title: Impact of Multisensory Environments on Behavior for People With Dementia: A Systematic Literature Review.
abstract: OBJECTIVE
  Behavioral and psychological symptoms of dementia (BPSD) affect quality of life for people with dementia. Nonpharmacological interventions are the preferred first line of treatment, and it is theorized that BPSD are directly influenced by sensory imbalance and improved by sensory equilibrium. The purpose of this article is to investigate the evidence regarding the use of multisensory environments (MSEs) as treatment for BPSD.
  
  
  METHODS
  A systematic literature review was performed using the PICO framework within PsycINFO, Web of Science, ERIC, PubMED, and Cinahl databases, as well as additional hand-searched documents. Included articles were published during 1990 to 2015 and report empirical studies of MSE BPSD interventions that include furniture, fixtures, and equipment to provide visual, auditory, tactile, and olfactory stimulation. Desired elements include ergonomic vibroacoustic furniture, bubble tubes, color-changing lights, and fiber optics.
  
  
  RESULTS
  Twelve articles met the inclusion criteria for review. Evidence supports the positive impact of sensory stimulation as a nonpharmacological behavioral treatment for dementia. Many studies investigated both behavior and mood, and several investigated biomedical parameters including heart rate and cognition. Significant differences were not found in the between-group studies when MSE was compared with other one-to-one interventions. Results on long-term effects were mixed. Variations can be seen in terms of research methods, types of environmental interventions, duration, and specific characteristics of participants, thus confounding the reliability of findings.
  
  
  CONCLUSIONS
  Key findings and directions for future research are discussed including primary outcomes, study design, environmental intervention types, and relevant assessment tools.
authors.affiliation: Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville.
authors.forename: Lesa N
authors.initials: LN
authors.lastname: Lorusso
authors.affiliation: Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville.
authors.forename: Sheila J
authors.initials: SJ
authors.lastname: Bosch
mesh_terms: D000161:Acoustic Stimulation; D000339:Affect; D003704:Dementia / Q000534:rehabilitation*; D006801:Humans; D010775:Photic Stimulation; D000066553:Problem Behavior; D011788:Quality of Life; D012677:Sensation