Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-19T03:47:12.042Z Has data issue: false hasContentIssue false
  • English
  • Français

The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: a systematic review

Published online by Cambridge University Press:  24 February 2014

Ingelin Testad ,
Ann Corbett ,
Dag Aarsland ,
Kristin Osland Lexow ,
Jane Fossey ,
Bob Woods  and
Clive Ballard
Ingelin Testad*
Affiliation:
Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
Ann Corbett
Affiliation:
King's College London, Wolfson Centre for Age-Related Diseases, Guy's Campus, London, UK
Dag Aarsland
Affiliation:
Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Kristin Osland Lexow
Affiliation:
Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
Jane Fossey
Affiliation:
Oxford Health NHS Foundation Trust, Oxford, UK
Bob Woods
Affiliation:
Dementia Services Development Centre Wales, Bangor University, Bangor, UK
Clive Ballard
Affiliation:
Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway King's College London, Wolfson Centre for Age-Related Diseases, Guy's Campus, London, UK
*
Correspondence should be addressed to: Ingelin Testad, PhD, Centre for Age-Related Medicine, Stavanger University Hospital, Post Box 8100, N-4068 Stavanger, Norway. Phone: +47-95797079; Fax: +47-51515161. Email: tesi@sus.no.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Several important systematic reviews and meta-analyses focusing on psychosocial interventions have been undertaken in the last decade. However, they have not focused specifically on the treatment of individual behavioral and psychological symptoms of dementia (BPSD) with personalized interventions. This updated systematic review will focus on studies reporting the effect of personalized psychosocial interventions on key BPSD in care homes.

Methods:

Systematic review of the evidence for psychosocial interventions for BPSD, focusing on papers published between 2000 and 2012. All care home and nursing home studies including individual and cluster randomized controlled trials (RCTs) and pre-/post-test studies with control conditions were included.

Results:

641 studies were identified, of which 40 fulfilled inclusion and exclusion criteria. There was good evidence to support the value of personalized pleasant activities with and without social interaction for the treatment of agitation, and reminiscence therapy to improve mood. The evidence for other therapies was more limited.

Conclusions:

There is a growing body of evidence indicating specific effects of different personalized psychosocial interventions on individual BPSD and mood outcomes.

Keywords

dementiapsychosocial interventionsnursing homesBPSD
Type
Review Article
Information
International Psychogeriatrics , Volume 26 , Issue 7 , July 2014 , pp. 1083 - 1098
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aylward, S., Stolee, P., Keat, N. and Johncox, V. (2003). Effectiveness of continuing education in long-term care: a literature review. Gerontologist, 43, 259–271.CrossRefGoogle ScholarPubMed
Ballard, C., Corbett, A., Chitramohan, R. and Aarsland, D. (2009). Management of agitation and aggression associated with Alzheimer's disease: controversies and possible solutions. Current Opinion in Psychiatry, 22, 532–540.Google Scholar
Brittle, N., Patel, S., Wright, C., Baral, S., Versfeld, P. and Sackley, C. (2009). An exploratory cluster randomized controlled trial of group exercise on mobility and depression in care home residents. Clinical Rehabilitation, 23, 146–154.CrossRefGoogle ScholarPubMed
Brooker, D. J., Argyle, E., Scally, A. J. and Clancy, D. (2011). The enriched opportunities programme for people with dementia: a cluster-randomised controlled trial in 10 extra care housing schemes. Aging and Mental Health, 15, 1008–1017.CrossRefGoogle ScholarPubMed
Buettner, L. L. and Fitzsimmons, S. (2002). AD-venture program: therapeutic biking for the treatment of depression in long-term care residents with dementia. American Journal of Alzheimer's Disease and Other Dementia, 17, 121–127.CrossRefGoogle ScholarPubMed
Buettner, L. L., Lundegren, H., Lago, D., Farrell, P. and Smith, R. (1996). Therapeutic recreation as an intervention for persons with dementia and agitation: an efficacy study. American Journal of Alzheimer's Disease, 11, 4.CrossRefGoogle Scholar
Chenoweth, L. et al. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurology, 8, 317–325.Google Scholar
Choi, A. N., Lee, M. S., Cheong, K. J. and Lee, J. S. (2009). Effects of group music intervention on behavioral and psychological symptoms in patients with dementia: a pilot-controlled trial. International Journal of Neuroscience, 119, 471–481.Google Scholar
Cohen-Mansfield, J. and Werner, P. (1997). Management of verbally disruptive behaviors in nursing home residents. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 52, M369–377.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Libin, A. and Marx, M. S. (2007). Nonpharmacological treatment of agitation: a controlled trial of systematic individualized intervention. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62, 908–916.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Marx, M. S., Dakheel-Ali, M., Regier, N. G., Thein, K. and Freedman, L. (2010). Can agitated behavior of nursing home residents with dementia be prevented with the use of standardized stimuli? Journal of the American Geriatric Society, 58, 1459–1464.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Thein, K., Marx, M. S., Dakheel-Ali, M. and Freedman, L. (2012). Efficacy of nonpharmacologic interventions for agitation in advanced dementia: a randomized, placebo-controlled trial. Journal of Clinical Psychiatry, 73, 1255–1261.Google Scholar
Conradsson, M., Littbrand, H., Lindelof, N., Gustafson, Y. and Rosendahl, E. (2010). Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: a cluster-randomized controlled trial. Aging and Mental Health, 14, 565–576.CrossRefGoogle ScholarPubMed
Corbett, A. et al. (2012). Systematic review of services providing information and/or advice to people with dementia and/or their caregivers. International Journal of Geriatric Psychiatry, 27, 628–636.CrossRefGoogle ScholarPubMed
Dechamps, A. et al. (2010). Effects of exercise programs to prevent decline in health-related quality of life in highly deconditioned institutionalized elderly persons: a randomized controlled trial. Archives of Internal Medicine, 170, 162–169.CrossRefGoogle ScholarPubMed
Deponte, A. and Missan, R. (2007). Effectiveness of validation therapy (VT) in group: preliminary results. Archives of Gerontology and Geriatrics, 44, 113–117.Google Scholar
Eggermont, L. H., Knol, D. L., Hol, E. M., Swaab, D. F. and Scherder, E. J. (2009). Hand motor activity, cognition, mood, and the rest-activity rhythm in dementia: a clustered RCT. Behavioural Brain Research, 196, 271–278.CrossRefGoogle ScholarPubMed
Fan, J. T. and Chen, K. M. (2011). Using silver yoga exercises to promote physical and mental health of elders with dementia in long-term care facilities. International Psychogeriatrics, 23, 1222–1230.CrossRefGoogle ScholarPubMed
Feil, N. (1982). Validation: The Feil Method. Cleveland: Edward Feil Productions.Google Scholar
Finnema, E. et al. (2005). The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial. International Journal of Geriatric Psychiatry, 20, 330–343.Google Scholar
Fossey, J. et al. (2006). Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. British Medical Journal, 332, 756–761.Google Scholar
Goldwasser, A. N., Auerbach, S. M. and Harkins, S. W. (1987). Cognitive, affective, and behavioral effects of reminiscence group therapy on demented elderly. International Journal of Aging & Human Development. 25: 209–222.CrossRefGoogle ScholarPubMed
Haslam, C., Haslam, S. A., Jetten, J., Bevins, A., Ravenscroft, S. and Tonks, J. (2010). The social treatment: the benefits of group interventions in residential care settings. Psychology and Aging, 25, 157–167.Google Scholar
Hsu, Y. C. and Wang, J. J. (2009). Physical, affective, and behavioral effects of group reminiscence on depressed institutionalized elders in Taiwan. Nursing Research, 58, 294–299.Google Scholar
Jones, E. D. (2003). Reminiscence therapy for older women with depression. Effects of nursing intervention classification in assisted-living long-term care. Journal of Gerontological Nursing, 29, 26–33; quiz 56–27.CrossRefGoogle ScholarPubMed
Karimi, H., Dolatshahee, B., Momeni, K., Khodabakhshi, A., Rezaei, M. and Kamrani, A. A. (2010). Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: An empirical study. Aging and Mental Health, 14, 881–887.CrossRefGoogle ScholarPubMed
Kerse, N. et al. (2008). Does a functional activity programme improve function, quality of life, and falls for residents in long term care? Cluster randomised controlled trial. British Medical Journal, 337, a1445.Google Scholar
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Buckingham: Open University Press Google Scholar
Kolanowski, A., Litaker, M., Buettner, L., Moeller, J. and Costa, P. T., Jr. (2011). A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents. Journal of the American Geriatrics Society, 59, 1032–1041.CrossRefGoogle ScholarPubMed
Kovach, C. R. et al. (2006). Effects of the Serial Trial Intervention on discomfort and behavior of nursing home residents with dementia. American Journal of Alzheimer's Disease and Other Dementia, 21, 147–155.CrossRefGoogle ScholarPubMed
Kovach, C. R., Taneli, Y., Dohearty, P., Schlidt, A. M., Cashin, S. and Silva-Smith, A. L. (2004). Effect of the BACE intervention on agitation of people with dementia. The Gerontologist, 44, 797–806.CrossRefGoogle ScholarPubMed
Kverno, K. S., Black, B. S., Nolan, M. T. and Rabins, P. V. (2009). Research on treating neuropsychiatric symptoms of advanced dementia with non-pharmacological strategies, 19982008: a systematic literature review. International Psychogeriatrics, 21, 825–843.Google Scholar
Ledger, A. J. and Baker, F. A. (2007). An investigation of long-term effects of group music therapy on agitation levels of people with Alzheimer's Disease. Aging and Mental Health, 11, 330–338.CrossRefGoogle ScholarPubMed
Lin, Y. et al. (2010). Effectiveness of group music intervention against agitated behavior in elderly persons with dementia. International Journal of Geriatric Psychiatry, 26, 670–678.Google Scholar
Livingston, G., Johnston, K., Katona, C., Paton, J. and Lyketsos, C. G. (2005). Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 162, 1996–2021.CrossRefGoogle Scholar
Olazaran, J. et al. (2010). Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dementia and Geriatric Cognitive Disorders, 30, 161–178.CrossRefGoogle ScholarPubMed
O'Neil, M. E., Freeman, M., Christensen, V., Telerant, R., Addleman, A. and Kansagara, D. (2011). A Systematic Evidence Review of Non-pharmacological Interventions for Behavioral Symptoms of Dementia. Washington, DC: Department of Veterans Affairs.Google Scholar
Phillips, L. J., Reid-Arndt, S. A. and Pak, Y. (2010). Effects of a creative expression intervention on emotions, communication, and quality of life in persons with dementia. Nursing Research, 59, 417–425.Google Scholar
Politis, A. M., Vozzella, S., Mayer, L. S., Onyike, C. U., Baker, A. S. and Lyketsos, C. G. (2004). A randomized, controlled, clinical trial of activity therapy for apathy in patients with dementia residing in long-term care. International Journal of Geriatric Psychiatry, 19, 1087–1094.Google Scholar
Proctor, R. et al. (1999). Behavioural management in nursing and residential homes: a randomised controlled trial. Lancet, 354, 26–29.Google Scholar
Raglio, A. et al. (2008). Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. Alzheimer Disease and Associated Disorders, 22, 158–162.Google Scholar
Rolland, Y. et al. (2007). Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial. Journal of the American Geriatrics Society, 55, 158–165.Google Scholar
Rosendahl, E., Gustafson, Y., Nordin, E., Lundin-Olsson, L. and Nyberg, L. (2008). A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities. Aging Clinical and Experimental Research, 20, 67–75.Google Scholar
Rosendahl, E. et al. (2006). High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living: a randomised controlled trial. The Australian Journal of Physiotherapy, 52, 105–113.CrossRefGoogle ScholarPubMed
Sackley, C. M. et al. (2009). Effects of a physiotherapy and occupational therapy intervention on mobility and activity in care home residents: a cluster randomised controlled trial. British Medical Journal, 339, b3123.CrossRefGoogle ScholarPubMed
Steele, C., Rovner, B., Chase, G. A. and Folstein, M. (1990). Psychiatric symptoms and nursing home placement of patients with Alzheimer's disease. The American Journal of Psychiatry, 147, 1049–1051.Google Scholar
Sung, H. C., Chang, A. M. and Lee, W. L. (2010). A preferred music listening intervention to reduce anxiety in older adults with dementia in nursing homes. Journal of Clinical Nursing, 19, 1056–1064.CrossRefGoogle ScholarPubMed
Sung, H. C., Chang, S. M., Lee, W. L. and Lee, M. S. (2006). The effects of group music with movement intervention on agitated behaviours of institutionalized elders with dementia in Taiwan. Complementary Therapies in Medicine, 14, 113–119.CrossRefGoogle ScholarPubMed
Sung, H. C., Lee, W. L., Li, T. L. and Watson, R. (2012). A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia. International Journal of Geriatric Psychiatry, 27, 621–627.CrossRefGoogle ScholarPubMed
Tondi, L., Ribani, L., Bottazzi, M., Viscomi, G. and Vulcano, V. (2007). Validation therapy (VT) in nursing home: a case-control study. Archives of Gerontology and Geriatrics, 44 (Suppl. 1), 407–411.CrossRefGoogle ScholarPubMed
Wang, J. J. (2007). Group reminiscence therapy for cognitive and affective function of demented elderly in Taiwan. International Journal of Geriatric Psychiatry, 22, 1235–1240.Google Scholar
Wang, J. J., Yen, M. and OuYang, W. C. (2009). Group reminiscence intervention in Taiwanese elders with dementia. Archives of Gerontology and Geriatrics, 49, 227–232.CrossRefGoogle ScholarPubMed
Williams, C. L. and Tappen, R. M. (2007). Effect of exercise on mood in nursing home residents with Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 22, 389–397.CrossRefGoogle ScholarPubMed
Williams, C. L. and Tappen, R. M. (2008). Exercise training for depressed older adults with Alzheimer's disease. Aging and Mental Health, 12, 72–80.CrossRefGoogle ScholarPubMed