Non-pharmacological interventions for behavioral and psychological symptoms of dementia: A systematic review and network meta-analysis protocol

Li, Yaqin; Yin, Zihan; Zhang, Xinyue; Chen, Zhenghong; Xia, Manze; Ji, Lai-Xi; Liang, Fanrong

doi:10.3389/fpsyt.2022.1039752

Cited by 5 publications

(2 citation statements)

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“…The study conducted an NMA following PRISMA‐NMA (Hutton et al., 2015) and AMSTAR ‐ 2 guidelines (Shea et al., 2017) (Table S1). The study protocol was previously registered on PROSPERO and was published (Li et al., 2022).…”

Section: Methodsmentioning

confidence: 99%

Comparative efficacy of multiple non‐pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta‐analysis of randomised controlled trials

Yin,

Li,

Bao

et al. 2023

Int J Mental Health Nurs

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Non‐pharmacological interventions can improve the behavioural and psychological symptoms of dementia (BPSD). However, the optimal non‐pharmacological treatments remain controversial. This study aimed to compare the efficacy of multiple non‐pharmacological methods and identify the optimal therapy for BPSD. Potential randomised controlled trials (RCTs) were searched and selected from 15 databases and sources from the inception of the databases until 1 October 2022. Two independent authors implemented study screening, data extraction, and methodological quality assessment. Primary outcome was reduction of Neuropsychiatric Inventory (NPI). The secondary outcome were changes of Cornell Scale for Depression in Dementia (CSDD), the Cohen‐Mansfield Agitation Inventory (CMAI), the Quality of Life in Alzheimer's Disease (QoL‐AD), the Abilities of Daily Living scale, and the Apathy Evaluation Scale. Meta‐analyses were performed using STATA v15.0 and ADDIS v1.16.8. The GRADE approaches were utilised to evaluate evidence quality. The present study included 43 RCTs with 4978 participants. The global methodological quality of the RCTs was moderate. Regarding NPI reduction, with moderate‐certainty evidence, exercise plus treatment as usual (TAU) outperformed TAU (mean difference [MD]: −7.13; 95% confidence interval [CI]: −13.22, −0.76) and ranked as the optimal treatment. For reduction in CSDD, with low‐ to moderate‐certainty evidence, massage plus TAU (MD: −15.26; 95% CI: −20.13, −10.52) and music plus TAU (MD: −2.40; 95% CI: −4.62, −0.12) were associated with greater reduction compared with TAU. For reduction in CMAI, with moderate‐certainty evidence, aromatherapy plus massage (MD: −15.84; 95% CI: −29.76, −2.42) and massage plus music (MD: −13.12; 95% CI: −25.43, −0.76) were significantly more effective than TAU. For improvement in QoL‐AD, with critically low‐ to low‐certainty evidence, there were no statistical differences between any of non‐pharmacological treatments and TAU. Due to the limited number of included studies, network meta‐analysis was not performed for other outcomes. In conclusion, non‐pharmacological treatments are effective for overall symptoms, depression, and agitation. Exercise plus treatment as usual may be an optimal non‐pharmacological intervention for improving the overall BPSD. This may help to guide patients, doctors, and policymakers.

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Section: Methodsmentioning

confidence: 99%

Comparative efficacy of multiple non‐pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta‐analysis of randomised controlled trials

Yin,

Li,

Bao

et al. 2023

Int J Mental Health Nurs

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“…Several non-pharmacological interventions have been used in managing cognitive impairment and BPSD in AD patients, including reminiscence, physical therapy, non-invasive brain stimulation, cognitive training, and cognitive stimulation ( Abraha et al, 2017 ; Berg-Weger and Stewart, 2017 ). To date, the vast majority of dementia management guidelines still recommend non-pharmacological interventions including cognitive stimulation therapy (CST) as a first line of treatment ( Li et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Improved connectivity and cognition due to cognitive stimulation in Alzheimer’s disease

Behfar,

Richter,

Kural

et al. 2023

Front. Aging Neurosci.

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BackgroundDue to the increasing prevalence of Alzheimer’s disease (AD) and the limited efficacy of pharmacological treatment, the interest in non-pharmacological interventions, e.g., cognitive stimulation therapy (CST), to improve cognitive dysfunction and the quality of life of AD patients are on a steady rise.ObjectivesHere, we examined the efficacy of a CST program specifically conceptualized for AD dementia patients and the neural mechanisms underlying cognitive or behavioral benefits of CST.MethodsUsing neuropsychological tests and MRI-based measurements of functional connectivity, we examined the (neuro-) psychological status and network changes at two time points: pre vs. post-stimulation (8 to 12 weeks) in the intervention group (n = 15) who received the CST versus a no-intervention control group (n = 15).ResultsAfter CST, we observed significant improvement in the Mini-Mental State Examination (MMSE), the Alzheimer’s Disease Assessment Scale, cognitive subsection (ADAS-cog), and the behavioral and psychological symptoms of dementia (BPSD) scores. These cognitive improvements were associated with an up-regulated functional connectivity between the left posterior hippocampus and the trunk of the left postcentral gyrus.ConclusionOur data indicate that CST seems to induce short-term global cognition and behavior improvements in mild to moderate AD dementia and enhances resting-state functional connectivity in learning- and memory-associated brain regions. These convergent results prove that even in mild to moderate dementia AD, neuroplasticity can be harnessed to alleviate cognitive impairment with CST.

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Comment on “The Relationship Between Antipsychotics, Cognitive Enhancers, and Major Adverse Cardiovascular/Cerebrovascular Events (MACCE) in Older Adults with Behavioral and Psychological Symptoms of Dementia”

Lenoir

2024

Drugs Aging

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Non-pharmacological interventions for behavioral and psychological symptoms of dementia: A systematic review and network meta-analysis protocol

Cited by 5 publications

References 50 publications

Comparative efficacy of multiple non‐pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta‐analysis of randomised controlled trials

Comparative efficacy of multiple non‐pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta‐analysis of randomised controlled trials

Improved connectivity and cognition due to cognitive stimulation in Alzheimer’s disease

Comment on “The Relationship Between Antipsychotics, Cognitive Enhancers, and Major Adverse Cardiovascular/Cerebrovascular Events (MACCE) in Older Adults with Behavioral and Psychological Symptoms of Dementia”

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