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Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Patients with mild cognitive impairment (MCI) and dementia are more prone to depression than people without MCI or dementia. Some studies have found nonpharmacological multi‐component intervention to be more effective than single‐component intervention in improving the condition of patients with MCI and dementia; however, their effect on depressive symptoms is still inconsistent. Therefore, it is necessary to explore the effectiveness of nonpharmacological multi‐component intervention in improving depressive symptoms in patients with MCI and dementia. This review retrieved papers from PubMed, Embase, Cochrane Library, CINAHL, PsycINFO and CNKI. The retrieval time limit was set from 1 January 1990 to 25 November 2022. The PRISMA 2020 guideline was used to report the included studies. The result showed that nonpharmacological multi‐component intervention could improve depressive symptoms in patients with MCI and dementia. Among them, nonpharmacological multi‐component intervention with a duration of <6 months, physical and cognitive activities, or other activities had significant effects. However, each study differed in terms of specific measures, duration and frequency of intervention methods. Accordingly, more randomized controlled trials with larger samples are required to discover the best scheme for nonpharmacological multi‐component intervention. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: The study tries to explore what effects multiple cognitive intervention, computer-based intervention, and memory training program had on dementia patients through meta-analysis. METHOD: Data was collected using an overseas search engine and 13 pieces of research published from January 2001 to April 2015 were selected. On papers that fit the selection criteria qualitative evaluation was conducted using Jadad evaluation and using pre-post average, standard deviation, and sample size of cognitive function, meta-analysis was conducted. RESULTS: The 13 studies selected included 6 multiple interventions, 4 computer-based interventions, and 3 memory training programs. In the Jadad evaluation all had 3 points or higher and there were 474 research participants and in the result of effect size analysis memory training intervention was found to be 'large effect size', computer-based intervention 'medium effect size', and multiple cognitive intervention 'small effect size'. All three intervention methods were all statistically significant (p<0.05). CONCLUSION: It was found that the effect on dementia patients was in the order of memory training intervention, computer-based intervention, and multiple cognitive intervention. Clinically, this can be objective basis for treatment method for cognitive intervention of dementia patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to systematically review the literature on the effects of mobile health applications in older adults with dementia or Mild Cognitive Impairment (MCI) and to quantify the effect size of these interventions through meta-analysis. Methods: A systematic review and meta-analysis was conducted, with a total of seven databases searched on April 18, 2023. The risk of bias was evaluated using the Revised Cochrane Risk of Bias and the Risk of Bias in Non-randomized Studies of Interventions tools. Effect sizes were calculated using Hedges' g within a random effects model, and subgroup analyses were also performed. Results: A total of 10 studies were included in the systematic review, and six studies were included in the meta-analysis. Intervention groups exhibited a statistically significant improvement in cognitive function (Hedges' g=0.33, 95% Confidence Interval [CI]=0.09~0.56, p=.007). Subgroup analyses revealed that older adults with MCI (Hedges' g=0.41, 95% CI=0.12~0.69, p=.006) and interventions lasting more than 4 weeks (Hedges' g=0.47, 95% CI=0.09~0.85, p=.016) demonstrated a significant cognitive improvement. Conclusion: The results of this study indicate that mobile health applications may represent a suitable approach for improving cognitive function in older adults with MCI, emphasizing the need for at least a four-week intervention. These findings underscore the potential of mobile health interventions as a practical option for cognitive improvement in the early stages of cognitive decline. [ABSTRACT FROM AUTHOR]

Objective: To summarize the effect of dual-task training on cognitive, physical function, and dual-task performance in people with mild cognitive impairment or dementia. Data sources: Embase, PEDro, PsycINFO, PubMed, CINAHL, The Cochrane Library, and a forward search conducted via Web of Science have been searched from inception to July 2023. Review methods: Good-quality randomized controlled trials compared dual-task training with no/placebo intervention or single-task training among people with a primary diagnosis of mild cognitive impairment or dementia were included. The PEDro scale was used to evaluate the methodological quality of individual studies. The Grading of Recommendations, Assessment, Development and Evaluations system was adopted to appraise the quality of evidence for each outcome. Results: Eighteen trials (1325 participants) were included, and 17 provided data for meta-analysis. Comparing with no intervention, dual-task training led to significant improvements on attention (mean difference (MD) = −20.66, 95%CI [−39.42, −1.90]), functional mobility (MD = −2.73; 95%CI [−3.98, −1.49]). Compared with single-task training, dual-task training had greater effects on overall cognitive function (standardized mean difference (SMD) = 0.29, 95%CI [0.09, 0.49]), balance (SMD = 0.78, 95%CI [0.40, 1.15]) and functional mobility (MD = −1.17; 95%CI [−1.77, −0.58]). Its effect on dual-task performance remains inconclusive due to the inconsistent results reported. Conclusion: Low- to moderate-quality evidence supports that dual-task training has beneficial effects on cognitive function and physical function in individuals with dementia or mild cognitive impairment. The optimal training protocol of dual-task training on cognitive and physical functions, and dual-task performance remains uncertain. Well-designed, randomized studies with large enough sample sizes are warranted. [ABSTRACT FROM AUTHOR]

Background: About 50 million people worldwide suffered from dementia in 2018—two-thirds of those with Alzheimer's disease (AD). By 2050, this number is expected to rise to 152 million—which is slightly larger than the country of Russia. About 90% of these people are over the age of 65, but early-onset dementia can occur at younger ages. Early detection is imperative to expedient treatment, which can improve outcomes over the span of diagnosis. Objectives: To conduct a meta-analysis of similar studies along with a systematic literature review to hasten the development of clinical practice guidelines to assist clinicians in the diagnosis of AD. We analyzed data points in each article published over the last 10 years to meet this objective: cost, efficiency, accuracy, acceptability (by physician and patient), patient satisfaction, and barriers to adoption. Methods: Four research databases were queried (PubMed, CINAHL Ultimate, Web of Science, and ScienceDirect). The review was conducted in accordance with a published protocol, the Kruse Protocol, and reported in accordance with PRISMA (2020). Results: Ten interventions were identified to help diagnose AD among older patients, and some involved a combination of methods (such as MRI and PET). The average sample size was 320.32 (SD = 437.51). These 10 interventions were identified as accurate, non-invasive, non-stressful, inexpensive, convenient, and rapid. Only one intervention was identified as statistically ineffective, and this same intervention was used effectively in other studies. The barriers identified were cost, training, expense of travel, and required physical presence of patient. The weighted average sensitivity was 85.16%, specificity was 88.53, and the weighted average effect size was 0.7339 (medium). Conclusion: Innovation can accurately diagnose AD, but not all methods are successful. Providers must ensure they have the proper training and familiarity with these interventions to ensure accuracy in diagnosis. While the physical presence of the patient is often required, many interventions are non-invasive, non-stressful, and relatively inexpensive. [ABSTRACT FROM AUTHOR]

Background: Previous cohort studies have found an association between Bacillus Calmette-Guérin (BCG) administration and incident dementia. In the systematic review and meta-analysis, we aimed to summarize the current evidence of the effect of BCG use on the risk of developing dementia. Methods: We searched six databases until 20 May 2023 for studies investigating the risk of dementia and BCG administration. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were pooled in themeta-analysis. Meta-regression, subgroup, and sensitivity analysis were conducted as well. Results: Of the 4,043 records initially evaluated, five articles were included for final analysis, with a total of 45,407 bladder cancer (BC) patients. All five studies were evaluated and rated as with high quality, and a low possibility of publication bias was indicated. A significant association between BCG and the incidence of dementia in BC patients was found in all five studies. Although a high heterogeneity (I² = 84.5%, p < 0.001) was observed, the pooled HR was 0.55 (0.42-0.73), indicating that BCG exposure or treatment reduced the risk of incident dementia by 45%. Moreover, the sensitivity analysis showed good robustness of the overall effect with no serious publication bias. Conclusion: BCG administration is associated with a significantly lower risk of developing dementia. However, an epidemiological cohort is needed to establish a relationship between BCG use and incident dementia in the normal population. Once the relationship is confirmed, more peoplemay benefit fromthe association. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the efficacy of non‐pharmacological interventions designed to reduce pain in people with dementia. Background: Pain is prevalent among patients with dementia but frequently remains untreated. Although non‐pharmacological interventions have been used to reduce pain in people with dementia, the efficacy of these interventions for pain management in people with dementia has not been thoroughly synthesised. Design: Systematic review and meta‐analysis. Methods: The study was conducted in accordance with PRISMA guidelines and Cochrane criteria for systematic reviews. A comprehensive search was performed using the Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, OVID and Web of Science databases, from databases inception to 13 March 2022. The modified Cochrane risk‐of‐bias tool (ROB‐2) was used to evaluate the methodological quality of each included study. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were synthesised using a random‐effects model to assess the efficacy of non‐pharmacological interventions for reducing pain in people with dementia (using Stata 16.0). Results: The final analysis assessed 12 studies, including 989 persons with dementia. Non‐pharmacological interventions were found to reduce pain in 4–8 weeks after the interventions (SMD: −0.32; 95% CI: −0.62 to −0.02). However, the effects of intervention frequency and patient age remain unknown. Conclusions: Non‐pharmacological interventions are effective for reducing pain in people with dementia. Further investigations remain necessary to explore the effectiveness of specific non‐pharmacological therapies for pain reduction in people with dementia (e.g. aromatherapy, play activity, singing or robotic care). Relevance to clinical practice: The findings of this study can guide healthcare practitioners when considering the use of non‐pharmacological pain management methods for people with dementia and may improve the implementation of these methods in clinical practice. Patient or public contributions: The study suggests non‐pharmacological interventions to reduce pain and underlines the relevance of health provider's viewpoints. The types, duration and length of follow‐up of non‐pharmacological interventions can be offered based on patient's conditions and the standard of clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to examine non‐pharmacological interventions for helping people with dementia who experience feeding difficulties in order to improve their nutritional status. Methods: The articles were searched using PsycINFO, Medline, PubMed, CINAHL and Cochrane. Two independent investigators critically appraised eligible studies. The PRISMA guidelines and checklist were used. The possibility of risk of bias was assessed using a tool to assess the quality of randomised control trials (RCT) and non‐RCT studies. A narrative synthesis was conducted as a method of synthesis. The Cochrane Review Manager (RevMan 5.4) was used for meta‐analysis. Results: The systematic review and meta‐analysis included seven publications. Six interventions were identified and categorised as: eating ability training for people with dementia, staff training and feeding assistance and support. The meta‐analysis found evidence of the effect of eating ability training on feeding difficulty, quantified by the Edinburgh Feeding Evaluation in Dementia scale (EdFED) with a weighted mean difference of −1.36 (95% confidence interval: −1.84 to −0.89, p < 0.001) and on self‐feeding time. A spaced retrieval intervention showed a positive effect on EdFED. The systematic review discovered that while feeding assistance had a positive effect on feeding difficulty, staff training had no effect. According to the meta‐analysis, these interventions had no effect on improving the nutritional status of people with dementia. Conclusions: None of the included RCTs met the Cochrane risk‐of‐bias criteria for randomised trials. This review found that direct training for people with dementia and indirect feeding support from care staff resulted in fewer mealtime difficulties. More RCT studies are needed to determine the efficacy of such interventions. [ABSTRACT FROM AUTHOR]

Objectives:To estimate the efficacy of computer-based cognitive interventions for improving cognition in people with dementia (PWD). Method:Online literature databases were searched for relevant studies. Interventions were categorised as follows: cognitive recreation, cognitive rehabilitation, cognitive stimulation or cognitive training. A systematic review, quality assessment and meta-analyses were conducted. Results:Twelve studies were identified. Their methodological quality was acceptable according to Downs & Black criteria, the weakest methodological area being the external validity. The meta-analyses indicated cognitive interventions lead to beneficial effects on cognition in PWD (SMD −0.69; 95% CI = −1.02 to −0.37;P< 0.0001;I2= 29%), depression (SMD 0.47; 95% CI = 0.16 to 0.78;p= 0.003;I2= 0%) and anxiety (SMD 0.55; 95% CI = 0.07 to 1.04;P< 0.03;I2= 42%). They benefited significantly more from the computer-based cognitive interventions than from the non-computer-based interventions in cognition (SMD 0.48; 95% CI = 0.09 to 0.87;P= 0.02;I2= 2%). Conclusion:Computer-based cognitive interventions have moderate effects in cognition, and anxiety and small effects in depression in PWD. No significant effects were found on activities of daily living. They led to superior results compared to non-computer-based interventions in cognition. Further research is needed on cognitive recreation and cognitive stimulation. There is also a need for longer-term follow-up to examine the potential retention of treatment effects, and for the design of specific outcome measures. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence indicates that poor periodontal health adversely impacts cognition. This review examined the available longitudinal evidence concerning the effect of poor periodontal health on cognitive decline and dementia. Methods: Comprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. Longitudinal studies having periodontal health as exposure and cognitive decline and/or dementia as outcomes were considered. Random effects pooled estimates and 95% confidence intervals were generated (pooled odds ratio for cognitive decline and hazards ratio for dementia) to assess whether poor periodontal health increases the risk of cognitive decline and dementia. Heterogeneity between studies was estimated by I2 and the quality of available evidence was assessed through quality assessment criteria. Results: Adopted search strategy produced 2132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in this review. Poor periodontal health (reflected by having periodontitis, tooth loss, deep periodontal pockets, or alveolar bone loss) was associated with both cognitive decline (OR = 1.23; 1.05–1.44) and dementia (HR = 1.21; 1.07–1.38). Further analysis, based on measures of periodontal assessment, found tooth loss to independently increase the risk of both cognitive decline (OR = 1.23; 1.09–1.39) and dementia (HR = 1.13; 1.04–1.23). Stratified analysis based on the extent of tooth loss indicated partial tooth loss to be important for cognitive decline (OR = 1.50; 1.02–2.23) and complete tooth loss for dementia (HR = 1.23; 1.05–1.45). However, the overall quality of evidence was low, and associations were at least partly due to reverse causality. Conclusions: Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well‐designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted. [ABSTRACT FROM AUTHOR]

Background: Music-based intervention has been used as first-line non-pharmacological treatment to improve cognitive function for people with mild cognitive impairment (MCI) or dementia in clinical practice. However, evidence regarding the effect of music-based intervention on general cognitive function as well as subdomains of cognitive functions in these individuals is scarce. Objective: To evaluate the efficacy of music-based interventions on a wide range of cognitive functions in people with MCI or dementia. Method: We searched the effect of various music therapies using randomized controlled trials on cognitive function using several databases. Studies based on any type of dementia or MCI were combined. The effects of music-based intervention on each cognitive function were pooled by meta-analysis. Results: A total of 19 studies involving n = 1024 participants (mean age ranged from 60 to 87 years old) were included. We found statistically significant improvements in MMSE (general cognitive function), the Frontal Assessment Battery (executive function), and the Auditory Verbal Learning Test (episodic memory). Conclusions: This study provides positive evidence to support music-based interventions for improving a wide range of cognitive functions in older adults with MCI and dementia. Therefore, we recommend increased use of music in people's homes, day care centers and nursing homes. This study was registered with PROSPERO, number 250383. [ABSTRACT FROM AUTHOR]

Background: The role of robotic care has been studied because it may be a care option applicable to dementia care. However, the effects of robotic care in dementia care are still inconclusive. Aim: To explore the span of the effects of robotic care intervention among patients with dementia. Design: Systematic review and meta‐analysis. Methods: This study searched systematically using the following databases: Academic Search Complete, CINAHL, Cochrane Library, MEDLINE, PubMed, SocINDEX, UpToDate (OVID) and Web of Science. The eligibility criteria were patients with dementia, randomised controlled trials and publications in English. The PEDro scale was used to assess the methodological quality in the included studies. The meta‐analysis was performed using a fixed‐effects model to calculate the pooled effects of robotic care interventions. STATA 16.0 was used for statistical analysis. The results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. Results: A total of 15 studies met the eligibility criteria and included 1684 participants. Overall, the robotic care interventions had positive effects on agitation (SMD = 0.09; 95% CI [−0.22–0.33]), anxiety (SMD = −0.07; 95% CI [−0.42–0.28]), cognitive function (SMD = 0.16; 95% CI [−0.08–0.40]), depression (SMD = −0.35; 95% CI [−0.69–0.02]), neuropsychiatric symptoms (SMD = 0.16; 95% CI [−0.29–0.61]), total hours of sleep during daytime (SMD = −0.31; 95% CI [−0.55 to 0.07]) and quality of life (SMD = 0.24; 95% CI [−0.23–0.70]). Conclusion: Robotic care intervention may be an effective and alternative intervention for improving the health outcomes for people with dementia. The robotic care effect on anxiety should be confirmed. Further studies may consider the frequency, duration of intervention and possible negative outcomes after robotic care interventions. Relevance to clinical practice: As a non‐pharmacological approach, nursing staff may consider the robotic care intervention in providing care for patients with dementia since this intervention has clinical benefits. [ABSTRACT FROM AUTHOR]

Purpose: Urinary incontinence is a syndrome common in older adults, but it is not clear whether urinary incontinence is associated with the risk for mortality in elderly nursing home residents. Methods: We conducted a systematic review and meta‐analysis in PubMed, Cochrane, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases. The Newcastle‐Ottawa Scale (NOS) was used to assess the quality of the included studies. The meta‐analysis was summarized using a random‐effects or fixed‐effects model, and the heterogeneity among studies was examined using the I2 statistic. Findings: Six cohort studies with 1,656 participants were included in the final analysis. The NOS score for each study was greater than 6. Urinary incontinence was significantly associated with a higher risk for mortality in nursing homes, with a hazard ratio (HR) of 1.20 (95% confidence interval [CI] 1.12–1.28, I2 = 41.6%). The significant association of urinary incontinence with increased mortality risk was observed in subgroup analysis according to region, status of dementia, and follow‐up period, with a pooled HR of 2.02 (95% CI 1.32–3.11, I2 = 0%) for Asian countries, 1.18 (95% CI 1.11–1.26, I2 = 41.6%) for Western countries, 1.17 (95% CI 1.09–1.26, I2 = 0%) for patients with dementia, 1.35 (95% CI 1.13–1.60, I2 = 58.9%) for patients without dementia, 1.16 (95% CI 1.07–1.25, I2 = 43.2%) for studies with a follow‐up period of 1 year, and 1.30 (95% CI 1.15–1.48, I2 = 24.5%) for studies with a follow‐up period of more than 1 year. Conclusions: Urinary incontinence is associated with an increased risk for death among residents of care facilities. Therefore, it was necessary to screen the elderly dwelling in nursing homes who were experiencing or at risk for urinary incontinence with useful tools (e.g., overactive bladder symptom score, bladder control self‐assessment questionnaire, three incontinence questions). In addition, early interventions strategies, such as weight loss, stopping smoking, pelvic floor muscle training, and medical and surgical treatments would contribute to decreasing the risk for urinary incontinence and preventing adverse outcomes in nursing home residents. Clinical Relevance: In our study, we found that the elderly with urinary incontinence who resided in nursing homes had a higher risk for mortality than those without urinary incontinence. Therefore, urinary incontinence in the elderly residing in nursing homes is of particular concern. Early detection and intervention are important for the elderly with urinary incontinence, and caregivers should be made aware of this importance. [ABSTRACT FROM AUTHOR]

Online interventions focused on mitigating the negative impact of care on family caregivers of people with dementia have become increasingly popular recently. The aim of this systematic review and meta-analysis was to analyze the effectiveness of these online support programs and to assess whether they do indeed enhance participants' wellbeing. A systematic literature search of 5 scientific databases was performed: PubMed, PsycInfo, CINAHL, Web of Science and Cochrane Library. Online interventions published between January 2014 and July 2018 targeted at informal family caregivers of people with dementia living at home were systemically reviewed. A total of 10 randomized controlled trials (RCTs) or studies with quasi-experimental designs were found. The characteristics of the interventions varied widely, as did their duration and results. In general, the effect size found was medium-small, despite the high methodological quality of the studies. The results reveal that online support interventions are a valid resource for improving caregivers' psychological wellbeing, including depression, anxiety, burden and caregiving competence. The best results were found for multi-component interventions: psychoeducation, training in psychological strategies and skills, professional support and online forums or support groups with other caregivers. The meta-analysis indicated that family caregivers' depression levels were reduced in the intervention group (Hedges' g = −0.21, 95% confidence interval of -0.410 to -0.025; z = −2.216: p = 0.027), although no significant differences were observed between the mean changes found in the intervention and control groups in relation to anxiety, burden or competence. Online interventions targeted at family caregivers can help improve their psychological wellbeing. Nevertheless, more randomized controlled trials are required, with rigorous methodological criteria, in order to provide further evidence of the utility of these interventions which seem to be effective. [ABSTRACT FROM AUTHOR]

This study aims to systematically evaluate the efficacy of mindfulness-based intervention (MBI) in improving mental health and quality of life for people with dementia. Comprehensive literature search was performed using the PubMed, EMBASE, Web of Science, Cochrane Library, and CINAHL databases from their inception till June 26, 2019. In total, nine articles met the eligibility criteria and were included. The results of the meta-analysis showed a statistically significant decrease in depressive symptoms (SMD = −0.39, 95% CI: − 0.62 to − 0.15), in people with dementia who were treated with MBI. However, there were no significant improvements in anxiety, stress, or quality of life. These findings suggest that MBI is a promising alternative to conventional interventions in the treatment of depression among dementia patients and warrant further study. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives. To (1) perform a meta-analysis of randomised controlled trials pertaining to the efficacy of music therapy on disruptive behaviours, anxiety levels, depressive moods and cognitive functioning in people with dementia; and (2) clarify which interventions, therapists and participant characteristics exerted higher and more prominent effects. Background. Present study was the first to perform a meta-analysis that included all the randomised controlled trials found in literature relating to music therapy for people with dementia over the past 15 years. Design. A meta-analysis study design. Methods. Quantitative studies were retrieved from PubMed, Medline, Cochrane Library Database, CINAHL, SCOPUS and PsycINFO. A meta-analysis was used to calculate the overall effect sizes of music therapy on outcome indicators. Results. Music therapy significantly improved disruptive behaviours [Hedges g = -0-66; 95% confidence interval (CI) = -0-44 to -0-88] and anxiety levels (Hedges' g = -0-51; 95% CI = -0-02 to -1-00) in people with dementia. Music therapy might affect depressive moods (Hedges' g = --0-39; 95% CI = 0-01 to -0-78), and cognitive functioning (Hedges' g = 0-19; 95% CI = 0-45 to -0-08). Conclusion. Music therapy exerted a moderately large effect on disruptive behaviours of people with dementia, a moderate effect on anxiety levels and depressive moods, and a small effect on cognitive functioning. Relevance to clinical practice. Individual music therapy provided once a week to patients with cognitive functioning and manual guided in music intervention construction is suggested. Group music therapy is provided several times a week to reduce their disruptive behaviours, anxiety levels and depressive moods. Music therapy is a cost-effective, enjoyable, noninvasive therapy and could be useful for clinical nurses in creating an environment that is conducive to the well-being of patients with dementia. [ABSTRACT FROM AUTHOR]

Aim: This critical review explores the review material on falls prevention interventions in older adults with cognitive impairment, such as dementia. Method: A systematic review of reviews was conducted using the following bibliographic databases: PubMed/Medline, EMBASE, AMED, CINAHL and the Cochrane electronic library. The search terms used were: 'falls'; 'rehabilitation'; 'falls prevention'; 'interventions'; 'cognitive impairment'; 'dementia'; and 'Alzheimer's disease'. All available studies were marked against predetermined inclusion and exclusion criteria. Results: Of the seven review articles that met the inclusion criteria, only one had a homogenous population of adults with a cognitive impairment. The most reported intervention was exercise, which was included in all seven reviews of 91 studies. Multifactorial and multicomponent falls prevention programmes were also frequently reported. Reports of efficacy were inconsistent for all the interventions reported. Conclusion: Evidence for falls prevention interventions for adults with cognitive impairment is varied and inconclusive. When compared with the literature on falls interventions in healthy older adult populations, both primary and synthesis studies in older adults with cognitive impairment are lacking in number, quality and homogeneity of sample population and interventions. Promising results are emerging but clinical recommendations cannot be made at this time. [ABSTRACT FROM AUTHOR]