背景:非药物干预被认为是治疗痴呆的行为和心理症状的一线治疗方法。鉴于这些症状的异质性特征,每个人都不同,而且往往会波动,针对痴呆症患者提供个性化的非药物干预措施需要针对症状的方法.然而,目前缺乏针对痴呆的个体症状或行为和心理症状群的适当干预措施的明确指南.
目的:本综述旨在总结目前对痴呆的行为和心理症状进行非药物干预的证据,并为确定针对痴呆的每种行为和心理症状的适当干预类型提供指导。
方法:系统综述和/或荟萃分析。
方法:本综述采用了Cochrane总括性综述方法,并注册了审查方案。PubMed,CINAHL,Embase,PsycINFO,和Cochrane数据库使用\'人口搜索相关评论,干预,control,和结果制定。两名审稿人独立筛选了提取的文章的资格。每个选定的审查的质量由两名审查者使用评估系统审查2的测量工具独立评估。根据每种症状对结果进行叙述合成和分类。
结果:35项系统评价,其中71%也是荟萃分析,包括在这次审查中。纳入的评论中采用的方法具有明显的异质性。评论的质量从低到中等不等。在综述中发现了各种类型的非药物干预措施,音乐疗法是最经常讨论的。在各种症状中,抑郁症是最常见的问题,其次是总体症状,激动,焦虑,睡眠问题,和冷漠。发现音乐疗法可有效改善整体和特定症状,包括抑郁和焦虑.值得注意的是,相对薄弱的证据支持运动在解决每种症状方面的有效性。芳香疗法可以考虑用于躁动,而回忆可能有效地管理整体和特定的症状,比如抑郁症。
结论:结果表明,非药物干预的症状特异性有效性的证据因痴呆症的不同行为和心理症状而异,强调在未来的研究中需要针对症状的方法。此外,未来的研究需要促进制定症状特异性指南,以提高个性化痴呆护理的质量.
背景:于2022年11月9日在PROSPERO(编号:CRD42022340930)注册。
BACKGROUND: Non-pharmacological interventions are considered the first-line treatment for managing the behavioral and psychological symptoms of dementia. Given the heterogeneous characteristics of these symptoms, which vary for each individual and tend to fluctuate, a symptom-specific approach is necessary for providing individualized non-pharmacological interventions for people with dementia. However, clear guidelines regarding the appropriate types of interventions for individual symptoms or clusters of behavioral and psychological symptoms of dementia are lacking.
OBJECTIVE: The aim of this umbrella review was to summarize the current evidence on non-pharmacological interventions for behavioral and psychological symptoms of dementia and provide guidance for determining the appropriate types of interventions for each behavioral and psychological symptom of dementia.
METHODS: An umbrella review of systematic reviews and/or meta-analyses.
METHODS: The Cochrane methodology for umbrella reviews was employed for this review, and the review protocol was registered. PubMed, CINAHL, Embase, PsycINFO, and Cochrane databases were searched for relevant reviews using the \'population, intervention, control, and outcomes\' formulation. Two reviewers independently screened the extracted articles for eligibility. The quality of each selected review was independently assessed by the two reviewers using A Measurement Tool to Assess Systematic Reviews 2. The results were narratively synthesized and categorized according to each symptom.
RESULTS: Thirty-five systematic reviews, 71 % of which were also meta-analyses, were included in this review. The methodologies employed in the included reviews were significantly heterogeneous. The qualities of the reviews ranged from low to moderate. Diverse types of non-pharmacological interventions were identified in the reviews, with music therapy being the most frequently discussed. Among the various symptoms, depression was most frequently addressed, followed by overall symptoms, agitation, anxiety, sleep problems, and apathy. Music therapy was found to be effective for improving both overall and specific symptoms, including depression and anxiety. Notably, relatively weak evidence supports the effectiveness of exercise in addressing each symptom. Aromatherapy could be considered for agitation, whereas reminiscence may be effective in managing overall and specific symptoms, such as depression.
CONCLUSIONS: The results showed that the evidence of symptom-specific effectiveness of non-pharmacological interventions varied across the different behavioral and psychological symptoms of dementia, highlighting the need for a symptom-specific approach in future research. Furthermore, future research is needed to facilitate the development of symptom-specific guidelines that can enhance the quality of individualized dementia care.
BACKGROUND: Registered with PROSPERO (number: CRD42022340930) on November 9, 2022.