Non-Pharmacological Interventions in the Management of Dementia-Related Psychosis: A Systematic Review and Meta-Analysis

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY International Journal of Geriatric Psychiatry Pub Date : 2024-08-07 DOI:10.1002/gps.6129

Alice Burnand, Tasmin Rookes, Farah Mahmood, Nathan Davies, Kate Walters, Stephen Orleans-Foli, Madiha Sajid, Victoria Vickerstaff, Rachael Frost

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Abstract

Objective

As populations age globally, there is an increasing prevalence of dementia, with an estimated 153 million living with dementia by 2050. Up to 70% of people with dementia experience dementia-related psychosis (D-RP). Antipsychotic medications are associated with many adverse effects in older people. This review aims to evaluate the evidence of non-pharmacological interventions in managing D-RP.

Method

The search of Medline, EMBASE, Web of Science, CINAHL, PsycINFO, and Cochrane included randomised controlled trials that evaluated non-pharmacological interventions. Data extraction and assessment of quality were assessed independently by two researchers. Heterogenous interventions were pooled using meta-analysis.

Results

A total of 18 articles (n = 2040 participants) were included and categorised into: sensory-, activity-, cognitive- and multi-component-orientated. Meta-analyses showed no significant impact in reducing hallucinations or delusions but person-centred care, cognitive rehabilitation, music therapy, and robot pets showed promise in single studies.

Conclusions and Implications

Future interventions should be developed and evaluated with a specific focus on D-RP as this was not the aim for many of the included articles.

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痴呆症相关精神病治疗中的非药物干预：系统回顾与元分析》。

目的：随着全球人口的老龄化，痴呆症的发病率越来越高，预计到 2050 年将有 1.53 亿人患有痴呆症。高达 70% 的痴呆症患者会出现痴呆症相关精神病（D-RP）。抗精神病药物对老年人有许多不良影响。本综述旨在评估非药物干预治疗 D-RP 的证据：方法：检索 Medline、EMBASE、Web of Science、CINAHL、PsycINFO 和 Cochrane，纳入评估非药物干预措施的随机对照试验。数据提取和质量评估由两名研究人员独立完成。采用荟萃分析法对异质性干预措施进行了汇总：共纳入了 18 篇文章（n = 2040 名参与者），并将其分为：以感觉为导向、以活动为导向、以认知为导向和以多组分为导向。元分析表明，在减少幻觉或妄想方面没有显著效果，但以人为本的护理、认知康复、音乐疗法和机器人宠物在单项研究中显示出了前景：未来干预措施的开发和评估应特别关注幻觉和妄想，因为这并不是许多收录文章的目标。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.