Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-22T18:39:08.587Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychosocial treatments of psychological symptoms in dementia: a systematic review of reports meeting quality standards

Published online by Cambridge University Press:  13 January 2009

Daniel W. O'Connor ,
David Ames ,
Betina Gardner  and
Madeleine King
Daniel W. O'Connor*
Affiliation:
Department of Psychological Medicine, Monash University, Melbourne, Australia
David Ames
Affiliation:
National Ageing Research Institute, University of Melbourne, Melbourne, Australia
Betina Gardner
Affiliation:
Department of Psychological Medicine, Monash University, Melbourne, Australia
Madeleine King
Affiliation:
Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia
*
Correspondence should be addressed to: Professor Daniel O'Connor, Aged Mental Health Research Unit, Kingston Centre, Warrigal Road, Cheltenham, Victoria 3192, Australia. Phone: +61 (03) 9265 1700; Fax: +61 (03) 9265 1711. Email: [email protected].
Get access

Abstract

Background: This paper provides a systematic review of selected experimental studies of the effectiveness of psychosocial treatments in reducing psychological symptoms in dementia (e.g. anxiety, depression, irritability and social withdrawal).

Method: English language reports published or in press by February 2008 were identified by means of database searches and checks of previous reviews. Reports were appraised with respect to study design, participants' characteristics and reporting details. Because people with dementia often respond positively to personal contact, studies were included only if control conditions entailed similar levels of social attention or if one treatment was compared with another.

Results: Only 12 of 48 relevant papers met every specification. Treatments proved more effective in reducing psychological symptoms than an attention control condition or another treatment in only six of the 12 selected studies. Interventions with moderate effect sizes included music and recreation therapy.

Conclusions: Some psychosocial interventions appear to have specific therapeutic properties, over and above those due to the benefits of participating in a clinical trial. Their effects were generally modest with an unknown duration of action. This limited efficacy suggests that treatments will work best in specific, time-limited situations, tailored to individuals' requirements. There is no preferred method to rate psychological symptoms.

Keywords

dementiaanxietydepressiontreatmentevidencesystematic review
Type
Review Article
Information
International Psychogeriatrics , Volume 21 , Issue 2 , April 2009 , pp. 241 - 251
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altman, D. G., Schulz, K. F., Moher, D., Egger, M. and Davidoff, F. (2001). The revised CONSORT statement for reporting randomised trials: explanation and elaboration. Annals of Internal Medicine, 134, 663–694.CrossRefGoogle ScholarPubMed
Ayalon, L., Gum, A. M., Feliciano, L. and Arean, P. A. (2006). Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia. Archives of Internal Medicine, 166, 2182–2188.CrossRefGoogle ScholarPubMed
Baker, R. et al. (2003). Effects of multi-sensory stimulation for people with dementia. Journal of Advanced Nursing, 43, 465–477.CrossRefGoogle ScholarPubMed
Beck, C. K. et al. (2002). Effects of behavioral interventions on disruptive behavior and affect in demented nursing home residents. Nursing Research, 51, 219–228.CrossRefGoogle ScholarPubMed
Camberg, L. et al. (1999). Evaluation of simulated presence: a personalized approach to enhance well-being in persons with Alzheimer's disease. Journal of the American Geriatrics Society, 47, 446–452.CrossRefGoogle Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd edn). Hillsdale, NJ: Lawrence Earlbaum.Google Scholar
Cohen-Mansfield, J. (2001). Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique. American Journal of Geriatric Psychiatry, 9, 361–381.CrossRefGoogle ScholarPubMed
Forbes, D. A. (1998). Strategies for managing behavioral symptomatology associated with dementia of the Alzheimer type: a systematic overview. Canadian Journal of Nursing Research, 30, 67–86.Google ScholarPubMed
Garland, K., Beer, E., Eppingstall, B. and O'Connor, D.W. (2007). A comparison of two treatments of agitated behavior in nursing home residents with dementia: simulated presence and preferred music. American Journal of Geriatric Psychiatry, 15, 514–521.CrossRefGoogle ScholarPubMed
Goldwasser, A. N., Auerbach, S. M. and Harkins, S. W. (1987). Cognitive, affective, and behavioral effects of reminiscence group therapy on demented elderly. International Journal of Aging and Human Development, 25, 209–222.CrossRefGoogle ScholarPubMed
Greve, M. and O'Connor, D. (2005). A survey of Australian and New Zealand old age psychiatrists' preferred medications to treat behavioral and psychological symptoms of dementia. International Psychogeriatrics, 17, 165–178.CrossRefGoogle ScholarPubMed
Herrmann, N. and Lanctôt, K. L. (2007). Pharmacological management of neuropsychiatric symptoms of Alzheimer disease. Canadian Journal of Psychiatry, 52, 630–646.CrossRefGoogle ScholarPubMed
Jeste, D. V. et al. (2008). ACNP White Paper. Update on use of antipsychotic drugs in elderly people with dementia. Neuropsychopharmacology, 33, 957–970.CrossRefGoogle Scholar
Kolanowski, A. M., Litaker, M. and Buettner, L. (2005). Efficacy of theory-based activities for behavioral symptoms of dementia. Nursing Research, 54, 219–228.CrossRefGoogle ScholarPubMed
Livingston, G., Johnston, K., Katona, K., Paton, J. and Lyketsos, C. G. (2005). Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 162, 1996–2021.CrossRefGoogle Scholar
Lyketsos, C. G., Steinberg, M., Tschanz, J. T., Norten, M. C., Steffens, D. C. and Breitner, J. C. S. (2000). Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. American Journal of Psychiatry, 157, 708–714.CrossRefGoogle Scholar
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the Cardiovascular Health Study. JAMA, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Magai, C., Cohen, C.I. and Gomberg, D. (2002). Impact of training dementia caregivers in sensitivity to nonverbal emotion signals. International Psychogeriatrics, 14, 25–38.CrossRefGoogle ScholarPubMed
NH & MRC (2000). How to Review the Evidence: Systematic Identification and Review of the Scientific Literature. Canberra: National Health and Medical Research Council.Google Scholar
O'Connor, D. W., Ames, D., Gardner, B. and King, M. (2009). Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. International Psychogeriatrics, 21, 225–240. doi: 10.1017/S1041610208007588.Google ScholarPubMed
Opie, J., Rosewarne, R. and O'Connor, D. W. (1999). The efficacy of psychosocial approaches to behavior disorders in dementia: a systematic literature review. Australian and New Zealand Journal of Psychiatry, 33, 789–799.CrossRefGoogle ScholarPubMed
Ragneskog, H., Bråne, G., Karlsson, I. and Kihlgren, M. (1996). Influence of dinner music on food intake and symptoms common in dementia. Scandinavian Journal of Caring Sciences, 10, 11–17.CrossRefGoogle ScholarPubMed
Rosnow, R. L. and Rosenthal, R. (1996). Computing contrasts, effect sizes, and counternulls on other people's published data: general procedures for research consumers. Psychological Methods, 1, 331–340.CrossRefGoogle Scholar
Suhr, J., Anderson, S. and Tranel, D. (1999). Progressive muscle relaxation in the management of behavioral disturbance in Alzheimer's disease. Neuropsychological Rehabilitation, 9, 31–44.CrossRefGoogle Scholar
Teri, L., Logsdon, R. G., Uomoto, J. and McCurry, S. M. (1997). Behavioral treatment of depression in dementia: a controlled clinical trial. Journals of Gerontology, 52B, 159–166.CrossRefGoogle Scholar
Toseland, R. W., Diehl, M., Freeman, K., Manzanares, T., Naleppa, M. and McCallion, P. (1997). The impact of validation group therapy on nursing home residents with dementia. Journal of Applied Gerontology, 16, 31–50.CrossRefGoogle Scholar
Verkaik, R., Van Weert, J. C. M. and Francke, A. L. (2005). The effects of psychosocial methods on depressed, aggressive and apathetic behaviors of people with dementia: a systematic review. International Journal of Geriatric Psychiatry, 20, 301–314.CrossRefGoogle ScholarPubMed
Watson, N. M., Wells, T. J. and Cox, C. (1998). Rocking chair therapy for dementia patients: its effect on psychosocial well-being and balance. American Journal of Alzheimer's Disease, 13, 296–308.CrossRefGoogle Scholar
Williams, C. L. and Tappen, R. M. (2007). Effect of exercise on mood in nursing home residents with Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 22, 389–397.CrossRefGoogle ScholarPubMed