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Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials

  • Gill Livingston (a1), Lynsey Kelly (a1), Elanor Lewis-Holmes (a1), Gianluca Baio (a2), Stephen Morris (a3), Nishma Patel (a3), Rumana Z. Omar (a2), Cornelius Katona (a4) and Claudia Cooper (a4)...
Abstract
Background

Agitation in dementia is common, persistent and distressing and can lead to care breakdown. Medication is often ineffective and harmful.

Aims

To systematically review randomised controlled trial evidence regarding non-pharmacological interventions.

Method

We reviewed 33 studies fitting predetermined criteria, assessed their validity and calculated standardised effect sizes (SES).

Results

Person-centred care, communication skills training and adapted dementia care mapping decreased symptomatic and severe agitation in care homes immediately (SES range 0.3–1.8) and for up to 6 months afterwards (SES range 0.2–2.2). Activities and music therapy by protocol (SES range 0.5–0.6) decreased overall agitation and sensory intervention decreased clinically significant agitation immediately. Aromatherapy and light therapy did not demonstrate efficacy.

Conclusions

There are evidence-based strategies for care homes. Future interventions should focus on consistent and long-term implementation through staff training. Further research is needed for people living in their own homes.

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Copyright
Corresponding author
Professor Gill Livingston, Charles Bell House, 67–73 Riding House Street, London W1W 7EH, UK. Email: g.livingston@ucl.ac.uk
Footnotes
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This article presents independent research commissioned by the UK National Institute for Health Research (NIHR) Health Technology Assessment Programme: HTA 10/43/01. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA Programme, NIHR, the National Health Service or the Department of Health. The study was sponsored by University College London. Neither funders nor sponsors had a role in the study design and the collection, analysis, and interpretation of data and the writing of the article and the decision to submit it for publication. The researchers were independent from funders and sponsors.

Declaration of interest

None.

Footnotes
References
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Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials

  • Gill Livingston (a1), Lynsey Kelly (a1), Elanor Lewis-Holmes (a1), Gianluca Baio (a2), Stephen Morris (a3), Nishma Patel (a3), Rumana Z. Omar (a2), Cornelius Katona (a4) and Claudia Cooper (a4)...
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