Non-pharmacological interventions for dementia-related psychosis

More than 57 million people live with dementia worldwide and with an ageing population this figure is expected to reach 152.8 million in 2050. Roughly 20-70% of those who have a dementia diagnosis will experience dementia-related psychosis symptoms, such as hallucinations, delusional or paranoid thoughts. This can cause a reduction in quality of life, increased caregiver burden, worsening memory and earlier admission into hospital and nursing homes, all of which come at a cost to the NHS. GPs are usually the first point of contact for those with dementia when they need medical, psychological, and social support, but it is suggested primary care does not have enough resources and is unprepared for addressing dementia-related psychosis. Medicines can be used to treat symptoms of dementia-related psychosis, commonly these are ‘atypical antipsychotic’ drugs. However, they are not for long-term use, and have many side effects such as increased drowsiness, falls, inability to sit still, and increased confusion. There is currently no approved medicine for the treatment of dementia-related psychosis.

There are other ways to support people with dementia without the use of medicine, which are called non-pharmacological interventions. These have been tested in studies to see if they are as good as medicines in reducing symptoms of dementia. The treatments have much fewer side effects than medicines and may be more cost-effective for the NHS. This is not currently known.

Our project will review existing evidence and summarise the results of studies of non-pharmacological treatments that have tried to help people with dementia reduce their symptoms of psychosis. We will search through online libraries for research studies and combine all the results in a table and produce a summary. Two researchers will independently check these results to make sure all the studies are suitable to include in our review.

When all the relevant studies have been decided, we will collect and summarise information on each of them, who took part and what the participants received. We will determine which treatments lead to an improvement in symptoms of dementia-related psychosis, quality of life, and if they were more cost-effective and safer than using medicines. This will help to better support people with dementia without the need for medicine, which will reduce pressure on GPs, pharmacists, and the NHS.

One Patient and Public Involvement member with first-hand experience of supporting a person with dementia-related psychosis is working with us as a co-applicant in the funding application process and will be involved in future activities throughout the project. Findings will be shared with researchers and professionals in relevant journal articles, conferences, and we will write a policy summary. Results will be shared with the public through an engagement workshop, plain language summaries, social media posts, leaflets, and blog articles.

Amount awarded: £17,436