34-54 Poplar Rd, Parkville, VIC, Australia.
⁵ School of Psychology, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, 139 Baker Street, Randwick, Sydney, NSW, Australia. Electronic address: m.mortby@unsw.edu.au.

PMID: 35220139
DOI: 10.1016/j.ijnurstu.2022.104187

Abstract

Background: Prevalence of neuropsychiatric symptoms amongst people living with dementia in residential aged care is high. Their presence is associated with poorer quality of life for residents and higher burden of care for staff. Existing reviews have not focused on the evaluation of efficacy of non-pharmacological interventions in specific population settings (community vs. residential aged care).

Objectives: To determine the efficacy of non-pharmacological interventions to manage neuropsychiatric symptoms of dementia in residential aged care settings.

Design: An umbrella review was conducted.

Data sources: PubMed/Medline, Embase, Cochrane Library and Web of Science were searched for eligible reviews in December 2019, February 2020 and June 2021.

Methods: Two authors independently screened titles and abstracts, and assessed full-text reviews for eligibility. The quality of reviews was appraised with 'AMSTAR-2: A Measurement tool to assess systematic reviews'. Narrative summaries grouped findings by intervention domains.

Results: From 1362 systematic reviews identified, 26 met the inclusion criteria. Of these, 10 focused on person tailored interventions, six on sensory stimulation interventions, three on environmental interventions, three on exercise interventions, and four on multiple intervention types. Quality ratings identified reviews to be of mostly moderate quality (73%). The majority or reviews reported positive results but not all were 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 heterogeneous across interventions.

Conclusions: The findings of this umbrella review suggest that combining different types of interventions and tailoring them to the personal experiences of the resident is recommended. A more standardised approach for outcome measures used is vital to assess efficacy and allow comparison of future non-pharmacological interventions.

Keywords: Behavioural symptoms; Dementia; Depression; Intervention studies; Music therapy; Nursing care; Residential facilities/residential facility; Systematic review.

Publication types

Review

MeSH terms

Aged
Dementia* / psychology
Dementia* / therapy
Humans
Quality of Life*
Systematic Reviews as Topic