[논문]Systematic review of the current psychosocial interventions for people with moderate to severe dementia

Hui, Esther K.; Tischler, Victoria; Wong, Gloria H. Y.; Lau, W. Y. Tiffany; Spector, Aimee

doi:10.1002/gps.5554

Systematic review of the current psychosocial interventions for people with moderate to severe dementia 원문보기

International journal of geriatric psychiatry, v.36 no.9, 2021년, pp.1313 - 1329

Hui, Esther K. (Department of Clinical, Educational and Health Psychology, University College London, London, UK) , Tischler, Victoria (European Center for Environment and Human Health, The University of Exeter, Truro, UK) , Wong, Gloria H. Y. (Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong) , Lau, W. Y. Tiffany (Department of Clinical, Educational and Health Psychology, University College London, London, UK) , Spector, Aimee (Department of Clinical, Educational and Health Psychology, University College London, London, UK)

Abstract ▼ AI-Helper

AbstractObjectiveDementia, a global epidemic, currently affects 50 million individuals worldwide. There are currently limited effective treatments for moderate to severe dementia, and most treatments focus on reducing symptoms rather than improving positive factors. It is unclear if improvements are not possible due to disease severity. This review examines the efficacy of the current psychosocial interventions for people with moderate to severe dementia, focusing on improving cognition and quality of life (QoL) to evaluate what treatments are working and whether improvements are possible.MethodsA systematic search was conducted using six key databases to identify psychosocial interventions for people with moderate to severe dementia, measuring cognition or QoL in randomized controlled trials (RCTs), published between 2000 and 2020.ResultsThe search identified 4193 studies, and 74 articles were assessed for full‐text review. Fourteen RCTs were included and appraised with the Physiotherapy Evidence Database Scale. The included RCTs were moderate in quality.ConclusionsAromatherapy and reminiscence therapy showed the strongest evidence in improving QoL. There was some evidence that aerobic exercise enhanced cognition, and a multicomponent study improved QoL. However, a quality assessment, using pre‐specified criteria, indicated many methodological weaknesses. While we found improvements in cognition and QoL for moderate to severe dementia, results must be interpreted with caution. Future interventions with rigorous study designs are a pressing need and required before we can recommend specific interventions.Key pointsWhile cognition and quality of life (QoL) are largely considered as key outcomes for dementia interventions, little is known about their scope of improvement for moderate to severe dementia. Intervention outcomes tend to focus on managing problem behaviors rather than improving positive aspects.Aromatherapy and reminiscence therapy showed the strongest evidence in improving QoL, and both studies are high‐quality randomized controlled trials with sufficient power. A multicomponent and an aerobic exercise intervention also enhanced QoL and cognition, respectively.Improving cognition and QoL might be possible, even in moderate to severe dementia. However, due to the limited number and quality of studies, our results must be interpreted with caution.

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Systematic review of the current psychosocial interventions for people with moderate to severe dementia 원문보기

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