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European Journal of Medical Research

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Open Access 01-12-2023 | Dementia | Research

Effectiveness of creative story therapy for dementia: a systematic review and meta-analysis

Authors: Jinlong Ma, Qian Wang, Yanmei Lang, Shi Lv, Yuzhen Xu, Baojian Wei

Published in: European Journal of Medical Research | Issue 1/2023

Abstract

Objective

To conduct a meta-analysis of the effectiveness of creative story therapy versus routine nursing alone for the treatment of dementia.

Methods

We manually searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China VIP Database (VIP), China Biomedical Literature Database (CBM), and Wanfang Data up to May 2023. Randomized controlled trials (RCTs) of creative story therapy combined with routine nursing versus routine nursing for the treatment of dementia were included.

Results

A total of 597 participants were enrolled in the 9 RCTs. Among them, 296 were in the creative story therapy group, and 301 were in the routine nursing group. We found statistically significant effects of creative story therapy combined with routine nursing on cognitive function [standardized mean difference (SMD) = 0.99, 95% CI 0.57, 1.41, P < 0.00001], CSDD score [mean difference (MD) = − 1.71, 95% CI − 3.27, − 0.14, P < 0.00001], quality of life [SMD = 0.97, 95% CI 0.04, 1.90, P = 0.04], and social communication [MD = 0.46, 95% CI 0.17, 0.74, P < 0.00001] between the creative story therapy group and routine nursing groups; no significant difference in change in basic needs communication [MD = 0.09, 95% CI − 0.58, 0.76, P < 0.00001].

Conclusion

This meta-analysis shows that creative story therapy combined with routine nursing has significant effectiveness in improving cognitive function and depression in people with dementia. More high-quality RCTs are required to validate these results.

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Shinan-Altman S, Werner P. Illness representations of dementia: a scoping review. Clin Interv Aging. 2019;14:179–93. https://doi.org/10.2147/CIA.S193316.CrossRefPubMedPubMedCentral

Dementia: World Health Organization. 2023. https://www.who.int/news-room/fact-sheets/detail/dementia. Accessed 15 Mar 2023.

Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673–734. https://doi.org/10.1002/GPS.4198.CrossRefPubMed

Schaller S, Mauskopf J, Kriza C, Wahlster P, Kolominsky-Rabas PL. The main cost drivers in dementia: a systematic review. Int J Geriatr Psychiatry. 2015;30(2):111–29. https://doi.org/10.1002/GPS.4198.CrossRefPubMed

Jönsson L, Tate A, Frisell O, Wimo A. The costs of dementia in Europe: an updated review and meta-analysis. Pharmacoeconomics. 2023;41(1):59–75. https://doi.org/10.1007/s40273-022-01212-z.CrossRefPubMed

Tao P, Xu W, Gu S, Shi H, Wang Q, Xu Y. Traditional Chinese medicine promotes the control and treatment of dementia. Front Pharmacol. 2022;13:1015966. https://doi.org/10.3389/fphar.2022.1015966.CrossRefPubMedPubMedCentral

Robinson L, Hutchings D, Dickinson H, Corner L, Beyer F, Finch T, et al. Effectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia: a systematic review. Int J Geriatr Psychiatry. 2007;22(1):9–22. https://doi.org/10.1002/GPS.1643.CrossRefPubMed

Letrondo PA, Ashley SA, Flinn A, Burton A, Kador T, Mukadam N. Systematic review of arts and culture-based interventions for people living with dementia and their caregivers. Ageing Res Rev. 2022;83:101793. https://doi.org/10.1016/j.arr.2022.101793.CrossRefPubMed

Quail Z, Carter MM, Wei A, Li X. Management of cognitive decline in Alzheimer’s disease using a non-pharmacological intervention program: a case report. Medicine. 2020;99(21): e20128. https://doi.org/10.1097/MD.0000000000020128.CrossRefPubMedPubMedCentral

10.

Zhang Y, Cai J, An L, Hui F, Ren T, Ma H, et al. Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis. Ageing Res Rev. 2017;35:1–11. https://doi.org/10.1016/j.arr.2016.12.003.CrossRefPubMed

11.

Kim SK, Park M. Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis. Clin Interv Aging. 2017. https://doi.org/10.2147/CIA.S117637.CrossRefPubMedPubMedCentral

12.

Lee KH, Lee JY, Kim B. Person-centered care in persons living with dementia: a systematic review and meta-analysis. Gerontologist. 2022;62(4):e253–64. https://doi.org/10.1093/geront/gnaa207.CrossRefPubMed

13.

Wagner LM, Van Haitsma K, Kolanowski A, Spetz J. Recommendations to deliver person-centered long-term care for persons living with dementia. J Am Med Dir Assoc. 2021;22(7):1366–70. https://doi.org/10.1016/j.jamda.2021.05.003.CrossRefPubMedPubMedCentral

14.

Kim S. A story of a healing relationship: the person-centered approach in expressive arts therapy. J Creat Ment Health. 2010;5(1):93–8. https://doi.org/10.1080/15401381003627350.CrossRef

15.

Basting A. Building creative communities of care: arts, dementia, and hope in the United States. Dementia. 2018;17(6):744–54. https://doi.org/10.1177/1471301217740959.CrossRefPubMed

16.

Swinnen A, de Medeiros K. Participatory arts programs in residential dementia care: playing with language differences. Dementia. 2018;17(6):763–74. https://doi.org/10.1177/1471301217729985.CrossRefPubMed

17.

Kim S, Chee KH, Gerhart O. Generativity in creative storytelling: evidence from a dementia care community. Innov Aging. 2020;4(2):igaa002. https://doi.org/10.1093/geroni/igaa002.CrossRefPubMedPubMedCentral

18.

Swinnen A, Medeiros KD. “Play” and people living with dementia: a humanities-based inquiry of TimeSlips and the Alzheimer’s poetry project. Gerontologist. 2018;58(2):261–9. https://doi.org/10.1093/geront/gnw196.CrossRefPubMed

19.

Chen S-Q, Wang Z-S, Ma Y-X, Zhang W, Lu J-L, Liang Y-R, et al. Neuroprotective effects and mechanisms of tea bioactive components in neurodegenerative diseases. Molecules. 2018;23(3):512. https://doi.org/10.3390/molecules23030512.CrossRefPubMedPubMedCentral

20.

George DR, Stuckey HL, Dillon CF, Whitehead MM. Impact of participation in TimeSlips, a creative group-based storytelling program, on medical student attitudes toward persons with dementia: a qualitative study. Gerontologist. 2011;51(5):699–703. https://doi.org/10.1093/geront/gnr035.CrossRefPubMedPubMedCentral

21.

Fay SM, García-Toro M, Hincapié Henao L, Andrade Villegas Á, Lopera F. Creativity during COVID-19: evaluating an online TimeSlips storytelling program for people living with dementia during quarantine in Colombia. Gerontologist. 2023. https://doi.org/10.1093/geront/gnac191.CrossRefPubMed

22.

Vigliotti AA, Chinchilli VM, George DR. Evaluating the benefits of the TimeSlips creative storytelling program for persons with varying degrees of dementia severity. Am J Alzheimers Dis Other Demen. 2019;34(3):163–70. https://doi.org/10.1177/1533317518802427.CrossRefPubMed

23.

Cochrane. RoB 2: a revised Cochrane risk-of-bias tool for randomized trials: Cochrane. https://methods.cochrane.org/bias/resources/rob-2-revised-cochrane-risk-bias-tool-randomized-trials.

24.

Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34. https://doi.org/10.1136/bmj.315.7109.629.CrossRefPubMedPubMedCentral

25.

Cai Z, Gao J, Li F. Effect of creative story therapy in elderly patients with moderate dementia. Chin J Mod Nurs. 2019;25(13):1595–9. https://doi.org/10.3760/cma.j.issn.1674-2907.2019.13.003.CrossRef

26.

Fan Y, Gu Y. Effect of creative story therapy on senile dementia patients. Chin J Soc Med. 2021;38(5):587–90. https://doi.org/10.3969/j.issn.1673-5625.2021.05.028.CrossRef

27.

Lin R, Chen H-Y, Li H, Li J. Effects of creative expression therapy on Chinese elderly patients with dementia: an exploratory randomized controlled trial. Neuropsychiatr Dis Treat. 2019;15:2171–80. https://doi.org/10.2147/NDT.S200045.CrossRefPubMedPubMedCentral

28.

Phillips LJ, Reid-Arndt SA, Pak Y. Effects of a creative expression intervention on emotions, communication, and quality of life in persons with dementia. Nurs Res. 2010;59(6):417. https://doi.org/10.1097/NNR.0b013e3181faff52.CrossRefPubMedPubMedCentral

29.

Shen Y, Chen H, Liu M, Shao L, Shen C, Wang F, et al. Effect of creative story therapy on alexithymia in patients with mild dementia. J Nurs. 2021;28(11):70–3. https://doi.org/10.16460/j.issn1008-9969.2021.11.070.CrossRef

30.

Wang LY, Shen C. Intervention practice in older age dementia based on life story books. Chin J Gerontol. 2013;33(21):5239–41. https://doi.org/10.3969/j.issn.1005-9202.2013.21.007.CrossRef

31.

Wang LY. The impact of creative story therapy on cognitive function in patients with Alzheimer’s disease. Electr J Pract Gynecol Endocrinol. 2020;7(36):96–7. https://doi.org/10.16484/j.cnki.issn2095-8803.2020.36.066.CrossRef

32.

Xia Y. The impact of creative story therapy on cognitive function and quality of life in patients with Alzheimer’s disease. Chin Sci Technol J Med Health. 2020;2020(11):414–6.

33.

Yeh Y-T, Lin Y-F, Liu MF. Effects of TimeSlips on depressive symptoms and quality of life in people with dementia in day care centers. J Nurs. 2019;66(6):65–72. https://doi.org/10.6224/JN.201912_66(6).08.CrossRef

34.

Dorris JL, Neely S, Terhorst L, VonVille HM, Rodakowski J. Effects of music participation for mild cognitive impairment and dementia: a systematic review and meta-analysis. J Am Geriatr Soc. 2021;69(9):2659–67. https://doi.org/10.1111/jgs.17208.CrossRefPubMedPubMedCentral

35.

Houser WS, George DR, Chinchilli VM. Impact of TimeSlips creative expression program on behavioral symptoms and psychotropic medication use in persons with dementia in long-term care: a cluster-randomized pilot study. Am J Geriatr Psychiatry. 2014;22(4):337–40. https://doi.org/10.1016/j.jagp.2012.12.005.CrossRefPubMed

36.

Ismail S, Dodd E, Christopher G, Wildschut T, Sedikides C, Cheston R. The content of nostalgic memories among people living with dementia. Int J Aging Hum Dev. 2022;94(4):436–58. https://doi.org/10.1177/00914150211024185.CrossRefPubMed

37.

Zhao J. Research on the effect and central mechanism of innovative expression cognitive intervention in the elderly 2017, Fujian Medical University, PhD dissertation. 2017. https://kns.cnki.net/KCMS/detail/detail.aspx?dbname=CDFDLAST2018&filename=1017857391.nh.

38.

Luo Y, Lin R, Yan Y, et al. Effects of remote expressive arts program in older adults with mild cognitive impairment: a randomized controlled trial. J Alzheimers Dis. 2023;91(2):815–31. https://doi.org/10.3233/JAD-215685.CrossRefPubMedPubMedCentral

39.

Attard A, Larkin M. Art therapy for people with psychosis: a narrative review of the literature. Lancet Psychiatry. 2016;3(11):1067–78. https://doi.org/10.1016/S2215-0366(16)30146-8.CrossRefPubMed

40.

Tomasović S, Sremec J, Košćak Lukač J, Sedlić M, Klepac N. The prevalence of depression in dementia syndrome. Psychiatr Danub. 2022;34(4):700–5. https://doi.org/10.24869/psyd.2022.700.CrossRefPubMed

41.

Orgeta V, Tabet N, Nilforooshan R, Howard R. Efficacy of antidepressants for depression in Alzheimer’s disease: systematic review and meta-analysis. J Alzheimers Dis. 2017;58(3):725–33. https://doi.org/10.3233/JAD-161247.CrossRefPubMedPubMedCentral

42.

Cammisuli DM, Cipriani G, Giusti EM, Castelnuovo G. Effects of reminiscence therapy on cognition, depression and quality of life in elderly people with Alzheimer’s disease: a systematic review of randomized controlled trials. J Clin Med. 2022;11(19):5752. https://doi.org/10.3390/jcm11195752.CrossRefPubMedPubMedCentral

Title: Effectiveness of creative story therapy for dementia: a systematic review and meta-analysis
Authors: Jinlong Ma
Qian Wang
Yanmei Lang
Shi Lv
Yuzhen Xu
Baojian Wei
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Dementia
Dementia
Alzheimer's Disease
Alzheimer's Disease
Care
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01337-7

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Springer Medicine

Effectiveness of creative story therapy for dementia: a systematic review and meta-analysis

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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