A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia

A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia: From a perspective of ergonomics

Wang, G. (TU Delft Applied Ergonomics and Design)
Albayrak, A. (TU Delft Applied Ergonomics and Design)
van der Cammen, T.J.M. (TU Delft Applied Ergonomics and Design; Erasmus MC; Brighton and Sussex Medical School)

2018

Background:
Non-pharmacological interventions for Behavioral and Psychological Symptoms of Dementia (BPSD) have been developed; however, a systematic review on the effectiveness of this type of intervention from a perspective of ergonomics is lacking. According to ergonomics, the capabilities of Persons with Dementia (PwD) should be considered in the interventions for the outcomes to be reliable. We aimed to systematically review the non-pharmacological interventions for BPSD in nursing home residents with an additional assessment criterion based on ergonomics, specifically, capability consideration.

Methods:
The electronic databases MEDLINE, EMBASE, and PsycINFO were searched for non-pharmacological interventions treating BPSD in nursing homes. The interventions were categorized according to the capabilities of PwD required to participate. Study quality was assessed by National Health and Medical Research Council (NHMRC) evidence hierarchy and the capability consideration.

Results:
Sixty-four clinical trials met the inclusion criteria; 41 trials reported a significant reduction in at least one BPSD symptom; 20 trials reported no significant reduction in BPSD symptoms; three trials reported adverse effects after the intervention. Interventions were categorized into sensory-, cognition-, and movement-oriented. Capabilities of PwD were not considered in 28 trials, especially for sensory capabilities.

Conclusions:
The majority of the clinical trials reported a significant reduction in BPSD. The quality of evidence for nonpharmacological interventions in these trials is low due to the lack of capability consideration, data inhomogeneity, and inadequate study design and reporting. Future studies should focus on improving the quality of evidence by including capability consideration and examining if a relationship between capability consideration and effectiveness of non-pharmacological interventions exists.

behavioral and psychological symptoms of dementia
behavioral therapy
nursing homes
aging
dementia

http://resolver.tudelft.nl/uuid:5e296945-5638-44ba-a1ca-14175c2029e4

https://doi.org/10.1017/S1041610218001679

1041-6102

International Psychogeriatrics, 31 (8), 1137-1149

Institutional Repository

journal article

© 2018 G. Wang, A. Albayrak, T.J.M. van der Cammen