Skip to main content
Top
Published in: Systematic Reviews 1/2013

Open Access 01-12-2013 | Protocol

A protocol for a systematic review of research on managing behavioural and psychological symptoms in dementia for community-dwelling older people: evidence mapping and syntheses

Authors: Daksha Trivedi, Claire Goodman, Angela Dickinson, Heather Gage, Jennifer McLaughlin, Jill Manthorpe, Kunle Ashaye, Steve Iliffe

Published in: Systematic Reviews | Issue 1/2013

Login to get access

Abstract

Background

Non-cognitive behavioural and psychological symptoms of dementia affect up to 90% of people with dementia during the disease course and result in distress, increased carer burden, high service utilization and unwanted moves to care homes. Research has focused on long-term settings and has not considered people with dementia living at home and at different stages of the disease trajectory. Our aim is to review systematically the evidence concerning non-pharmacological strategies to minimise behavioural and psychological symptoms in community-dwelling older people with dementia.

Methods/Design

Our approach is a two-stage co-design: a systematic mapping of the broad evidence around behavioural and psychological symptoms followed by an in-depth systematic review of studies of non-pharmacological interventions for behavioural and psychological symptoms from the perspective of their impact on community-dwelling older people with dementia and their carers. The review will include published literature involving a wide range of electronic databases using sensitive and comprehensive searches and lateral searching including checking citations.
We will produce a descriptive map of the studies by design and by the focus of interventions and apply further inclusion criteria, developed in conjunction with lay experts, to select studies for an in-depth systematic review that will include independent quality assessment and detailed data extraction by two reviewers.
The review process will be integrated with stakeholder meetings and a multidisciplinary expert advisory group to guide the review parameters and shape the research questions on the management of behavioural and psychological symptoms in people with dementia. Because studies are likely to be diverse in methodology and interventions, we will conduct a narrative synthesis of the in-depth systematic review. If appropriate, we will pool studies in a meta-analysis. We will explore review findings at both stages through focus groups and interviews with service providers, practitioners, people with dementia and carers.

Discussion

This integrated review in collaboration with key stakeholders will synthesise research evidence to identify appropriate interventions for effective management of behavioural and psychological symptoms that supports people with dementia living at home and their carers, and which reflects their priorities. It will make recommendations for research and practice.

Study registration

PROSPERO registration number: CRD42013004344
Appendix
Available only for authorised users
Literature
1.
go back to reference A’s S: Dementia UK: the Full Report. 2007, London: Alzheimer’s Society A’s S: Dementia UK: the Full Report. 2007, London: Alzheimer’s Society
2.
go back to reference Downs M, Turner S, Bryans M, Wilcock J, Keady J, Levin E, O’Carroll R, Howie K, Iliffe S: Effectiveness of educational interventions in improving detection and management of dementia in primary care: cluster randomised controlled study. BMJ. 2006, 332: 692-696. 10.1136/bmj.332.7543.692.CrossRefPubMedPubMedCentral Downs M, Turner S, Bryans M, Wilcock J, Keady J, Levin E, O’Carroll R, Howie K, Iliffe S: Effectiveness of educational interventions in improving detection and management of dementia in primary care: cluster randomised controlled study. BMJ. 2006, 332: 692-696. 10.1136/bmj.332.7543.692.CrossRefPubMedPubMedCentral
3.
go back to reference Robinson L, Iliffe S, Brayne C, Goodman C, Rait G, Manthorpe J, Ashley P, Moniz-Cook E, DeNDRoN Primary Care Clinical Studies Group: Primary care and dementia: 2 long-term care at home: psychosocial interventions, information provision, carer support and case management. Int J Geriatr Psychiatry. 2010, 25: 657-664.CrossRefPubMed Robinson L, Iliffe S, Brayne C, Goodman C, Rait G, Manthorpe J, Ashley P, Moniz-Cook E, DeNDRoN Primary Care Clinical Studies Group: Primary care and dementia: 2 long-term care at home: psychosocial interventions, information provision, carer support and case management. Int J Geriatr Psychiatry. 2010, 25: 657-664.CrossRefPubMed
4.
go back to reference Department of Health: Living Well With Dementia: a National Dementia Strategy. 2009, London: The Stationery Office Department of Health: Living Well With Dementia: a National Dementia Strategy. 2009, London: The Stationery Office
6.
go back to reference Robinson L, Hutchings D, Corner L, Beyer F, Dickinson H, Vanoli A, Finch T, Hughes J, Ballard C, May C, Bond J: Wandering in dementia: a systematic literature review of the effectiveness of nonpharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use. Health Technol Assess. 2006, 10: 1-124.CrossRef Robinson L, Hutchings D, Corner L, Beyer F, Dickinson H, Vanoli A, Finch T, Hughes J, Ballard C, May C, Bond J: Wandering in dementia: a systematic literature review of the effectiveness of nonpharmacological interventions to prevent wandering in dementia and evaluation of the ethical implications and acceptability of their use. Health Technol Assess. 2006, 10: 1-124.CrossRef
7.
go back to reference Savva GM, Zaccai J, Matthews FE, Davidson JE, McKeith I, Brayne C: Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. Br J Psychiatry. 2009, 194: 212-219. 10.1192/bjp.bp.108.049619.CrossRefPubMed Savva GM, Zaccai J, Matthews FE, Davidson JE, McKeith I, Brayne C: Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. Br J Psychiatry. 2009, 194: 212-219. 10.1192/bjp.bp.108.049619.CrossRefPubMed
8.
go back to reference Finkel S: Introduction to behavioural and psychological symptoms of dementia (BPSD). Int J Geriatr Psychiatry. 2000, 15 (Suppl 1): S2-S4.CrossRefPubMed Finkel S: Introduction to behavioural and psychological symptoms of dementia (BPSD). Int J Geriatr Psychiatry. 2000, 15 (Suppl 1): S2-S4.CrossRefPubMed
9.
go back to reference Aselage M, Amella E: An evolutionary analysis of mealtime difficulties in older adults with dementia. J Clin Nurs. 2010, 19: 33-41. 10.1111/j.1365-2702.2009.02969.x.CrossRefPubMed Aselage M, Amella E: An evolutionary analysis of mealtime difficulties in older adults with dementia. J Clin Nurs. 2010, 19: 33-41. 10.1111/j.1365-2702.2009.02969.x.CrossRefPubMed
10.
go back to reference Manthorpe J, Watson R: Poorly served? Eating and dementia. J Adv Nurs. 2003, 41: 162-169. 10.1046/j.1365-2648.2003.02520.x.CrossRefPubMed Manthorpe J, Watson R: Poorly served? Eating and dementia. J Adv Nurs. 2003, 41: 162-169. 10.1046/j.1365-2648.2003.02520.x.CrossRefPubMed
11.
go back to reference Watson R, Green SM: Feeding and dementia: a systematic literature review. J Adv Nurs. 2006, 54: 86-93. 10.1111/j.1365-2648.2006.03793.x.CrossRefPubMed Watson R, Green SM: Feeding and dementia: a systematic literature review. J Adv Nurs. 2006, 54: 86-93. 10.1111/j.1365-2648.2006.03793.x.CrossRefPubMed
12.
go back to reference Bianchetti A, Scuratti A, Zanetti O, Binetti G, Frisoni GB, Magni E, Trabucchi M: Predictors of mortality and institutionalization in Alzheimer disease patients 1 year after discharge from an Alzheimer dementia unit. Dementia. 1995, 6 (2): 108-112.PubMed Bianchetti A, Scuratti A, Zanetti O, Binetti G, Frisoni GB, Magni E, Trabucchi M: Predictors of mortality and institutionalization in Alzheimer disease patients 1 year after discharge from an Alzheimer dementia unit. Dementia. 1995, 6 (2): 108-112.PubMed
13.
go back to reference Donaldson C, Tarrier N, Burns A: The impact of the symptoms of dementia on caregivers. Br J Psychiatry. 1997, 170: 62-68. 10.1192/bjp.170.1.62.CrossRefPubMed Donaldson C, Tarrier N, Burns A: The impact of the symptoms of dementia on caregivers. Br J Psychiatry. 1997, 170: 62-68. 10.1192/bjp.170.1.62.CrossRefPubMed
14.
go back to reference NICE-SCIE: A NICE–SCIE Guideline on Supporting People with Dementia and Their Carers in Health and Social Care. National Clinical Practice Guideline Number 42. 2007, Leicester, UK: British Psychological Society NICE-SCIE: A NICE–SCIE Guideline on Supporting People with Dementia and Their Carers in Health and Social Care. National Clinical Practice Guideline Number 42. 2007, Leicester, UK: British Psychological Society
16.
go back to reference Livingston G, Johnston K, Katona C, Paton J, Lyketsos CG: Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry. 2005, 162: 1996-2021. 10.1176/appi.ajp.162.11.1996.CrossRefPubMed Livingston G, Johnston K, Katona C, Paton J, Lyketsos CG: Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry. 2005, 162: 1996-2021. 10.1176/appi.ajp.162.11.1996.CrossRefPubMed
17.
go back to reference Robinson L, Hutchings D, Dickinson HO, Corner L, Beyer F, Finch T, Hughes J, Vanoli A, Ballard C, Bond J: Effectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia: a systematic review. Int J Geriatr Psychiatry. 2007, 22: 9-22. 10.1002/gps.1643.CrossRefPubMed Robinson L, Hutchings D, Dickinson HO, Corner L, Beyer F, Finch T, Hughes J, Vanoli A, Ballard C, Bond J: Effectiveness and acceptability of non-pharmacological interventions to reduce wandering in dementia: a systematic review. Int J Geriatr Psychiatry. 2007, 22: 9-22. 10.1002/gps.1643.CrossRefPubMed
18.
go back to reference Selwood A, Johnston K, Katona C, Lyketsos C, Livingston G: Systematic review of the effect of psychological interventions on family caregivers of people with dementia. J Affect Disord. 2007, 101: 75-89. 10.1016/j.jad.2006.10.025.CrossRefPubMed Selwood A, Johnston K, Katona C, Lyketsos C, Livingston G: Systematic review of the effect of psychological interventions on family caregivers of people with dementia. J Affect Disord. 2007, 101: 75-89. 10.1016/j.jad.2006.10.025.CrossRefPubMed
19.
go back to reference O’Connor DW, Ames D, Gardner B, King M: Psychosocial treatments of psychological symptoms in dementia: a systematic review of reports meeting quality standards. Int Psychogeriatr. 2009, 21 (2): 241-251. 10.1017/S1041610208008223.CrossRefPubMed O’Connor DW, Ames D, Gardner B, King M: Psychosocial treatments of psychological symptoms in dementia: a systematic review of reports meeting quality standards. Int Psychogeriatr. 2009, 21 (2): 241-251. 10.1017/S1041610208008223.CrossRefPubMed
20.
go back to reference O’Connor DW, Ames D, Gardner B, King M: Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. Int Psychogeriatr. 2009, 21: 225-240. 10.1017/S1041610208007588.CrossRefPubMed O’Connor DW, Ames D, Gardner B, King M: Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. Int Psychogeriatr. 2009, 21: 225-240. 10.1017/S1041610208007588.CrossRefPubMed
21.
go back to reference Chung J, Lai C: Snoezelen for dementia. Cochrane Database Syst Rev. 2002, 4: CD003152-PubMed Chung J, Lai C: Snoezelen for dementia. Cochrane Database Syst Rev. 2002, 4: CD003152-PubMed
22.
go back to reference Clare L, Woods RT, Moniz Cook ED, Orrell M, Spector A: Cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev. 2003, 4: CD003260-PubMed Clare L, Woods RT, Moniz Cook ED, Orrell M, Spector A: Cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev. 2003, 4: CD003260-PubMed
23.
go back to reference Forbes D, Culum I, Lischka AR, Morgan DG, Peacock S, Forbes J, Forbes S: Light therapy for managing cognitive, sleep, functional, behavioural, or psychiatric disturbances in dementia. Cochrane Database Syst Rev. 2009, 4: CD003946-PubMed Forbes D, Culum I, Lischka AR, Morgan DG, Peacock S, Forbes J, Forbes S: Light therapy for managing cognitive, sleep, functional, behavioural, or psychiatric disturbances in dementia. Cochrane Database Syst Rev. 2009, 4: CD003946-PubMed
24.
go back to reference Verkaik R, van Weert JC, Francke AL: The effects of psychosocial methods on depressed, aggressive and apathetic behaviors of people with dementia: a systematic review. Int J Geriatr Psychiatry. 2005, 20: 301-314. 10.1002/gps.1279.CrossRefPubMed Verkaik R, van Weert JC, Francke AL: The effects of psychosocial methods on depressed, aggressive and apathetic behaviors of people with dementia: a systematic review. Int J Geriatr Psychiatry. 2005, 20: 301-314. 10.1002/gps.1279.CrossRefPubMed
25.
go back to reference Woods B, Spector A, Jones C, Orrell M, Davies S: Reminiscence therapy for dementia. Cochrane Database Syst Rev. 2005, 2: CD001120-PubMed Woods B, Spector A, Jones C, Orrell M, Davies S: Reminiscence therapy for dementia. Cochrane Database Syst Rev. 2005, 2: CD001120-PubMed
26.
go back to reference Kong E-H, Evans LK, Guevara JP: Nonpharmacological intervention for agitation in dementia: a systematic review and meta-analysis. Aging Ment Health. 2009, 13: 512-520. 10.1080/13607860902774394.CrossRefPubMed Kong E-H, Evans LK, Guevara JP: Nonpharmacological intervention for agitation in dementia: a systematic review and meta-analysis. Aging Ment Health. 2009, 13: 512-520. 10.1080/13607860902774394.CrossRefPubMed
27.
go back to reference Logsdon RG, McCurry SM, Teri L: Evidence-based psychological treatments for disruptive behaviors in individuals with dementia. Psychol Aging. 2007, 22: 28-36.CrossRefPubMed Logsdon RG, McCurry SM, Teri L: Evidence-based psychological treatments for disruptive behaviors in individuals with dementia. Psychol Aging. 2007, 22: 28-36.CrossRefPubMed
28.
go back to reference Finnema E, Droes RM, Ribbe M, Van Tilburg W: The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature. Int J Geriatr Psychiatry. 2000, 15: 141-161. 10.1002/(SICI)1099-1166(200002)15:2<141::AID-GPS92>3.0.CO;2-5.CrossRefPubMed Finnema E, Droes RM, Ribbe M, Van Tilburg W: The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature. Int J Geriatr Psychiatry. 2000, 15: 141-161. 10.1002/(SICI)1099-1166(200002)15:2<141::AID-GPS92>3.0.CO;2-5.CrossRefPubMed
33.
go back to reference Goodman C, Evans C, Wilcock J, Froggatt K, Drennan V, Sampson E, Blanchard M, Bissett M, Iliffe S: End of life care for community dwelling older people with dementia: an integrated review. Int J Geriatr Psychiatry. 2010, 25: 329-337. 10.1002/gps.2343.CrossRefPubMed Goodman C, Evans C, Wilcock J, Froggatt K, Drennan V, Sampson E, Blanchard M, Bissett M, Iliffe S: End of life care for community dwelling older people with dementia: an integrated review. Int J Geriatr Psychiatry. 2010, 25: 329-337. 10.1002/gps.2343.CrossRefPubMed
34.
go back to reference Trivedi D, Brooks F, Bunn F, Graham M: Early fatherhood: a mapping of the evidence base relating to pregnancy prevention and parenting support. Health Educ Res. 2009, 24: 999-1028. 10.1093/her/cyp025.CrossRefPubMed Trivedi D, Brooks F, Bunn F, Graham M: Early fatherhood: a mapping of the evidence base relating to pregnancy prevention and parenting support. Health Educ Res. 2009, 24: 999-1028. 10.1093/her/cyp025.CrossRefPubMed
36.
go back to reference Moriarty J, Manthorpe J, Wilcock J, Iliffe S: Consulting with stakeholders: using the expertise of researchers, professionals, carers and older people in systematic reviews. Dementia. 2007, 6: 449-452. 10.1177/14713012070060030704.CrossRef Moriarty J, Manthorpe J, Wilcock J, Iliffe S: Consulting with stakeholders: using the expertise of researchers, professionals, carers and older people in systematic reviews. Dementia. 2007, 6: 449-452. 10.1177/14713012070060030704.CrossRef
37.
go back to reference Iliffe S, Kharicha K, Harari D, Swift C, Goodman C, Manthorpe J: User involvement in the development of a health promotion technology for older people: findings from the SWISH project. Health Soc Care Community. 2010, 18: 147-159. 10.1111/j.1365-2524.2009.00882.x.CrossRefPubMed Iliffe S, Kharicha K, Harari D, Swift C, Goodman C, Manthorpe J: User involvement in the development of a health promotion technology for older people: findings from the SWISH project. Health Soc Care Community. 2010, 18: 147-159. 10.1111/j.1365-2524.2009.00882.x.CrossRefPubMed
38.
go back to reference Goodman C, Evans C: Using focus groups. The Research Process in Nursing. Edited by: Gerrish K, Lacey A. 2006, Chichester: Wiley-Blackwell, 352-366. Goodman C, Evans C: Using focus groups. The Research Process in Nursing. Edited by: Gerrish K, Lacey A. 2006, Chichester: Wiley-Blackwell, 352-366.
40.
go back to reference Centre for Reviews and Dissemination: Systematic Reviews: CRD’s Guidance for Undertaking Reviews in Health Care. 2009, York: University of York Centre for Reviews and Dissemination: Systematic Reviews: CRD’s Guidance for Undertaking Reviews in Health Care. 2009, York: University of York
41.
go back to reference Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Loannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009, 339: b2700-10.1136/bmj.b2700.CrossRefPubMedPubMedCentral Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Loannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009, 339: b2700-10.1136/bmj.b2700.CrossRefPubMedPubMedCentral
42.
go back to reference Robinson L, Bamford C, Beyer F, Clark A, Dickinson C, Emmet C, Exley C, Hughes J, Robson L, Rousseau N: Patient preferences for future care–how can advance care planning become embedded into dementia care: a study protocol. BMC Geriatr. 2010, 10: 2-10.1186/1471-2318-10-2.CrossRefPubMedPubMedCentral Robinson L, Bamford C, Beyer F, Clark A, Dickinson C, Emmet C, Exley C, Hughes J, Robson L, Rousseau N: Patient preferences for future care–how can advance care planning become embedded into dementia care: a study protocol. BMC Geriatr. 2010, 10: 2-10.1186/1471-2318-10-2.CrossRefPubMedPubMedCentral
43.
go back to reference Greenhalgh T, Peacock R: Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005, 331: 1064-1065. 10.1136/bmj.38636.593461.68.CrossRefPubMedPubMedCentral Greenhalgh T, Peacock R: Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005, 331: 1064-1065. 10.1136/bmj.38636.593461.68.CrossRefPubMedPubMedCentral
45.
go back to reference Pocock M, Trivedi D, Wills W, Bunn F, Magnusson J: Parental perceptions regarding healthy behaviours for preventing overweight and obesity in young children: a systematic review of qualitative studies. Obes Rev. 2010, 11: 338-353. 10.1111/j.1467-789X.2009.00648.x.CrossRefPubMed Pocock M, Trivedi D, Wills W, Bunn F, Magnusson J: Parental perceptions regarding healthy behaviours for preventing overweight and obesity in young children: a systematic review of qualitative studies. Obes Rev. 2010, 11: 338-353. 10.1111/j.1467-789X.2009.00648.x.CrossRefPubMed
46.
go back to reference Bunn F, Goodman C, Sworn K, Rait G, Brayne C: Psychosocial factors that shape patient and carer experiences of dementia diagnosis and treatment: a systematic review of qualitative studies. PLoS Med. 2012, 9 (10): e1001331-10.1371/journal.pmed.1001331.CrossRefPubMedPubMedCentral Bunn F, Goodman C, Sworn K, Rait G, Brayne C: Psychosocial factors that shape patient and carer experiences of dementia diagnosis and treatment: a systematic review of qualitative studies. PLoS Med. 2012, 9 (10): e1001331-10.1371/journal.pmed.1001331.CrossRefPubMedPubMedCentral
47.
go back to reference Oliver S, Harden H, Rees R, Shepherd J, Brunton G, Garcia J: An emerging framework for including different types of evidence in systematic reviews for public policy. Evaluation. 2005, 11: 428-446. 10.1177/1356389005059383.CrossRef Oliver S, Harden H, Rees R, Shepherd J, Brunton G, Garcia J: An emerging framework for including different types of evidence in systematic reviews for public policy. Evaluation. 2005, 11: 428-446. 10.1177/1356389005059383.CrossRef
48.
go back to reference Thomas J, Harden A: Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008, 8: 45-10.1186/1471-2288-8-45.CrossRefPubMedPubMedCentral Thomas J, Harden A: Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008, 8: 45-10.1186/1471-2288-8-45.CrossRefPubMedPubMedCentral
49.
go back to reference Bunn F, Dickinson A, Barnett-Page E, Horton K: A systematic review of older people’s perceptions of facilitators and barriers to participation in falls prevention interventions. Ageing & Society. 2008, 28: 449-472.CrossRef Bunn F, Dickinson A, Barnett-Page E, Horton K: A systematic review of older people’s perceptions of facilitators and barriers to participation in falls prevention interventions. Ageing & Society. 2008, 28: 449-472.CrossRef
50.
go back to reference Drummond MF, Jefferson TO: Guidelines for authors and peer reviewers of economic submissions to the BMJ. The BMJ Economic Evaluation Working Party. BMJ. 1996, 313: 275-283. 10.1136/bmj.313.7052.275.CrossRefPubMedPubMedCentral Drummond MF, Jefferson TO: Guidelines for authors and peer reviewers of economic submissions to the BMJ. The BMJ Economic Evaluation Working Party. BMJ. 1996, 313: 275-283. 10.1136/bmj.313.7052.275.CrossRefPubMedPubMedCentral
Metadata
Title
A protocol for a systematic review of research on managing behavioural and psychological symptoms in dementia for community-dwelling older people: evidence mapping and syntheses
Authors
Daksha Trivedi
Claire Goodman
Angela Dickinson
Heather Gage
Jennifer McLaughlin
Jill Manthorpe
Kunle Ashaye
Steve Iliffe
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2013
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/2046-4053-2-70

Other articles of this Issue 1/2013

Systematic Reviews 1/2013 Go to the issue