PMID- 38012101
OWN - NLM
STAT- Publisher
LR  - 20231127
IS  - 1447-0349 (Electronic)
IS  - 1445-8330 (Linking)
DP  - 2023 Nov 27
TI  - Comparative efficacy of multiple non-pharmacological interventions for 
      behavioural and psychological symptoms of dementia: A network meta-analysis of 
      randomised controlled trials.
LID - 10.1111/inm.13254 [doi]
AB  - Non-pharmacological interventions can improve the behavioural and psychological 
      symptoms of dementia (BPSD). However, the optimal non-pharmacological treatments 
      remain controversial. This study aimed to compare the efficacy of multiple 
      non-pharmacological methods and identify the optimal therapy for BPSD. Potential 
      randomised controlled trials (RCTs) were searched and selected from 15 databases 
      and sources from the inception of the databases until 1 October 2022. Two 
      independent authors implemented study screening, data extraction, and 
      methodological quality assessment. Primary outcome was reduction of 
      Neuropsychiatric Inventory (NPI). The secondary outcome were changes of Cornell 
      Scale for Depression in Dementia (CSDD), the Cohen-Mansfield Agitation Inventory 
      (CMAI), the Quality of Life in Alzheimer's Disease (QoL-AD), the Abilities of 
      Daily Living scale, and the Apathy Evaluation Scale. Meta-analyses were performed 
      using STATA v15.0 and ADDIS v1.16.8. The GRADE approaches were utilised to 
      evaluate evidence quality. The present study included 43 RCTs with 4978 
      participants. The global methodological quality of the RCTs was moderate. 
      Regarding NPI reduction, with moderate-certainty evidence, exercise plus 
      treatment as usual (TAU) outperformed TAU (mean difference [MD]: -7.13; 95% 
      confidence interval [CI]: -13.22, -0.76) and ranked as the optimal treatment. For 
      reduction in CSDD, with low- to moderate-certainty evidence, massage plus TAU 
      (MD: -15.26; 95% CI: -20.13, -10.52) and music plus TAU (MD: -2.40; 95% CI: 
      -4.62, -0.12) were associated with greater reduction compared with TAU. For 
      reduction in CMAI, with moderate-certainty evidence, aromatherapy plus massage 
      (MD: -15.84; 95% CI: -29.76, -2.42) and massage plus music (MD: -13.12; 95% CI: 
      -25.43, -0.76) were significantly more effective than TAU. For improvement in 
      QoL-AD, with critically low- to low-certainty evidence, there were no statistical 
      differences between any of non-pharmacological treatments and TAU. Due to the 
      limited number of included studies, network meta-analysis was not performed for 
      other outcomes. In conclusion, non-pharmacological treatments are effective for 
      overall symptoms, depression, and agitation. Exercise plus treatment as usual may 
      be an optimal non-pharmacological intervention for improving the overall BPSD. 
      This may help to guide patients, doctors, and policymakers.
CI  - (c) 2023 John Wiley & Sons Australia, Ltd.
FAU - Yin, Zihan
AU  - Yin Z
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Li, Yaqin
AU  - Li Y
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
FAU - Bao, Qiongnan
AU  - Bao Q
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Zhang, Xinyue
AU  - Zhang X
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Xia, Manze
AU  - Xia M
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Zhong, Wanqi
AU  - Zhong W
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Wu, Kexin
AU  - Wu K
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Yao, Jin
AU  - Yao J
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Chen, Zhenghong
AU  - Chen Z
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Sun, Mingsheng
AU  - Sun M
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Zhao, Ling
AU  - Zhao L
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
FAU - Liang, Fanrong
AU  - Liang F
AD  - School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, 
      Chengdu, China.
AD  - Acupuncture Clinical Research Center of Sichuan Province, Chengdu, China.
LA  - eng
GR  - 81973961/National Natural Science Foundation of China/
GR  - 82004486/National Natural Science Foundation of China/
GR  - 2021YFS0087/Project of Science and Technology Department of Sichuan Province/
GR  - 2019YFC1709700/State Administration of Traditional Chinese Medicine, National Key 
      Research and Development Program of China/
PT  - Journal Article
PT  - Review
DEP - 20231127
PL  - Australia
TA  - Int J Ment Health Nurs
JT  - International journal of mental health nursing
JID - 101140527
OTO - NOTNLM
OT  - BPSD
OT  - network meta-analysis
OT  - non-pharmacological intervention
EDAT- 2023/11/28 00:42
MHDA- 2023/11/28 00:42
CRDT- 2023/11/27 22:53
PHST- 2023/10/14 00:00 [revised]
PHST- 2023/05/22 00:00 [received]
PHST- 2023/10/31 00:00 [accepted]
PHST- 2023/11/28 00:42 [medline]
PHST- 2023/11/28 00:42 [pubmed]
PHST- 2023/11/27 22:53 [entrez]
AID - 10.1111/inm.13254 [doi]
PST - aheadofprint
SO  - Int J Ment Health Nurs. 2023 Nov 27. doi: 10.1111/inm.13254.