Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series

Iosief Abraha, Joseph M Rimland, Fabiana Mirella Trotta, Giuseppina Dell'Aquila, Alfonso Cruz-Jentoft, Mirko Petrovic, Adalsteinn Gudmundsson, Roy Soiza, Denis O'Mahony, Antonio Guaita, Antonio Cherubini

Research output: Contribution to journalReview articlepeer-review

285 Citations (Scopus)
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OBJECTIVE: To provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD).

DESIGN: Systematic overview of reviews.

DATA SOURCES: PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015).

ELIGIBILITY CRITERIA: Systematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD.

DATA EXTRACTION: Eligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs.

DATA ANALYSIS: Extracted data were synthesised using a narrative approach.

RESULTS: 38 SRs and 129 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (25 SRs, 66 primary studies) that encompassed: shiatsu and acupressure, aromatherapy, massage/touch therapy, light therapy, sensory garden and horticultural activities, music/dance therapy, dance therapy, snoezelen multisensory stimulation therapy, transcutaneous electrical nerve stimulation; (2) cognitive/emotion-oriented interventions (13 SRs; 26 primary studies) that included cognitive stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 22 primary studies); (4) Multicomponent interventions (3 SR; four primary studies); (5) other therapies (5 SRs, 15 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions.

CONCLUSIONS: A large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.

Original languageEnglish
Article numbere012759
JournalBMJ Open
Issue number3
Early online date16 Mar 2017
Publication statusPublished - 2017


  • Aged
  • Aged, 80 and over
  • Anxiety
  • Cognitive Therapy
  • Complementary Therapies
  • Dementia
  • Home Care Services
  • Humans
  • Phototherapy
  • Physical Therapy Modalities
  • Psychomotor Agitation
  • Review Literature as Topic
  • Journal Article
  • Review
  • Research Support, Non-U.S. Gov't


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