Summary of the Systematic Review

Article Citation

Overview of Systematic Reviews: Effective Home Support in Dementia Care, Components and Impacts - Stage 1, Psychosocial Interventions for Dementia

Clarkson, P., Hughes, J., et al. (2017).
Journal of Advanced Nursing, 73, 2845-4863.
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Sponsoring Body

National Institute for Health Research (United Kingdom)

Article Quality Ratings

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Indicators of Review Quality

  • Yes The review states a clearly focused question/aim.
  • Yes Criteria for inclusion of studies are provided.
  • No Search strategy described in sufficient detail for replication.
  • Yes Included studies are assessed for study quality.
  • Yes Quality assessments are reproducible.
  • Yes Characteristics of the included studies are provided.

Article Details

Description

This is a systematic review of systematic reviews examining the use of various nonpharmacological interventions for individuals with dementia. A variety of psychosocial, behavioral, cognitive and caregiver support interventions were included and described, a portion of which were within the scope of speech-language pathology.

Questions/Aims Addressed

"To synthesize evidence to identify the components of effective psychosocial interventions in dementia care to inform clinical practice, policy and research" (p. 2845)

Population

Individuals with dementia

Intervention/Assessment

"Psychosocial (i.e. non-pharmacological) interventions for dementia" (p. 2847)

Number of Studies Included

36

Years Included

Not stated

Evidence Ratings for This Document

Evidence was rated based on the number and quality of relevant included reviews. The rating scale in this paper was based off of methods from both the Cochrane Collaboration and the Oxford Centre of Evidence-Based Medicine. Levels of evidence are defined as follows:

  • Level 1: 'Sufficient evidence', or "consistent evidence from high, moderate quality, or reviews of specific interventions" (p. 2851)
  • Level 2: 'Some evidence', or less consistent high or moderate quality reviews, or a majority of reviews/studies in favor of intervention
  • Level 3: 'Insufficient evidence', or conflicting results, or evidence suggesting ineffectiveness
  • Level 4: 'Insufficient evidence to determine', or lack of primary studies or information

Conclusions from This Systematic Review

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Treatment

There was insufficient evidence (Level 3) to support the use of validation therapy for individuals with dementia. 

Keywords: Cognitive-Communication, Validation Therapy

There was level 2 evidence from six systematic reviews supporting the use of reminiscence treatment, sensory stimulation and activities of daily living training with individuals with dementia.

Keywords: Cognitive-Communication, Reminiscence Therapy

Six systematic reviews provided level 1 evidence for the use of cognitive stimulation and cognitive training (e.g., memory aid training) to improve the cognitive skills of individuals with early-stage dementia. 

Keywords: Severity/Stage, Mild-Moderate/Early Stage, Cognitive-Communication, Cognitive Stimulation

Notes on This Article

This umbrella systematic review contains a number of reviews, only some of which are related to SLP practice. Of particular relevance to the article’s conclusions are the following reviews:

  • Cooper, C., Li, R., Lyketsos, C., et al. (2013). Treatment for Mild Cognitive Impairment: Systematic Review. British Journal of Psychiatry, 203(3), 255-264. doi:10.1192/bjp.bp.113.127811
  • Livingston, G., Johnston, et al. (2005). Systematic Review of Psychological Approaches to the Management of Neuropsychiatric Symptoms of Dementia. American Journal of Psychiatry, 162(11), 1996-2021. 
  • Logsdon, R. G., McCurry, S. M., et al. (2007). Evidence-Based Psychological Treatments for Disruptive Behaviors in Individuals with Dementia. Psychology and Aging, 22(1), 28-36. 
  • Neal, M., & Barton Wright, P. (2003). Validation Therapy for Dementia. Cochrane Database of Systematic Reviews, 3, CD001394. 
  • Olazaran, J., Reisberg, B., et al. (2010). Nonpharmacological Therapies in Alzheimer's Disease: A Systematic Review of Efficacy. Dementia and Geriatric Cognitive Disorders, 30(2), 161-178. 
  • Sanchez, A., Millan-Calenti, J. C., et al. (2013). Multisensory Stimulation for People with Dementia: A Review of the Literature. American Journal of Alzheimer's Disease & Other Dementias, 28(1), 7-14. 
  • Sitzer, D. I., Twamley, E. W., et al. (2006). Cognitive Training in Alzheimer's Disease: A Meta-Analysis of the Literature. Acta Psychiatrica Scandinavica, 114(2), 75-90. doi:10.1111/j.1600-0447.2006.00789.x
  • Vernooij-Dassen, M., Vasse, et a;. (2010). Psychosocial Interventions for Dementia Patients in Long-Term Care. International Psychogeriatrics, 22(7), 1121-1128.
  • Woods, B., Aguirre, E., et al. (2012). Cognitive Stimulation to Improve Cognitive Functioning in People with Dementia. Cochrane Database of Systematic Reviews, 2, CD005562. 
  • Woods, B., Spector, A., et al. (2005). Reminiscence Therapy for Dementia. Cochrane Database of Systematic Reviews, 2, CD001120. doi:10.1002/14651858.CD001120.pub2

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