Nonpharmacological dementia interventions may be more effective in reducing aggression, agitation
Nonpharmacologic interventions, including massage and touch therapy, may be more effective than pharmacologic methods in reducing aggression and agitation in adults with dementia, according to findings published in the Annals of Internal Medicine.
“Reducing symptoms of aggression and agitation can facilitate the safe provision of personal care to persons living with dementia by their caregivers,” Jennifer A. Watt, MD, PhD, a geriatrician at St. Michael's Hospital-Unity Health in Toronto, Canada, told Healio Primary Care.
Watt noted that although certain medications used to treat dementia have been associated with potential harms, including mortality, they are still used frequently.
To compare the efficacy of pharmacologic and nonpharmacologic interventions to treat aggression and agitation in dementia patients, researchers conducted a systematic review and network meta-analysis of randomized control trials comparing these interventions.
The researchers included 163 studies involving 23,143 patients in their analysis.
Among 148 studies of interventions that focused on aggression and agitation in patients with dementia, researchers found that multidisciplinary care (standardized mean difference [SMD] = –0.5; 95% credible interval [CrI], –0.99 to –0.01), massage and touch therapy (SMD = –0.75; 95% CrI, –1.12 to –0.38), and music combined with massage and touch therapy (SMD = –0.91; 95% CrI, –1.75 to –0.07) were more effective in reducing symptoms than usual care with medications.
The researchers also found that recreation therapy was statistically but not clinically more efficacious than usual care (SMD = –0.29; 95% CrI, –0.57 to –0.01).
“Nonpharmacological interventions have not been associated with the same harmful outcomes as medications and, if possible, nonpharmacological interventions should be tried first,” said Watt, who is also an assistant professor in the department of medicine at the University of Toronto.
“Primary care physicians and allied health professionals can offer to work with patients and their caregivers to help them understand available resources in their area to support the implementation of nonpharmacological interventions,” she continued. – by Erin Michael
Disclosures: The authors report no relevant financial disclosures.