title: Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia.
abstract: BACKGROUND
  People with dementia report lower quality of life, but we know little about what interventions might improve it.
  
  
  METHODS
  We systematically reviewed 20 randomized controlled trials reporting the effectiveness of non-pharmacological interventions in improving quality of life or well-being of people with dementia meeting predetermined criteria. We rated study validity with a checklist. We contacted authors for additional data. We calculated standardized mean differences (SMD) and, for studies reporting similar interventions, pooled standardized effect sizes (SES).
  
  
  RESULTS
  Pooled analyses found that family carer coping strategy-based interventions (four studies, which did not individually achieve significance; n = 420; SES 0.24 (range 0.03-0.45)) and combined patient activity and family carer coping interventions (two studies, not individually significant; n = 191; SES 0.84 (range 0.54-1.14)) might improve quality of life. In one high-quality study, a care management system improved quality of life of people with dementia living at home. Group Cognitive Stimulation Therapy (GCST) improved quality of life of people with dementia in care homes.
  
  
  CONCLUSIONS
  Preliminary evidence indicated that coping strategy-based family carer therapy with or without a patient activity intervention improved quality of life of people with dementia living at home. GCST was the only effective intervention in a higher quality trial for those in care homes, but we did not find such evidence in the community. Few studies explored whether effects continued after the intervention stopped. Future research should explore the longer-term impact of interventions on, and devise strategies to increase, life quality of people with dementia living in care homes or at home without a family carer.
authors.affiliation: University College London, London, UK. c.cooper@ucl.ac.uk
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
authors.forename: Naaheed
authors.initials: N
authors.lastname: Mukadam
authors.forename: Cornelius
authors.initials: C
authors.lastname: Katona
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.forename: David
authors.initials: D
authors.lastname: Ames
authors.forename: Peter
authors.initials: P
authors.lastname: Rabins
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
authors.forename: Carlos
authors.initials: C
authors.lastname: de Mendonça Lima
authors.forename: Dan
authors.initials: D
authors.lastname: Blazer
authors.forename: Linda
authors.initials: L
authors.lastname: Teri
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005081:Exercise Therapy; D006299:Health Services for the Aged; D006699:Home Care Services; D006801:Humans; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome