What do Cochrane systematic reviews say about non-pharmacological interventions for treating cognitive decline and dementia?
Author: Vilela VC1, Pacheco RL1, Latorraca COC2, Pachito DV3, Riera R4
Affiliation:
1Undergraduate Medical Student, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
2Master and Psychologist, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
3Master of Science, Neurologist and Doctoral Student, Evidence-Based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil; and Assistant Researcher, Cochrane Brazil, São Paulo (SP), Brazil.
4Doctor and Master of Science, Rheumatologist and Adjunct Professor, Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP); and Assistant Coordinator, Cochrane Brazil, São Paulo (SP), Brazil.
Conference/Journal: Sao Paulo Med J.
Date published: 2017 May-Jun
Other:
Volume ID: 135 , Issue ID: 3 , Pages: 309-320 , Special Notes: doi: 10.1590/1516-3180.2017.0092060617. , Word Count: 232
BACKGROUND:: Dementia is a highly prevalent condition worldwide. Its chronic and progressive presentation has an impact on physical and psychosocial characteristics and on public healthcare. Our aim was to summarize evidence from Cochrane reviews on non-pharmacological treatments for cognitive disorders and dementia.
DESIGN AND SETTING:: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo.
METHODS:: Cochrane reviews on non-pharmacological interventions for cognitive dysfunctions and/or type of dementia were included. For this, independent assessments were made by two authors.
RESULTS:: Twenty-four reviews were included. These showed that carbohydrate intake and validation therapy may be beneficial for cognitive disorders. For dementia, there is a potential benefit from physical activity programs, cognitive training, psychological treatments, aromatherapy, light therapy, cognitive rehabilitation, cognitive stimulation, hyperbaric oxygen therapy in association with donepezil, functional analysis, reminiscence therapy, transcutaneous electrical stimulation, structured decision-making on feeding options, case management approaches, interventions by non-specialist healthcare workers and specialized care units. No benefits were found in relation to enteral tube feeding, acupuncture, Snoezelen stimulation, respite care, palliative care team and interventions to prevent wandering behavior.
CONCLUSION:: Many non-pharmacological interventions for patients with cognitive impairment and dementia have been studied and potential benefits have been shown. However, the strength of evidence derived from these studies was considered low overall, due to the methodological limitations of the primary studies.
PMID: 28746664 DOI: 10.1590/1516-3180.2017.0092060617
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