Effectiveness of Environment-Based Interventions That Address Behavior, Perception, and Falls in People With Alzheimer’s Disease and Related Major Neurocognitive Disorders: A Systematic Review

Abstract

Strong evidence indicates that person-centered approaches can improve behavior. Moderate evidence supports noise regulation, environmental design, unobtrusive visual barriers, and environmental relocation strategies to reduce problematic behaviors. Evidence is insufficient for the effectiveness of mealtime ambient music, bright light, proprioceptive input, wander gardens, optical strategies, and sensory devices in improving behavior or reducing wandering and falls. Although evidence supports many environment-based interventions used by occupational therapy practitioners to address behavior, perception, and falls in people with AD and related major NCDs, more studies are needed.

Occupational Therapy Interventions for People With Alzheimer’s Disease

“…Tamara reviewed the evidence from the September/ October 2017 issue of the American Journal of Occupational Therapy (Jensen & Padilla, 2017;Smallfield & Syrovatla-Keckenlaible, 2017) and also read the intervention recommendations with strong evidence from the Occupational Therapy Practice Guidelines for Adults With Alzheimer's Disease and Related Major Neurocognitive Disorders (Piersol & Jensen, 2017). She was encouraged to find strong evidence that rooms designed consistent with the intended purpose, as is found in home environments, improved behaviors of people with AD because she had often anecdotally noted this as a benefit for her clients receiving therapy in the home.…”

Supporting Adults With Alzheimer’s Disease and Related Major Neurocognitive Disorders and Their Caregivers: Effective Occupational Therapy Interventions

“…Reviewing literature regarding environment-based interventions that address the outcomes of behavior, perception, and fall prevention for adults with AD and related major NCDs, Jensen and Padilla (2017) found strong evidence and therefore recommend routine use of ambient music (except at mealtime); multisensory interventions; and private, personalized rooms to positively influence the behavior of adults with AD and related major NCDs. Similarly, the evidence is strong for the use of monitoring devices to prevent falls in the home.…”

Smartphone-Based Interventions to Foster Simple Activity and Personal Satisfaction in People With Advanced Alzheimer’s Disease

“…Alzheimer's disease is a neurodegenerative condition which has an increasingly larger incidence among older people (ie, people older than 65 years of age) with extremely serious personal and social consequences. [1][2][3][4] In fact, people affected by the disease experience a progressive deterioration in their cognitive and behavioral functions, which eventually leads them to total dependence. [5][6][7] Accordingly, their families as well as treatment and care centers in charge of their positive occupation and well-being are required to provide progressively higher levels of support, with growing emotional, practical, and economical costs.…”

“…[5][6][7] Accordingly, their families as well as treatment and care centers in charge of their positive occupation and well-being are required to provide progressively higher levels of support, with growing emotional, practical, and economical costs. 2,3,8,9 At present, the disease is neither preventable nor curable. [10][11][12][13] Pharmacological and behavioral interventions are being applied as ways to slow down the progress of the disease; alleviate some of the related functional, emotional, and physical drawbacks; and provide some respite to the persons affected and their staff and caregivers.…”