title: [Non-pharmacological treatment of dementia in geriatric psychiatry care units : Scoping review].
abstract: BACKGROUND
  The number of persons suffering from dementia will continuously increase in the coming years; therefore, evidence-based interventions are needed in geriatric psychiatric care. When evidence is poor scoping reviews may help to identify knowledge gaps and needs for research.
  
  
  OBJECTIVE
  To present an overview of clinical trials on non-pharmacological treatment for elderly with dementia in hospitals, wards and nursing homes, specializing in gerontopsychiatric care.
  
  
  METHODS
  A systematic search was carried out by one of the authors for clinical trials (randomized controlled, controlled and single group pre-post design, English and German, 1998-2014) in PsycINFO, PubMED, PSYNDEX and the Cochrane Library as well as a manual search in two relevant German peer-reviewed journals. Two authors included studies according to a priori defined inclusion criteria. One author extracted data after consulting the second author in cases of ambiguity. The risk of bias of the studies was not assessed.
  
  
  CONCLUSIONS
  A total of 77 studies were identified, 29 studies on restructured treatment pathways or settings, 14 trials on environmental changes and 34 studies on therapeutic single or group interventions. Both the methodological quality of the studies and the evidence for the efficacy of non-pharmacological treatment were limited. There are clear indications for an advantage of specialized environments and treatment settings for the elderly with dementia in hospitals, wards and nursing homes. There are consistent indications for positive effects of psychosocial activation alone or in combination with cognitive or physical activation, partly with high-quality study designs. This is consistent with the German S3 guidelines for dementia. For single interventions, such as electroconvulsive therapy or horticultural activities, the level of evidence remains limited.
authors.affiliation: Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Lehener Str. 88, 79106, Freiburg, Deutschland. anne.goehner@uniklinik-freiburg.de.
authors.forename: Anne
authors.identifier: http://orcid.org/0000-0002-4642-4699
authors.initials: A
authors.lastname: Göhner
authors.affiliation: Klinik für Alterspsychiatrie und Psychotherapie, Klinik für Psychiatrie und Psychotherapie, Zentrum für Psychiatrie Emmendingen, Universitätsklinikum Freiburg, Emmendingen, Freiburg, Deutschland.
authors.forename: Michael
authors.initials: M
authors.lastname: Hüll
authors.affiliation: Cochrane Deutschland, Universitätsklinikum Freiburg, Freiburg, Deutschland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Voigt-Radloff
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005069:Evaluation Studies as Topic; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany; D006707:Homes for the Aged; D006769:Hospitals, General; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009735:Nursing Homes; D011567:Psychiatric Department, Hospital; D016032:Randomized Controlled Trials as Topic
keywords: Activities of daily living; Cognition; Inpatients; Intervention study; Neuropsychiatric symptoms