Non-Pharmacological Interventions in the Management of Dementia-Related Psychosis: A Systematic Review and Meta-Analysis
Alice Burnand, Tasmin Rookes, Farah Mahmood, Nathan Davies, Kate Walters, Stephen Orleans-Foli, Madiha Sajid, Victoria Vickerstaff, Rachael Frost
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.