[Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis].
OBJECTIVE
This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia.


METHODS
Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the 'meta' package and the Comprehensive Meta-Analysis (CMA 2.0) program.


RESULTS
Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as '++' for eight studies and '+' for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges' g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity (I²=62.8%), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected.


CONCLUSIONS
Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia pateints.
Department of Psychotherapy, College of Nursing and Public Health, Kyungil University, Kyungsan, Korea.
Eun Young
EY
Kim
Department of Social Welfare, College of Social Science, Kyungpook National University, Daegu, Korea.
Sung Dong
SD
Hwang
Department of Nursing, College of Health and Medical Science, Daejeon University, Korea. ejkim@dju.kr.
Eun Joo
EJ
Kim
D000161:Acoustic Stimulation; D016208:Databases, Factual; D003704:Dementia / Q000451:nursing / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D009147:Music Therapy; D000066553:Problem Behavior; D026421:Sensory Art Therapies
Acoustic stimulation; Behavioral symptoms; Dementia; Meta-analysis; Sensory art therapies