Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews
Bibliographic record
Abstract
AIMS AND OBJECTIVES: To review the evidence on nonpharmacological approaches to care for behavioural and psychological symptoms of dementia in older adults. BACKGROUND: Dementia is increasing in worldwide prevalence and can have severe and life-altering impacts on older adults. Behavioural and psychological symptoms of dementia can occur as a result of unmet needs and are distressing for family and caregivers. Many reviews have examined specific approaches to behaviours, but few have compared interventions for effectiveness and applicability across settings. DESIGN: Systematic review of reviews. METHODS: The search was limited to reviews that were published between October 2009-April/May 2015. Seven databases were searched, and reviews with a focus on nonpharmacological approaches to behaviours in older adults with dementia were included. All reviews were independently screened by two reviewers, quality appraised and data extracted. Results are reported through narrative synthesis. RESULTS: There were 18 international reviews that met inclusion criteria describing individual therapies, targeted interventions and organisational interventions. The organisational interventions of care planning using a consultation or dementia mapping process demonstrated modest benefits. The most conclusive evidence supported individual, sensory-focused interventions such as music therapy, interventions targeting pain, person-centred approaches and education for family caregivers. CONCLUSIONS: Although there remains a paucity of high-quality research in this area, the existing evidence indicates that behavioural and psychological symptoms of dementia require a range of nonpharmacologic sensory-focused approaches that are tailored to the individual. Further research is needed to determine the interventions best suited for specific behaviours and contexts, particularly inappropriate sexual behaviours. RELEVANCE TO CLINICAL PRACTICE: There is a need for nurses to be informed of best practices in order to effectively plan appropriate interventions to address behaviours in older adults with dementia. Care planning and tailored, sensory-focused, nonpharmacologic approaches are safe and effective options for nurses to consider in practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".