Non-Pharmacological Interventions for People With Dementia Who Live Alone: A Systematic Review

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2025-02-26 DOI:10.1002/gps.70059

Sarah Polack, Georgia Bell, Barbora Silarova, Molly Hebditch, Alison Tingle, Andrew Sommerlad, Elena Portacolone, Kath Sykes, Naji Tabet

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引用次数: 0

Abstract

Objectives

Approximately one third of people with dementia live on their own and they face an increased risk of unmet needs and loneliness. This systematic review aimed to identify and describe non-pharmacological interventions that have been evaluated for people with dementia living alone and to examine the effectiveness of these interventions.

Methods

Following PRISMA guidelines, six databases were systematically searched: MEDLINE, Embase, CINAHL, PsycINFO, Social Care online, and ClinicalTrials.gov. Studies that reported on the impact or experience of an intervention for people with dementia living alone in the community (not long-term care) and that had been published since 2000 were included in the review. No restrictions were applied in terms of study design or outcome measures. Study risk of bias was assessed, and a narrative approach was used to synthesize findings.

Results

Thirteen studies of 13 different interventions were included, grouped into five intervention categories: home-based dementia case/care management (n = 4), technology (n = 3), social (n = 3), cognitive (n = 2) and psychological (n = 1). There was one randomized controlled trial (RCT), and two economic evaluations that used data from RCTs. Most other studies were small-scale, and only two were evaluated to have low risk of bias. Most studies reported positive or mixed findings in terms of the intervention's impact on the person with dementia or aspects of feasibility. However, studies were heterogeneous in terms of intervention, study design, and outcomes.

Conclusions

This review of a limited body of research highlights the potential for interventions to support people with dementia who live alone. It also identifies key evidence gaps and the need for more robust and comparable research to better understand what works, why, for who, and how. Involving people with dementia who live alone in the design, implementation, and evaluation of these interventions will be crucial to ensure that their needs and preferences are met.

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对独居痴呆患者的非药物干预：系统综述

大约三分之一的痴呆症患者独自生活，他们面临需求未得到满足和孤独的风险增加。本系统综述旨在确定和描述已对独居痴呆患者进行评估的非药物干预措施，并检查这些干预措施的有效性。方法按照PRISMA指南，系统检索MEDLINE、Embase、CINAHL、PsycINFO、Social Care online和ClinicalTrials.gov等6个数据库。自2000年以来发表的关于干预对社区独居痴呆症患者（非长期护理）的影响或经历的研究被纳入该综述。在研究设计或结果测量方面没有限制。评估研究偏倚风险，并采用叙述方法综合研究结果。结果纳入13项不同干预措施的13项研究，分为5类干预措施：以家庭为基础的痴呆病例/护理管理（n = 4）、技术（n = 3）、社会（n = 3）、认知（n = 2）和心理（n = 1）。有1项随机对照试验（RCT）和2项使用RCT数据的经济评估。大多数其他研究都是小规模的，只有两项被评估为低偏倚风险。在干预对痴呆症患者的影响或可行性方面，大多数研究报告了积极或混合的结果。然而，研究在干预、研究设计和结果方面存在异质性。本综述对有限的研究主体进行了回顾，强调了干预措施支持独居痴呆患者的潜力。它还确定了关键的证据差距，以及需要进行更有力和可比较的研究，以便更好地了解什么有效、为什么有效、对谁有效以及如何有效。让独居的痴呆症患者参与这些干预措施的设计、实施和评估，对于确保满足他们的需求和偏好至关重要。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.