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Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia

Published online by Cambridge University Press:  16 January 2012

Claudia Cooper ,
Naaheed Mukadam ,
Cornelius Katona ,
Constantine G. Lyketsos ,
David Ames ,
Peter Rabins ,
Knut Engedal ,
Carlos de Mendonça Lima ,
Dan Blazer  and
Linda Teri
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Claudia Cooper*
Affiliation:
University College London, London, UK
Naaheed Mukadam
Affiliation:
University College London, London, UK
Cornelius Katona
Affiliation:
University College London, London, UK
Constantine G. Lyketsos
Affiliation:
Department of Psychiatry, Johns Hopkins Medicine, The Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
David Ames
Affiliation:
National Ageing Research Institute, Parkville, Victoria, Australia University of Melbourne, Victoria, Australia
Peter Rabins
Affiliation:
Department of Psychiatry, Johns Hopkins Medicine, The Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
Knut Engedal
Affiliation:
Oslo University Hospital, Nydalen, Oslo, Norway
Carlos de Mendonça Lima
Affiliation:
Centro Hospitalar do Alto Ave, Rua dos Cutileiros, GUIMARÃES, Portugal
Dan Blazer
Affiliation:
Duke University Medical Center, Durham, NC, USA
Linda Teri
Affiliation:
University of Washington, Seattle, WA, USA
Henry Brodaty
Affiliation:
National Ageing Research Institute, Parkville, Victoria, Australia University of Melbourne, Victoria, Australia
Gill Livingston
Affiliation:
University College London, London, UK
*
Correspondence should be addressed to: Dr. Claudia Cooper, Department of Mental Health Sciences, University College London, Holborn Union Building, Archway Campus, Highgate Hill, London, N19 5LW, UK. Phone: +0207 288 5931; Fax: +0207 288 3411. Email: c.cooper@ucl.ac.uk.
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Abstract

Background: People with dementia report lower quality of life, but we know little about what interventions might improve it.

Methods: We systematically reviewed 20 randomized controlled trials reporting the effectiveness of non-pharmacological interventions in improving quality of life or well-being of people with dementia meeting predetermined criteria. We rated study validity with a checklist. We contacted authors for additional data. We calculated standardized mean differences (SMD) and, for studies reporting similar interventions, pooled standardized effect sizes (SES).

Results: Pooled analyses found that family carer coping strategy-based interventions (four studies, which did not individually achieve significance; n = 420; SES 0.24 (range 0.03–0.45)) and combined patient activity and family carer coping interventions (two studies, not individually significant; n = 191; SES 0.84 (range 0.54–1.14)) might improve quality of life. In one high-quality study, a care management system improved quality of life of people with dementia living at home. Group Cognitive Stimulation Therapy (GCST) improved quality of life of people with dementia in care homes.

Conclusion: Preliminary evidence indicated that coping strategy-based family carer therapy with or without a patient activity intervention improved quality of life of people with dementia living at home. GCST was the only effective intervention in a higher quality trial for those in care homes, but we did not find such evidence in the community. Few studies explored whether effects continued after the intervention stopped. Future research should explore the longer-term impact of interventions on, and devise strategies to increase, life quality of people with dementia living in care homes or at home without a family carer.

Keywords

well-beingsystematic reviewmeta-analysiscontrolled trial
Type
Review Article
Information
International Psychogeriatrics , Volume 24 , Issue 6 , June 2012 , pp. 856 - 870
Copyright
Copyright © International Psychogeriatric Association 2012

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