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KMID : 1118520190160050325
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Psychiatry Investigation
2019 Volume.16 No. 5 p.325 ~ p.335
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A Systematic Review and Meta-Analysis of Nonpharmacological Interventions for Moderate to Severe Dementia
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Na Ri-Young
Yang Ji-Hye
Yeom Yu-Sung
Kim You-Joung
Byun Seon-Jeong
Kim Ki-Won
Kim Ki-Woong
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Abstract
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Objective: Due to limited efficacy of medications, non-pharmacological interventions (NPI) are frequently co-administered to people with moderate to severe dementia (PWMSD). This systematic review and meta-analysis investigated the effects of NPI on activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD), and cognition and quality of life (QoL) of PWMSD.
Methods: A literature search was conducted in the following databases: Cochrane CENTRAL, EMBASE, Medline, CIHNAL, PsycINFO, KoreaMED, KMbase, and KISS. We conducted a meta-analysis on randomized controlled trials and used the generic inverse variance method with a fixed-effects model to calculate the standardized mean difference (SMD). The protocol had been registered (CRD42017058020).
Results: Ten randomized controlled trials met the inclusion criteria of the current meta-analysis. NPI were effective in improving ADL [SMD=0.28, 95% confidence interval (CI)=0.11-0.45] and reducing depression (SMD=-0.44, 95% CI=-0.70- -0.19). However, NPI were not effective in reducing agitation, anxiety, or overall, or improving cognitive function. In a subgroup analysis, music therapy was effective in reducing overall BPSD (SMD=-0.52, 95% CI=-0.90- -0.13).
Conclusion: Albeit the number of studies was limited, NPI improved ADL and depression in PWMSD.
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KEYWORD
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Dementia, Nonpharmacological intervention, Activities of daily living, Depression, Behavioral and psychological symptoms of dementia
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