PMID- 29143695
OWN - NLM
STAT- MEDLINE
DCOM- 20190124
LR  - 20220409
IS  - 1741-203X (Electronic)
IS  - 1041-6102 (Linking)
VI  - 30
IP  - 3
DP  - 2018 Mar
TI  - An overview of systematic reviews of pharmacological and non-pharmacological 
      interventions for the treatment of behavioral and psychological symptoms of 
      dementia.
PG  - 295-309
LID - 10.1017/S1041610217002344 [doi]
AB  - ABSTRACTBackground:This systematic overview reports findings from systematic 
      reviews of randomized controlled trials of pharmacological and 
      non-pharmacological interventions for behavioural and psychological symptoms of 
      dementia (BPSD). METHODS: The Cochrane Database of Systematic Reviews, DARE, 
      Medline, EMBASE, and PsycINFO were searched to September 2015. RESULTS: Fifteen 
      systematic reviews of eighteen different interventions were included. A 
      significant improvement in BPSD was seen with: functional analysis-based 
      interventions (GRADE quality of evidence moderate; standardized mean difference 
      (SMD) -0.10, 95%CI -0.20 to 0.00), music therapy (low; SMD -0.49, 95%CI -0.82 to 
      -0.17), analgesics (low; SMD -0.24, 95%CI -0.47 to -0.01), donepezil (high; SMD 
      -0.15 95% CI -0.29 to -0.01), galantamine (high; SMD -0.15, 95%CI -0.28 to 
      -0.03), and antipsychotics (high; SMD -0.13, 95%CI -0.21 to -0.06). The estimate 
      of effect size for most interventions was small. CONCLUSIONS: Although some 
      pharmacological interventions had a slightly larger effect size, current evidence 
      suggests functional analysis-based interventions should be used as first line 
      management of BPSD whenever possible due to the lack of associated adverse 
      events. Music therapy may also be beneficial, but further research is required as 
      the quality of evidence to support its use is low. Cholinesterase inhibitors 
      donepezil and galantamine should be trialled for the management of BPSD where 
      non-pharmacological treatments have failed. Low-quality evidence suggests that 
      assessment of pain should be conducted and a stepped analgesic approach trialled 
      when appropriate. Antipsychotics have proven effectiveness but should be avoided 
      where possible due to the high risk of serious adverse events and availability of 
      safer alternatives.
FAU - Dyer, Suzanne M
AU  - Dyer SM
AD  - Department of Rehabilitation,Aged and Extended Care,Faculty of Medicine,Nursing 
      and Health Sciences,School of Health Sciences,Flinders University,Level 1,C 
      Block,Repatriation General Hospital,Daw Park,SA,Australia.
FAU - Harrison, Stephanie L
AU  - Harrison SL
AD  - Department of Rehabilitation,Aged and Extended Care,Faculty of Medicine,Nursing 
      and Health Sciences,School of Health Sciences,Flinders University,Level 1,C 
      Block,Repatriation General Hospital,Daw Park,SA,Australia.
FAU - Laver, Kate
AU  - Laver K
AD  - Department of Rehabilitation,Aged and Extended Care,Faculty of Medicine,Nursing 
      and Health Sciences,School of Health Sciences,Flinders University,Level 1,C 
      Block,Repatriation General Hospital,Daw Park,SA,Australia.
FAU - Whitehead, Craig
AU  - Whitehead C
AD  - Department of Rehabilitation,Aged and Extended Care,Faculty of Medicine,Nursing 
      and Health Sciences,School of Health Sciences,Flinders University,Level 1,C 
      Block,Repatriation General Hospital,Daw Park,SA,Australia.
FAU - Crotty, Maria
AU  - Crotty M
AD  - Department of Rehabilitation,Aged and Extended Care,Faculty of Medicine,Nursing 
      and Health Sciences,School of Health Sciences,Flinders University,Level 1,C 
      Block,Repatriation General Hospital,Daw Park,SA,Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20171116
PL  - England
TA  - Int Psychogeriatr
JT  - International psychogeriatrics
JID - 9007918
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Cholinesterase Inhibitors)
SB  - IM
MH  - Antipsychotic Agents/*therapeutic use
MH  - Behavioral Symptoms/complications/*therapy
MH  - Cholinesterase Inhibitors/*therapeutic use
MH  - Complementary Therapies
MH  - Dementia/psychology/*therapy
MH  - Humans
MH  - Mental Disorders/complications/*drug therapy
MH  - *Music Therapy
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - antipsychotics
OT  - behavioral symptoms
OT  - cholinesterase inhibitors
OT  - complementary therapies
OT  - dementia
OT  - systematic review
EDAT- 2017/11/17 06:00
MHDA- 2019/01/25 06:00
CRDT- 2017/11/17 06:00
PHST- 2017/11/17 06:00 [pubmed]
PHST- 2019/01/25 06:00 [medline]
PHST- 2017/11/17 06:00 [entrez]
AID - S1041610217002344 [pii]
AID - 10.1017/S1041610217002344 [doi]
PST - ppublish
SO  - Int Psychogeriatr. 2018 Mar;30(3):295-309. doi: 10.1017/S1041610217002344. Epub 
      2017 Nov 16.