Reviewing the evidence on how to treat and care for people with early-stage dementia without drugs
Research project: Non-pharmacological interventions for patients with dementia and their carers: a systematic mapping review of experimental studies involving patients living in the community
Lead investigator: Professor Carol Brayne
Institution: University of Cambridge
Grant type: Project
Duration: 1 year
This project was supported in part by the family of Miriam Frances Clement.
What was the project, and what did the researchers do?
While some drugs can improve the symptoms of dementia and temporarily slow down its progression they may not work for everyone. There may also be a number of side effects from taking these drugs such as feeling sick, loss of appetite, dizziness and headaches. Other techniques that do not use drugs (called 'non-pharmacological interventions') have also been tested as treatments for dementia; examples of these interventions include counselling, education, light therapy and music therapy. Researchers hope that these 'non-pharmacological interventions' will help people with dementia and their carers, but it is not clear how well these treatments have been researched or what benefits they may have.
This research reviewed the scientific literature to examine which interventions have been studied and how. With this information, Professor Brayne was able to make recommendations about next steps for research in this area to improve understanding of this subject.
What were the key results, and how will this help in the fight against dementia?
The review looked at hundreds of papers on a wide range of interventions. Professor Brayne and her team found that there were many issues with these studies, and were not able to show that any intervention was more effective than another.
The researchers have made several recommendations of what they believe could improve studies of non-pharmacological interventions.
They suggest that more studies are needed, and that these studies need more participants. The team found there were not enough studies of different interventions to draw conclusions about the effectiveness of any intervention. The studies also tended to study small numbers of participants - having a large number of participants in a study is very important, as it ensures that the results are as representative of reality as possible.
They made several other recommendations. They suggest researchers need to address the quality of their reports. Also, they suggest standard measures for effectiveness of interventions should be agreed on by the dementia research community so that comparisons between studies are more informative when the studies have used the same or similar measures. Finally, Professor Brayne’s team suggest that the research portfolio should have more ‘balance’. In particular, the review showed that there are few studies that investigate how an intervention may affect carers.
This review has shown many potential problems with the current research on non-drug interventions for dementia. This result and the recommendations provided may help indicate how future research into non-pharmacological Alzheimer's interventions could be improved, providing more robust evidence for the treatments studied.
What happened next? Future work and additional grants
Professor Brayne's team hopes to conduct more in depth reviews into the research around particular interventions. They will apply for more funding to continue this work.
How were people told about the results? Conferences and publications
Lafortune L*, Martin S*, Chinnock P, Lafortune L, Brayne C. Non-pharmacological interventions for community-dwelling people with dementia and their caregivers: a systematic review of interventions, outcomes measured and study quality. *Joint first authorship. In preparation.
Lafortune L*, Martin S*, Chinnock P, Lafortune L, Brayne C. A review of community-based interventions in dementia research: Towards a standard reporting of interventions and outcomes. *Joint first authorship. In preparation.
Martin S*, Lafortune L, Chinnock P, Lafortune L, Brayne C. Core outcome measures in effectiveness trials of non-pharmacological community-based interventions. *Joint first authorship In preparation.