EBP Compendium: Summary of Clinical Practice Guideline

Scottish Intercollegiate Guidelines Network
Management of Patients with Dementia
Scottish Intercollegiate Guidelines Network. (2006).
Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN), SIGN Publication No. 86, 57 pages.

AGREE Rating: Highly Recommended

Description:

This guideline provides recommendations for the management of individuals with dementia. The target audience of this guideline includes physicians, healthcare professionals, patients and carers. Of particular interest to speech-language pathologists is the section pertaining to non-pharmacological interventions for the behavioral symptoms of dementia. Levels of evidence are provided and defined as follows: Grade A recommendations are based on evidence from systematic reviews and meta-analyses of randomized controlled trials that are directly relevant to the population. Grade B recommendations include high quality case control or cohort studies or high quality systematic reviews of those studies that are directly applicable to the population, or recommendations extrapolated from Grade A evidence. Grade C recommendations include well conducted case control or cohort studies or recommendations extrapolated from Grade B evidence. Grade D recommendations are based on evidence from non-analytic studies or expert opinion or recommendations extrapolated from Grade C evidence. Good Practice Points are recommendations based on the clinical experience of the guideline development group.

Recommendations:

• Assessment/Diagnosis
  • Assessment Instruments
    • Cognition
      • Mini-Mental Status Examination - The Mini-Mental Status Examination (MMSE) can be used to assess individuals with cognitive impairment. The MMSE should be used to diagnosis dementia in individuals with suspected cognitive impairments (Grade B Evidence).
• Treatment
  • Cognition
    • Compensatory Treatments
      • Memory Books - The use of memory books "lacked evidence of clinical effectiveness" (p. 12).
    • Restorative Treatments
      • Cognitive Stimulation - "Cognitive stimulation should be offered to individuals with dementia (Grade B Evidence)" (p. 8)
      • Reality Orientation - "Reality orientation therapy should be used by a skilled practitioner on an individualized basis, with people who are disoriented in time, place or person" (Grade D Evidence) (p. 11).
      • Reminiscence Therapy - Reminiscence therapy "lacked sufficient evidence of clinical effectiveness" (p. 12).
      • Simulated-Presence Therapy -"Simulated presence therapy is not effective for reduction of agitation in nursing home residents with severe dementia" (p. 12).  

Keywords: Dementia

Access the Guideline

Added to Compendium: November 2011