Overview of systematic reviews: Effective home support in dementia care, components and impacts-Stage 1, psychosocial interventions for dementia

Aim: To synthesize evidence to identify the components of effective psychosocial interventions in dementia care to inform clinical practice, policy and research.

Background: With population ageing, dementia represents a significant care challenge with 60% of people with dementia living at home.

Design: Overview of systematic reviews with narrative summary.

Data sources: Electronic searches of published systematic reviews in English using Cochrane Database of Systematic Reviews, DARE and EPPI-Centre, between September 2013 - April 2014.

Review methods: Systematic reviews were appraised against Cochrane Collaboration levels of effectiveness. Components of psychosocial interventions were identified with their theoretical rationale. Findings were explored with a Patient, Public and Carer Involvement group.

Results: Thirty-six systematic reviews were included. From interventions, 14 components were identified, nine for people with dementia and five for carers, mostly undertaken in nursing/care homes. For people with dementia, there was evidence of effectiveness for cognitive stimulation and cognitive training, but less evidence for sensory stimulation, reminiscence, staff education, behavioural therapy and ADL training. For carers, there was evidence of effectiveness for education and training, psychotherapy and counselling.

Conclusion: There was a lack of definitive evidence of effectiveness for most psychosocial interventions. Further studies with stronger methodology or replication of existing studies would strengthen the evidence base. Few interventions were undertaken with people with dementia and their carers living at home. Further work will investigate the extent to which components identified here are present in models of home support for people with dementia and carers and their effectiveness.