Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia

Gill Livingston, Kate Johnston, Cornelius Katona, Joni Paton, Constantine G Lyketsos

Research output: Contribution to journalArticle

Abstract

Objective: The authors systematically reviewed the literature on psychological approaches to treating the neuropsychiatric symptoms of dementia. Method: Reports of studies that examined effects of any therapy derived from a psychological approach that satisfied pre-specified criteria were reviewed. Data were extracted, the quality of each study was rated, and an overall rating was given to each study by using the Oxford Centre for Evidence-Based Medicine criteria. Results: A total of 1,632 studies were identified, and 162 satisfied the inclusion criteria for the review. Specific types of psychoeducation for caregivers about managing neuropsychiatric symptoms were effective treatments whose benefits lasted for months, but other caregiver interventions were not. Behavioral management techniques that are centered on individual patients' behavior or on caregiver behavior had similar benefits, as did cognitive stimulation. Music therapy and Snoezelen, and possibly sensory stimulation, were useful during the treatment session but had no longer-term effects; interventions that changed the visual environment looked promising, but more research is needed. Conclusions: Only behavior management therapies, specific types of caregiver and residential care staff education, and possibly cognitive stimulation appear to have lasting effectiveness for the management of dementia-associated neuropsychiatric symptoms. Lack of evidence regarding other therapies is not evidence of lack of efficacy. Conclusions are limited because of the paucity of high-quality research (only nine level-1 studies were identified). More high-quality investigation is needed.

Original languageEnglish (US)
Pages (from-to)1996-2021
Number of pages26
JournalAmerican Journal of Psychiatry
Volume162
Issue number11
DOIs
StatePublished - Nov 2005
Externally publishedYes

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Caregivers
Dementia
Psychology
Music Therapy
Behavior Therapy
Evidence-Based Medicine
Therapeutics
Research
Education

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. / Livingston, Gill; Johnston, Kate; Katona, Cornelius; Paton, Joni; Lyketsos, Constantine G.

In: American Journal of Psychiatry, Vol. 162, No. 11, 11.2005, p. 1996-2021.

Research output: Contribution to journalArticle

Livingston, Gill ; Johnston, Kate ; Katona, Cornelius ; Paton, Joni ; Lyketsos, Constantine G. / Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. In: American Journal of Psychiatry. 2005 ; Vol. 162, No. 11. pp. 1996-2021.
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