Exploring Factors Associated With Successful Nonpharmacological Interventions for People With Dementia
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and purpose: We investigated existing nonpharmacological programs for people with dementia (PWD) to explore critical factors related to the effectiveness of these types of programs. Methods: We conducted a qualitative systematic literature review to identify nonpharmacological intervention programs developed for PWD and reviewed 36 randomized controlled trials. Among several outcomes reported in each study, we focused on the most common outcomes including quality of life (QoL), neuropsychiatric symptoms, depression, agitation, and cognition for further review. Results: Several factors were identified that might affect the outcomes of nonpharmacological interventions for PWD including study design, characteristics of the intervention, maintaining research participants, heterogeneity issues, and implementation fidelity. About half of studies in this review reported positive program effects on their targeted outcomes such as Well-being and Health for PWD on improving quality of life, neuropsychiatric symptoms and agitation; cognitive stimulation therapy on QoL, neuropsychiatric symptoms and cognition; and a stepwise multicomponent intervention on neuropsychiatric symptoms, depression and agitation. Conclusions: We found some programs even with a rigorous study design did not produce expected outcomes while other programs with poor designs reported positive outcomes, which necessitates further investigation on the validity of the assessments. Factors such as individual tailored and customized interventions, promoting social interactions, ease of administration and compatibility of interventions, and developing program theory need to be considered when developing nonpharmacological intervention programs.
Abstract
Background and purpose: We investigated existing nonpharmacological programs for people with dementia (PWD) to explore critical factors related to the effectiveness of these types of programs. Methods: We conducted a qualitative systematic literature review to identify nonpharmacological intervention programs developed for PWD and reviewed 36 randomized controlled trials. Among several outcomes reported in each study, we focused on the most common outcomes including quality of life (QoL), neuropsychiatric symptoms, depression, agitation, and cognition for further review. Results: Several factors were identified that might affect the outcomes of nonpharmacological interventions for PWD including study design, characteristics of the intervention, maintaining research participants, heterogeneity issues, and implementation fidelity. About half of studies in this review reported positive program effects on their targeted outcomes such as Well-being and Health for PWD on improving quality of life, neuropsychiatric symptoms and agitation; cognitive stimulation therapy on QoL, neuropsychiatric symptoms and cognition; and a stepwise multicomponent intervention on neuropsychiatric symptoms, depression and agitation. Conclusions: We found some programs even with a rigorous study design did not produce expected outcomes while other programs with poor designs reported positive outcomes, which necessitates further investigation on the validity of the assessments. Factors such as individual tailored and customized interventions, promoting social interactions, ease of administration and compatibility of interventions, and developing program theory need to be considered when developing nonpharmacological intervention programs.
참고문헌 (65)
- Alzheimer’s Association, "2019 Alzheimer’s disease facts and figures", Alzheimers Dement, 15, pp.321~387 (2019)
- "Dementia: fact sheet" (2020)[URL]
- "Alzheimer's disease and related dementias" (2020)[URL]
- Kumar A, "Alzheimer Disease" (2019), StatPearls Publishing
- Wang D, "Longitudinal modeling of functional decline associated with pathologic Alzheimer’s disease in older persons without cognitive impairment", J Alzheimers Dis, 62, pp.855~865 (2018)
- "Alzheimer's disease fact sheet" (2020)[URL]
- Bhattacharjee S, "Alzheimer’s disease medication and risk of all-cause mortality and all-cause hospitalization: A retrospective cohort study", Alzheimers Dement (N Y), 5, pp.294~302 (2019)
- Bishara D, "The pharmacological management of Alzheimer’s disease", Prog Neurol Psychiatry, 19, pp.9~16 (2015)
- Blennow K, "Alzheimer’s disease", Lancet, 368, pp.387~403 (2006)
- Hung SY, "Drug candidates in clinical trials for Alzheimer’s disease", J Biomed Sci, 24, pp.47~ (2017)
- Nickel F, "Health economic evaluations of non-pharmacological interventions for persons with dementia and their informal caregivers : a systematic review", BMC Geriatr, 18, pp.69~ (2018)
- Kallio EL, "Effects of cognitive training on cognition and quality of life of older persons with dementia", J Am Geriatr Soc, 66, pp.664~670 (2018)
- Lyu J, "The effects of music therapy on cognition, psychiatric symptoms, and activities of daily living in patients with Alzheimer’s disease", J Alzheimers Dis, 64, pp.1347~1358 (2018)
- O’Connor CM, "The tailored activity program(TAP)to address behavioral disturbances in frontotemporal dementia : a feasibility and pilot study", Disabil Rehabil, 41, pp.299~310 (2019)
- Clare L, "Goal-oriented cognitive rehabilitation for early-stage Alzheimer’s and related dementias : the GREAT RCT", Health Technol Assess, 23, pp.1~242 (2019)
- Agency for Healthcare Research and Quality, "Care Interventions for People With Dementia (PWD) and Their Caregivers", Agency for Healthcare Research and Quality, ~ (2019)
- Turner T, "Dementia care : an overview of available non-pharmacological therapies", Pharm J, pp.296~ (2016)
- 이주연, "Home-Visiting Cognitive Intervention for the Community-Dwelling Elderly Living Alone", Dementia and Neurocognitive Disorders(대한치매학회지), 19(2), pp.65~73 (2020), 대한치매학회[DOI]
- 정영희, "Effect of Integrated Cognitive Intervention Therapy in Patients with Mild to Moderate Alzheimer's Disease", Dementia and Neurocognitive Disorders(대한치매학회지), 19(3), pp.86~95 (2020), 대한치매학회[DOI]
- Laakkonen ML, "Effects of selfmanagement groups for people with dementia and their spouses--randomized controlled trial", J Am Geriatr Soc, 64, pp.752~760 (2016)
- Cooper C, "Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia", Int Psychogeriatr, 24, pp.856~870 (2012)
- Orrell M, "The impact of individual cognitive stimulation therapy(iCST)on cognition, quality of life, caregiver health, and family relationships in dementia : A randomised controlled trial", PLoS Med, 14, pp.e1002269~ (2017)
- Bahar-Fuchs A, "Cognitive training for people with mild to moderate dementia", Cochrane Database Syst Rev, 3, pp.CD013069~ (2019)
- Charlesworth G, "Peer support and reminiscence therapy for people with dementia and their family carers : a factorial pragmatic randomised trial", J Neurol Neurosurg Psychiatry, 87, pp.1218~1228 (2016)
- Galik E, "Function focused care for assisted living residents with dementia", Gerontologist, 55(Suppl 1), pp.S13~S26 (2015)
- Pieper MJ, "Effects of a stepwise multidisciplinary intervention for challenging behavior in advanced dementia : a cluster randomized controlled trial", J Am Geriatr Soc, 64, pp.261~269 (2016)
- Prick AE, "The effects of a multicomponent dyadic intervention on the mood, behavior, and physical health of people with dementia : a randomized controlled trial", Clin Interv Aging, 11, pp.383~395 (2016)
- Hoffmann K, "Moderate-to-high intensity physical exercise in patients with Alzheimer’s disease : a randomized controlled trial", J Alzheimers Dis, 50, pp.443~453 (2016)
- Thyrian JR, "Effectiveness and safety of dementia care management in primary care : a randomized clinical trial", JAMA Psychiatry, 74, pp.996~1004 (2017)
- Churcher Clarke A, "An adapted mindfulness intervention for people with dementia in care homes : feasibility pilot study", Int J Geriatr Psychiatry, 32, pp.e123~e131 (2017)
- Liu B, "Effect of passive finger exercises on grip strength and the ability to perform activities of daily living for older people with dementia : a 12-week randomized controlled trial", Clin Interv Aging, 13, pp.2169~2177 (2018)
- Paddick SM, "Cognitive stimulation therapy as a sustainable intervention for dementia in sub-Saharan Africa : feasibility and clinical efficacy using a stepped-wedge design", Int Psychogeriatr, 29, pp.979~989 (2017)
- Sánchez A, "Comparing the effects of multisensory stimulation and individualized music sessions on elderly people with severe dementia : a randomized controlled trial", J Alzheimers Dis, 52, pp.303~315 (2016)
- Liang A, "A pilot randomized trial of a companion robot for people with dementia living in the community", J Am Med Dir Assoc, 18, pp.871~878 (2017)
- Moyle W, "Use of a robotic seal as a therapeutic tool to improve dementia symptoms : a cluster-randomized controlled trial", J Am Med Dir Assoc, 18, pp.766~773 (2017)
- Rajkumar AP, "Apathy and its response to antipsychotic review and nonpharmacological interventions in people with dementia living in nursing homes : WHELD, a factorial cluster randomized controlled trial", J Am Med Dir Assoc, 17, pp.741~747 (2016)
- Olsen C, "Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia : a cluster randomized controlled trial", Int J Geriatr Psychiatry, 31, pp.1312~1321 (2016)
- Raglio A, "Effect of active music therapy and individualized listening to music on dementia : a multicenter randomized controlled trial", J Am Geriatr Soc, 63, pp.1534~1539 (2015)
- Lamb SE, "Dementia And Physical Activity(DAPA)trial of moderate to high intensity exercise training for people with dementia : randomised controlled trial", BMJ, 361, pp.k1675~ (2018)
- Gitlin LN, "Targeting behavioral symptoms and functional decline in dementia : a randomized clinical trial", J Am Geriatr Soc, 66, pp.339~345 (2018)
- Livingston G, "DREAMS-START(Dementia RElAted Manual for Sleep; STrAtegies for RelaTives)for people with dementia and sleep disturbances : a single-blind feasibility and acceptability randomized controlled trial", Int Psychogeriatr, 31, pp.251~265 (2019)
- Griffiths AW, "Exploring self-report and proxy-report quality-of-life measures for people living with dementia in care homes", Qual Life Res, 29, pp.463~472 (2020)
- Ballard C, "Impact of person-centred care training and person-centred activities on quality of life, agitation, and antipsychotic use in people with dementia living in nursing homes : a cluster-randomised controlled trial", PLoS Med, 15, pp.e1002500~ (2018)
- Döpp CM, "Effectiveness of a training package for implementing a community-based occupational therapy program in dementia : a cluster randomized controlled trial", Clin Rehabil, 29, pp.974~986 (2015)
- MacNeil Vroomen J, "Communitydwelling patients with dementia and their informal caregivers with and without case management : 2-year outcomes of a pragmatic trial", J Am Med Dir Assoc, 16, pp.800.e1~800.e8 (2015)
- Harmer BJ, "What is meaningful activity for people with dementia living in care homes? A comparison of the views of older people with dementia, staff and family carers", Aging Ment Health, 12, pp.548~558 (2008)
- Phinney A, "Doing as much as I can do : the meaning of activity for people with dementia", Aging Ment Health, 11, pp.384~393 (2007)
- Mansbach WE, "Meaningful activity for long-term care residents with dementia : a comparison of activities and raters", Gerontologist, 57, pp.461~468 (2017)
- Regan B, "MAXCOG-maximizing cognition : a randomized controlled trial of the efficacy of goal-oriented cognitive rehabilitation for people with mild cognitive impairment and early Alzheimer disease", Am J Geriatr Psychiatry, 25, pp.258~269 (2017)
- Van Bogaert P, "SolCos model-based individual reminiscence for older adults with mild to moderate dementia in nursing homes : a randomized controlled intervention study", J Psychiatr Ment Health Nurs, 23, pp.568~575 (2016)
- Koivisto AM, "Early psychosocial intervention does not delay institutionalization in persons with mild Alzheimer disease and has impact on neither disease progression nor caregivers’ well-being : ALSOVA 3-year follow-up", Int J Geriatr Psychiatry, 31, pp.273~283 (2016)
- Woods RT, "REMCARE : pragmatic multicentre randomised trial of reminiscence groups for people with dementia and their family carers : effectiveness and economic analysis", PLoS One, 11, pp.e0152843~ (2016)
- Suominen MH, "Nutritional guidance improves nutrient intake and quality of life, and may prevent falls in aged persons with Alzheimer disease living with a spouse(NuAD Trial)", J Nutr Health Aging, 19, pp.901~907 (2015)
- Voigt-Radloff S, "Structured relearning of activities of daily living in dementia : the randomized controlled REDALI-DEM trial on errorless learning", Alzheimers Res Ther, 9, pp.22~ (2017)
- Orgeta V, "Individual cognitive stimulation therapy for dementia : a clinical effectiveness and cost-effectiveness pragmatic, multicentre, randomised controlled trial", Health Technol Assess, 19, pp.1~108 (2015)
- Lemke NC, "Transferability and sustainability of motor-cognitive dual-task training in patients with dementia : a randomized controlled trial", Gerontology, 65, pp.68~83 (2019)
- Guyatt GH, "What is"quality of evidence"and why is it important to clinicians", BMJ, 336, pp.995~998 (2008)
- Jones C, "Does cognitive impairment and agitation in dementia influence intervention effectiveness? findings from a cluster-randomized-controlled trial with the therapeutic robot, PARO", J Am Med Dir Assoc, 19, pp.623~626 (2018)
- Reus VI, "The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia", Focus(Am Psychiatr Publ), 15, pp.81~84 (2017)
- Howe E, "Improving the quality of life in patients with Alzheimer’s disease", Psychiatry(Edgmont), 5, pp.51~56 (2008)
- Hsiao YH, "Impact of social relationships on Alzheimer’s memory impairment : mechanistic studies", J Biomed Sci, 25, pp.3~ (2018)
- Hung L, "The benefits of and barriers to using a social robot PARO in care settings : a scoping review", BMC Geriatr, 19, pp.232~ (2019)
- Rogers PJ, "Using programme theory to evaluate complicated and complex aspects of interventions", Evaluation, 14, pp.29~48 (2008)
- Chatterjee P, "Evaluation research : some possible contexts of theory failure", J Sociol Soc Welf, 3, pp.3~ (1976)
- Donaldson SI, "Theory-Driven Program Evaluation in the New Millennium" (2003), Lawrence Erlbaum Associates