Variation in Placebo Effect Sizes in Clinical Trials of Oral Interventions for Management of the Behavioral and Psychological Symptoms of Dementia (BPSD): A Systematic Review and Meta-Analysis

2017 ◽  
Vol 25 (9) ◽  
pp. 994-1008 ◽  
Author(s):  
Anna J. Hyde ◽  
Brian H. May ◽  
Charlie Changli Xue ◽  
Anthony L. Zhang
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Placebo Effect ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Behavioral And Psychological Symptoms

Do We Need a Meta-Analysis Update on Antipsychotic Treatment of Behavioral and Psychological Symptoms of Dementia?

2000 ◽  
Vol 12 (S1) ◽  
pp. 305-311 ◽  
Author(s):  
Lon S. Schneider
Keyword(s):  
Clinical Trials ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Antipsychotic Treatment ◽  
Behavioral And Psychological Symptoms

Whether we need another meta-analysis of clinical trials of antipsychotic treatment of patients with behavioral and psychological symptoms of dementia (BPSD) depends on how we define meta analysis and our expectations for the results of such an analysis.

scholarly journals Herbal Medicine for Behavioral and Psychological Symptoms of Dementia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chan-Young Kwon ◽  
Boram Lee
Keyword(s):  
Systematic Review ◽  
Herbal Medicine ◽  
Global Health ◽  
Methodological Quality ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Complementary Therapy ◽  
Health Concern ◽  
Behavioral And Psychological Symptoms

Background: Dementia is a global health concern, causing serious health and socioeconomic burdens with population aging. The associated symptoms of dementia, called behavioral and psychological symptoms of dementia (BPSD), are factors contributing to the socioeconomic burden of dementia. Recently, herbal medicine (HM) has attracted attention as a potential complementary therapy for BPSD. Therefore, this systematic review was aimed at analyzing the effectiveness (or efficacy), safety, and research status of HM in BPSD management through a comprehensive review.Methods: Thirteen electronic databases were searched comprehensively. Related clinical studies published until December 28, 2020, were collected. The methodological quality was evaluated using tools such as the Cochrane Collaboration’s risk of bias tool according to the study design. The effectiveness (or efficacy) was analyzed for randomized controlled trials (RCTs) only, and when sufficient homogeneity was assured, effect estimates were presented as mean difference (MD) and risk ratio (RR), with 95% confidence interval (CIs), through a meta-analysis.Results: A total of 52 clinical studies, including 36 RCTs, were included in this review. As an adjunctive therapy, HM showed statistically significant benefits in BPSD severity assessed by the Behavior Pathology in Alzheimer’s Disease Rating Scale (combined with psychotropic drugs: MD = −3.48, 95% CI: −3.96 to −2.99; with anti-dementia drugs: MD = −2.81, 95% CI: −3.17 to −2.45) and Neuropsychiatric Inventory (with anti-dementia drugs: MD = −3.23, 95% CI: −4.06 to −2.40). Adverse events were significantly less frequent in the HM group (RR = 0.50; 95% CI: 0.28 to 0.88). However, the methodological quality of the RCTs included in this systematic review was not optimal overall.Conclusion: According to the findings of this review, HM may be associated with additional benefits in BPSD treatment, particularly when used as an adjunct to conventional medications, including psychotropic and anti-dementia drugs. However, considering the methodological quality of the included RCTs, this clinical evidence is not robust. Nevertheless, dementia is a global health concern, and considering the limitations of conventional psychotropic drugs for BPSD, a major cause of the disease burden, HM appears to be a promising complementary therapy that warrants further research.

Exercise training for managing behavioral and psychological symptoms in people with dementia: A systematic review and meta-analysis

2015 ◽  
Vol 24 ◽  
pp. 274-285 ◽  
Author(s):  
Philipe de Souto Barreto ◽  
Laurent Demougeot ◽  
Fabien Pillard ◽  
Maryse Lapeyre-Mestre ◽  
Yves Rolland
Keyword(s):  
Systematic Review ◽  
Exercise Training ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
People With Dementia ◽  
Behavioral And Psychological Symptoms

scholarly journals A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being

2016 ◽  
Vol 28 (11) ◽  
pp. 1761-1774 ◽  
Author(s):  
Alexandra Feast ◽  
Esme Moniz-Cook ◽  
Charlotte Stoner ◽  
Georgina Charlesworth ◽  
Martin Orrell
Keyword(s):  
Systematic Review ◽  
Motor Behavior ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Well Being ◽  
Future Research ◽  
The Individual ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:Behavioral and psychological symptoms in dementia (BPSD) are important predictors of institutionalization as well as caregiver burden and depression. Previous reviews have tended to group BPSD as one category with little focus on the role of the individual symptoms. This review investigates the role of the individual symptoms of BPSD in relation to the impact on different measures of family caregiver well-being.Methods:Systematic review and meta-analysis of papers published in English between 1980 and December 2015 reporting which BPSD affect caregiver well-being. Paper quality was appraised using the Downs and Black Checklist (1998).Results:Forty medium and high quality quantitative papers met the inclusion criteria, 16 were suitable to be included in a meta-analysis of mean distress scores. Depressive behaviors were the most distressing for caregivers followed by agitation/aggression and apathy. Euphoria was the least distressing. Correlation coefficients between mean total behavior scores and mean distress scores were pooled for four studies. Irritability, aberrant motor behavior and delusions were the most strongly correlated to distress, disinhibition was the least correlated.Conclusions:The evidence is not conclusive as to whether some BPSD impact caregiver well-being more than others. Studies which validly examined BPSD individually were limited, and the included studies used numerous measures of BPSD and numerous measures of caregiver well-being. Future research may benefit from a consistent measure of BPSD, examining BPSD individually, and by examining the causal mechanisms by which BPSD impact well-being by including caregiver variables so that interventions can be designed to target BPSD more effectively.

scholarly journals A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia

2016 ◽  
Vol 29 (8) ◽  
pp. 1308-1349 ◽  
Author(s):  
Kate Laver ◽  
Rachel Milte ◽  
Suzanne Dyer ◽  
Maria Crotty
Keyword(s):  
Systematic Review ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Randomized Controlled ◽  
People With Dementia ◽  
Significant Difference ◽  
Person With Dementia ◽  
Multicomponent Interventions ◽  
Behavioral And Psychological Symptoms

Objective: The aim of this study was to compare the efficacy of two approaches: multicomponent interventions that focus on working with the carer and dyadic interventions that work with both the carer and the person with dementia. Method: A systematic review involving a search of Medline, EMBASE, and PsycINFO in October 2015 was performed. Randomized controlled trials involving carers of people with dementia and comparing multicomponent interventions with usual care were included. Results: Pooling of all studies demonstrated that multicomponent interventions can reduce depressive symptoms, improve quality of life, reduce carer impact, and reduce behavioral and psychological symptoms of dementia as well as caregiver upset with these symptoms. We were unable to find a significant difference in the effects of dyadic interventions in comparison with carer focused interventions for these outcomes. Discussion: Although effect sizes associated with intervention are small, multicomponent interventions are relatively inexpensive to deliver, acceptable, and widely applicable.

scholarly journals A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia: from a perspective of ergonomics

2018 ◽  
Vol 31 (08) ◽  
pp. 1137-1149 ◽  
Author(s):  
Gubing Wang ◽  
Armagan Albayrak ◽  
Tischa J. M. van der Cammen
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Nursing Home ◽  
Psychological Symptoms ◽  
Nursing Home Residents ◽  
Inclusion Criteria ◽  
Pharmacological Interventions ◽  
Quality Of Evidence ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:Non-pharmacological interventions for Behavioral and Psychological Symptoms of Dementia (BPSD) have been developed; however, a systematic review on the effectiveness of this type of intervention from a perspective of ergonomics is lacking. According to ergonomics, the capabilities of Persons with Dementia (PwD) should be considered in the interventions for the outcomes to be reliable. We aimed to systematically review the non-pharmacological interventions for BPSD in nursing home residents with an additional assessment criterion based on ergonomics, specifically, capability consideration.Methods:The electronic databases MEDLINE, EMBASE, and PsycINFO were searched for non-pharmacological interventions treating BPSD in nursing homes. The interventions were categorized according to the capabilities of PwD required to participate. Study quality was assessed by National Health and Medical Research Council (NHMRC) evidence hierarchy and the capability consideration.Results:Sixty-four clinical trials met the inclusion criteria; 41 trials reported a significant reduction in at least one BPSD symptom; 20 trials reported no significant reduction in BPSD symptoms; three trials reported adverse effects after the intervention. Interventions were categorized into sensory-, cognition-, and movement-oriented. Capabilities of PwD were not considered in 28 trials, especially for sensory capabilities.Conclusions:The majority of the clinical trials reported a significant reduction in BPSD. The quality of evidence for nonpharmacological interventions in these trials is low due to the lack of capability consideration, data inhomogeneity, and inadequate study design and reporting. Future studies should focus on improving the quality of evidence by including capability consideration and examining if a relationship between capability consideration and effectiveness of non-pharmacological interventions exists.

Sign in / Sign up

Export Citation Format

Share Document