The Effectiveness of Non-Pharmacological Interventions on Apathy in Patients With Dementia: A Systematic Review of Systematic Reviews

Worldviews Evid Based Nurs. 2020 Aug;17(4):311-318. doi: 10.1111/wvn.12459. Epub 2020 Aug 7.

Abstract

Background: Apathy is one of the behavioral and psychological symptoms of dementia (BPSD), which is the most frequent and can accelerate the progress of dementia.

Aims: To systematically review the evidence of effectiveness of non-pharmacological interventions on apathy in patients with dementia.

Methods: Databases including the Cochrane Library, Joanna Briggs Institute (JBI) Library, PubMed, EMBASE, CINAHL, PsycINFO, Psychology and Behavioral Sciences Collection, CNKI, and Wan Fang Data were searched for systematic reviews of the effectiveness of non-pharmacological interventions on apathy in patients with dementia. AMSTAR 2 was applied to assess the methodological quality of reviews.

Results: Nine systematic reviews were included. The average level of overall confidence for included systematic reviews was low. Among all the non-pharmacological interventions involved in this review, the effectiveness of multisensory stimulation, music therapy, cognitive stimulation, and pet therapy was relatively robust. The effects of reminiscence therapy, therapeutic conversation, progressive muscle relaxation, art therapy, exercise therapy, occupational therapy, dementia special care units, nursing staff education, and comprehensive interventions need to be validated further. Meanwhile, the current evidence failed to support the effects of psychomotor therapy and validation therapy on apathy.

Linking evidence to action: Non-pharmacological interventions for apathy in patients with dementia are acceptable. In spite of requirements for adequate and high-quality original studies and quantitative systematic reviews to validate the efficacy of non-pharmacological interventions, multisensory stimulation, music therapy, cognitive stimulation, and pet therapy are deemed the most helpful according to evidences available.

Keywords: apathy; dementia; non-pharmacological intervention; systematic review of systematic reviews.

Publication types

  • Systematic Review

MeSH terms

  • Apathy*
  • Cognitive Behavioral Therapy / methods
  • Cognitive Behavioral Therapy / standards
  • Dementia / complications
  • Dementia / psychology*
  • Dementia / therapy*
  • Humans
  • Music Therapy / methods
  • Music Therapy / standards