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Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials.

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Title: Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials.
Authors: Scott, Iona (AUTHOR), Cooper, Claudia (AUTHOR), Leverton, Monica (AUTHOR), Burton, Alex (AUTHOR), Beresford‐Dent, Jules (AUTHOR), Rockwood, Kenneth (AUTHOR), Butler, Laurie (AUTHOR), Rapaport, Penny (AUTHOR), Beresford-Dent, Jules (AUTHOR)
Source: International Journal of Geriatric Psychiatry. Oct2019, Vol. 34 Issue 10, p1386-1402. 17p. 1 Diagram, 5 Charts.
Subjects: Meta-analysis, Dementia, Reminiscence therapy, Activities of daily living, Exercise therapy, Treatment of dementia, Research, Clinical trials, Research methodology, Systematic reviews, Evaluation research, Medical cooperation, Occupational therapy, Comparative studies, Group psychotherapy, Psychotherapy
Abstract: Objective: Slowing functional decline could enable people living with dementia to live for longer and more independently in their own homes. We aimed to update previous syntheses examining the effectiveness of nonpharmacological interventions in reducing functional decline (activities of daily living, activity-specific physical functioning, or function-specific goal attainment) in people living in their own homes with dementia.Methods: We systematically searched electronic databases from January 2012 to May 2018; two researchers independently rated risk of bias of randomised controlled trials (RCTs) fitting predetermined inclusion criteria using a checklist; we narratively synthesised findings, prioritising studies judged to have a lower risk of bias.Results: Twenty-nine papers (describing 26 RCTs) met eligibility criteria, of which we judged 13 RCTs to have a lower risk of bias. Study interventions were evaluated in four groups: physical exercise, occupational, multicomponent, and cognition-oriented interventions. Four out of 13 RCTs reported functional ability as a primary outcome. In studies judged to have a lower risk of bias, in-home tailored exercise, individualised cognitive rehabilitation, and in-home activities-focussed occupational therapy significantly reduced functional decline relative to control groups in individual studies. There was consistent evidence from studies at low risk of bias that group-based exercise and reminiscence therapies were ineffective at reducing functional decline.Conclusion: We found no replicated evidence of intervention effectiveness in decreasing functional decline. Interventions associated with slower functional decline in individual trials have been individually delivered and tailored to the needs of the person with dementia. This is consistent with previous findings. Future intervention trials should prioritise these approaches. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Geriatric Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials.
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  Data: <searchLink fieldCode="AR" term="%22Scott%2C+Iona%22">Scott, Iona</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cooper%2C+Claudia%22">Cooper, Claudia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Leverton%2C+Monica%22">Leverton, Monica</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burton%2C+Alex%22">Burton, Alex</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beresford‐Dent%2C+Jules%22">Beresford‐Dent, Jules</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rockwood%2C+Kenneth%22">Rockwood, Kenneth</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Butler%2C+Laurie%22">Butler, Laurie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rapaport%2C+Penny%22">Rapaport, Penny</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beresford-Dent%2C+Jules%22">Beresford-Dent, Jules</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Geriatric+Psychiatry%22">International Journal of Geriatric Psychiatry</searchLink>. Oct2019, Vol. 34 Issue 10, p1386-1402. 17p. 1 Diagram, 5 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Dementia%22">Dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Reminiscence+therapy%22">Reminiscence therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Activities+of+daily+living%22">Activities of daily living</searchLink><br /><searchLink fieldCode="DE" term="%22Exercise+therapy%22">Exercise therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+of+dementia%22">Treatment of dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trials%22">Clinical trials</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+research%22">Evaluation research</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+cooperation%22">Medical cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Occupational+therapy%22">Occupational therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Group+psychotherapy%22">Group psychotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Psychotherapy%22">Psychotherapy</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Objective: </bold>Slowing functional decline could enable people living with dementia to live for longer and more independently in their own homes. We aimed to update previous syntheses examining the effectiveness of nonpharmacological interventions in reducing functional decline (activities of daily living, activity-specific physical functioning, or function-specific goal attainment) in people living in their own homes with dementia.<bold>Methods: </bold>We systematically searched electronic databases from January 2012 to May 2018; two researchers independently rated risk of bias of randomised controlled trials (RCTs) fitting predetermined inclusion criteria using a checklist; we narratively synthesised findings, prioritising studies judged to have a lower risk of bias.<bold>Results: </bold>Twenty-nine papers (describing 26 RCTs) met eligibility criteria, of which we judged 13 RCTs to have a lower risk of bias. Study interventions were evaluated in four groups: physical exercise, occupational, multicomponent, and cognition-oriented interventions. Four out of 13 RCTs reported functional ability as a primary outcome. In studies judged to have a lower risk of bias, in-home tailored exercise, individualised cognitive rehabilitation, and in-home activities-focussed occupational therapy significantly reduced functional decline relative to control groups in individual studies. There was consistent evidence from studies at low risk of bias that group-based exercise and reminiscence therapies were ineffective at reducing functional decline.<bold>Conclusion: </bold>We found no replicated evidence of intervention effectiveness in decreasing functional decline. Interventions associated with slower functional decline in individual trials have been individually delivered and tailored to the needs of the person with dementia. This is consistent with previous findings. Future intervention trials should prioritise these approaches. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of International Journal of Geriatric Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1002/gps.5127
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      – Code: eng
        Text: English
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        PageCount: 17
        StartPage: 1386
    Subjects:
      – SubjectFull: Meta-analysis
        Type: general
      – SubjectFull: Dementia
        Type: general
      – SubjectFull: Reminiscence therapy
        Type: general
      – SubjectFull: Activities of daily living
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      – SubjectFull: Exercise therapy
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      – SubjectFull: Treatment of dementia
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      – SubjectFull: Research
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      – SubjectFull: Clinical trials
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      – SubjectFull: Research methodology
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      – SubjectFull: Systematic reviews
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      – SubjectFull: Occupational therapy
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      – SubjectFull: Group psychotherapy
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      – SubjectFull: Psychotherapy
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    Titles:
      – TitleFull: Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials.
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              M: 10
              Text: Oct2019
              Type: published
              Y: 2019
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