title: Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials.
abstract: BACKGROUND
  Agitation in dementia is common, persistent and distressing and can lead to care breakdown. Medication is often ineffective and harmful.
  
  
  OBJECTIVE
  To systematically review randomised controlled trial evidence regarding non-pharmacological interventions. Method We reviewed 33 studies fitting predetermined criteria, assessed their validity and calculated standardised effect sizes (SES).
  
  
  RESULTS
  Person-centred care, communication skills training and adapted dementia care mapping decreased symptomatic and severe agitation in care homes immediately (SES range 0.3-1.8) and for up to 6 months afterwards (SES range 0.2-2.2). Activities and music therapy by protocol (SES range 0.5-0.6) decreased overall agitation and sensory intervention decreased clinically significant agitation immediately. Aromatherapy and light therapy did not demonstrate efficacy.
  
  
  CONCLUSIONS
  There are evidence-based strategies for care homes. Future interventions should focus on consistent and long-term implementation through staff training. Further research is needed for people living in their own homes.
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Lynsey
authors.initials: L
authors.lastname: Kelly
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Elanor
authors.initials: E
authors.lastname: Lewis-Holmes
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Baio
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Morris
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Nishma
authors.initials: N
authors.lastname: Patel
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Rumana Z
authors.initials: RZ
authors.lastname: Omar
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Cornelius
authors.initials: C
authors.lastname: Katona
authors.affiliation: Gill Livingston, MD, Lynsey Kelly, BSc, Elanor Lewis-Holmes, BSc, Unit of Mental Health Sciences, Gianluca Baio, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Stephen Morris, PhD, Nishma Patel, MSc, Department of Applied Health Research, Rumana Z. Omar, PhD, Departments of Statistical Science and PRIMENT Clinical Trials Unit, Cornelius Katona, MD, Claudia Cooper, PhD, Unit of Mental Health Sciences, University College London, UK.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
mesh_terms: D001526:Behavioral Symptoms / Q000209:etiology / Q000523:psychology / Q000628:therapy; D002983:Clinical Competence; D003704:Dementia / Q000150:complications / Q000523:psychology; D055317:Evidence-Based Practice; D006801:Humans; D009147:Music Therapy / Q000379:methods*; D018802:Patient-Centered Care / Q000379:methods / Q000458:organization & administration; D011595:Psychomotor Agitation / Q000209:etiology / Q000523:psychology / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D012960:Socioenvironmental Therapy / Q000379:methods*