title: Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review.
abstract: BACKGROUND
  Behavioral and psychological symptoms of dementia (BPSD) are defined as a group of symptoms of disturbed perceptive thought content, mood, or behavior that include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, and wandering. Care of patients with BPSD involves pharmacological and nonpharmacological interventions. We reviewed studies of nonpharmacological interventions published in the last 10 years.
  
  
  METHODS
  We performed a systematic review in Medline and Embase databases, in the last 10 years, until June 2015. Key words used were (1) non-pharmacological interventions, (2) behavioral symptoms, (3) psychological symptoms, and (4) dementia.
  
  
  RESULTS
  We included 20 studies published in this period. Among these studies, program activities were more frequent (five studies) and the symptoms more responsive to the interventions were agitation.
  
  
  CONCLUSIONS
  Studies are heterogeneous in many aspects, including size sample, intervention, and instruments of measures.
  
  
  CONCLUSIONS
  Nonpharmacological interventions are able to provide positive results in reducing symptoms of BPSD. Most studies have shown that these interventions have important and significant efficacy.
authors.affiliation: Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil ; Occupational Therapy Service, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil.
authors.forename: Alexandra Martini
authors.initials: AM
authors.lastname: de Oliveira
authors.affiliation: Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil.
authors.forename: Marcia
authors.initials: M
authors.lastname: Radanovic
authors.affiliation: Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil ; Occupational Therapy Service, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil.
authors.forename: Patrícia Cotting Homem
authors.initials: PC
authors.lastname: de Mello
authors.affiliation: Occupational Therapy Service, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil.
authors.forename: Patrícia Cardoso
authors.initials: PC
authors.lastname: Buchain
authors.affiliation: Occupational Therapy Service, Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil.
authors.forename: Adriana Dias Barbosa
authors.initials: AD
authors.lastname: Vizzotto
authors.affiliation: Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil.
authors.forename: Diego L
authors.initials: DL
authors.lastname: Celestino
authors.affiliation: Biosciences Institute, Universidade Estadual Paulista (UNESP), 13506-900 Rio Claro, SP, Brazil.
authors.forename: Florindo
authors.initials: F
authors.lastname: Stella
authors.affiliation: Department of Occupational Therapy, Clinical Director, Jefferson Elder Care, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Catherine V
authors.initials: CV
authors.lastname: Piersol
authors.affiliation: Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, 05403-010 São Paulo, SP, Brazil.
authors.forename: Orestes V
authors.initials: OV
authors.lastname: Forlenza
mesh_terms: D000374:Aggression / Q000502:physiology / Q000523:psychology; D003704:Dementia / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D003863:Depression / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D026201:Musculoskeletal Manipulations; D011595:Psychomotor Agitation / Q000503:physiopathology / Q000628:therapy; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy