title: A Systematic Review of Montessori-Based Activities for Persons With Dementia.
abstract: OBJECTIVE
  Montessori-based activities are becoming a popular approach for the care of older adults living with dementia. The aim of this study was to systematically assess the quality of the research examining the benefits of Montessori-based activities for persons with dementia.
  
  
  METHODS
  Six peer-reviewed databases were systematically searched for all relevant articles published until April 2015. Included articles were peer-reviewed studies published in English that employed Montessori-based activities with persons with dementia. Methodological quality was assessed by 2 independent raters using the Physiotherapy Evidence Database Scale or the Downs and Black evaluation tool. Levels of evidence were assigned to the study design using a modified Sackett scale.
  
  
  RESULTS
  One hundred fifty articles were identified, and 14 were selected for inclusion. Level-2 evidence examining the impact of Montessori-based activities on eating behaviors suggested that difficulties with eating could be reduced with Montessori training. There was limited level-4 evidence for the benefits of Montessori-based activities on cognition, wherein benefits appeared to be specific to lower-level cognitive abilities including memory and attention. Finally, there is level-1 (n = 1), level-2 (n = 3), and level-4 (n = 6) evidence for the benefits of Montessori-based activities on engagement and affect, whereby constructive engagement and positive affect were heightened.
  
  
  CONCLUSIONS
  Overall, there is a strong level of evidence for the benefits of Montessori-based activities on eating behaviors and weak evidence for the benefits on cognition. Evidence for the benefits of Montessori-based activities on engagement and affect are mixed. Future research is needed to examine the long-term benefits of Montessori-based activities.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada. Electronic address: Christine.sheppard@uwaterloo.ca.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Sheppard
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Caitlin
authors.initials: C
authors.lastname: McArthur
authors.affiliation: Institute for the Life Course and Aging, University of Toronto, Toronto, Ontario, Canada; School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
authors.forename: Sander L
authors.initials: SL
authors.lastname: Hitzig
mesh_terms: D000203:Activities of Daily Living; D016208:Databases, Factual; D003704:Dementia / Q000451:nursing* / Q000534:rehabilitation*; D004435:Eating; D006801:Humans; D012046:Rehabilitation / Q000379:methods*
keywords: Alzheimer disease; Montessori Methods; dementia; systematic review