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Drug and Alcohol Dependence May 2015Overdose of amphetamine, related derivatives, and analogues (ARDA) continues to be a serious worldwide health problem. Patients frequently present to the hospital and... (Review)
Review
BACKGROUND
Overdose of amphetamine, related derivatives, and analogues (ARDA) continues to be a serious worldwide health problem. Patients frequently present to the hospital and require treatment for agitation, psychosis, and hyperadrenegic symptoms leading to pathologic sequelae and mortality.
OBJECTIVE
To review the pharmacologic treatment of agitation, psychosis, and the hyperadrenergic state resulting from ARDA toxicity.
METHODS
MEDLINE, PsycINFO, and the Cochrane Library were searched from inception to September 2014. Articles on pharmacologic treatment of ARDA-induced agitation, psychosis, and hyperadrenergic symptoms were selected. Evidence was graded using Oxford CEBM. Treatment recommendations were compared to current ACCF/AHA guidelines.
RESULTS
The search resulted in 6082 articles with 81 eligible treatment involving 835 human subjects. There were 6 high-quality studies supporting the use of antipsychotics and benzodiazepines for control of agitation and psychosis. There were several case reports detailing the successful use of dexmedetomidine for this indication. There were 9 high-quality studies reporting the overall safety and efficacy of β-blockers for control of hypertension and tachycardia associated with ARDA. There were 3 high-quality studies of calcium channel blockers. There were 2 level I studies of α-blockers and a small number of case reports for nitric oxide-mediated vasodilators.
CONCLUSIONS
High-quality evidence for pharmacologic treatment of overdose from ARDA is limited but can help guide management of acute agitation, psychosis, tachycardia, and hypertension. The use of butyrophenone and later-generation antipsychotics, benzodiazepines, and β-blockers is recommended based on existing evidence. Future randomized prospective trials are needed to evaluate new agents and further define treatment of these patients.
Topics: Adrenergic Antagonists; Akathisia, Drug-Induced; Amphetamine-Related Disorders; Amphetamines; Antipsychotic Agents; Benzodiazepines; Dexmedetomidine; Humans; Hypertension; Hypnotics and Sedatives; Prospective Studies; Psychoses, Substance-Induced; Tachycardia
PubMed: 25724076
DOI: 10.1016/j.drugalcdep.2015.01.040 -
Journal of Clinical Nursing Jul 2022To evaluate the effectiveness of horticultural therapy on cognitive function, agitation, positive emotion and engagement in people with dementia. (Meta-Analysis)
Meta-Analysis Review
AIMS AND OBJECTIVES
To evaluate the effectiveness of horticultural therapy on cognitive function, agitation, positive emotion and engagement in people with dementia.
BACKGROUND
The number of people with dementia is increasing rapidly, and nonpharmacological interventions such as horticultural therapy have been recommended as the first choice for these patients. Horticultural therapy involves participatory and ornamental horticultural therapy. Many original studies have examined the effectiveness of horticultural therapy in the last two decades. However, these studies vary in types of interventions, outcomes and measurement.
DESIGN
A quantitative systematic review and meta-analysis.
METHODS
This systematic review was conducted under PRISMA guidelines. Randomised controlled trials (RCTs) and quasi-experimental studies involving horticultural therapy for people with dementia were included. Risk of bias was assessed by the Cochrane's and Joanna Briggs Institute's tool. Reference lists and a relevant journal were searched. Meta-analyses were conducted using RevMan 5.3. PubMed, CINAHL, Embase, BIOSIS Previews, Web of Science Core Collection, China National Knowledge Infrastructure, Wanfang, SinoMed, Cochrane Library and ProQuest Health & Medical Complete were searched. Studies from database inception to 1 July 2019 were included.
RESULTS
This systematic review included 14 studies (4 RCTs and 10 quasi-experimental studies) involving 411 people with dementia. The results of meta-analyses indicated that significant differences were found in the effectiveness of participatory horticultural therapy on total score of cognitive function, agitation, positive emotion and engagement, but not in the effectiveness of ornamental horticultural activities on agitation and positive emotion.
CONCLUSIONS
The existing evidence supports the effectiveness of participatory horticultural therapy on cognitive function, agitation, positive emotion and engagement. Future high-quality original studies are needed to draw more robust conclusions.
RELEVANCE TO CLINICAL PRACTICE
The results support the use of participatory horticultural therapy for improving cognitive function, agitation, positive emotion and engagement of people with dementia.
Topics: China; Cognition; Dementia; Horticultural Therapy; Humans; Psychomotor Agitation
PubMed: 32017241
DOI: 10.1111/jocn.15204 -
Drugs & Aging Feb 2018Antipsychotic and benzodiazepine medications are widely used in nursing homes despite only modest efficacy and the risk of severe adverse effects. Numerous interventions... (Review)
Review
BACKGROUND
Antipsychotic and benzodiazepine medications are widely used in nursing homes despite only modest efficacy and the risk of severe adverse effects. Numerous interventions have been implemented to reduce their use. However, the outcomes for the residents and staff and the economic impact on the healthcare system remain relatively understudied.
OBJECTIVE
The aim was to examine the clinical and economic outcomes reported within interventions to reduce antipsychotic and/or benzodiazepine use in nursing homes.
METHODS
Databases searched included PubMed, EMBASE, CINAHL, CENTRAL, Scopus, and ProQuest. We focussed on interventions with professional (e.g. education) and/or organisational (e.g. formation of multidisciplinary teams) components. Data were extracted from the papers that included clinical and/or economic outcomes. Two authors independently reviewed articles for eligibility and quality.
RESULTS
Fourteen studies reported on clinical outcomes for the residents: 13 antipsychotic reduction studies and one study focussing exclusively on benzodiazepine reduction. There was substantial heterogeneity in the types of outcomes reported and the method of reporting. Change in behavioural and psychological symptoms was the most commonly reported outcome throughout the antipsychotic reduction interventions (n = 12 studies) and remained stable or improved in ten of 12 studies. Whilst improvements were seen in emotional responsiveness, measures of sleep, cognitive function, and subjective health score remained unchanged upon benzodiazepine reduction. No interventions included an economic analysis.
CONCLUSIONS
Efforts should be made to improve the consistency in reporting of clinical outcomes within interventions to reduce antipsychotic and/or benzodiazepine medications. Additionally, the economic impact of these interventions should be considered. Nonetheless, evidence suggests that interventions that reduce antipsychotic use are unlikely to have deleterious clinical effects. The clinical and economic effects of benzodiazepine reduction remain under-reported.
Topics: Antipsychotic Agents; Benzodiazepines; Drug Utilization; Humans; Nursing Homes; Psychomotor Agitation; Treatment Outcome
PubMed: 29374859
DOI: 10.1007/s40266-018-0518-6 -
The Cochrane Database of Systematic... Feb 2011Agitation and psychosis are common among older adults with dementia and are challenging to manage. At the present time, little is known about the efficacy and safety of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Agitation and psychosis are common among older adults with dementia and are challenging to manage. At the present time, little is known about the efficacy and safety of antidepressant medications when used to treat these symptoms.
OBJECTIVES
To assess the safety and efficacy of antidepressants in treating psychosis and agitation in older adults with Alzheimer's disease, vascular, or mixed dementia.
SEARCH STRATEGY
We searched the Cochrane Dementia and Cognitive Improvement Group's Specialized Register which included Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), MEDLINE (January 1950 to October 2009), EMBASE (1980 - October 2009), CINAHL (all dates - October 2009) and PsycINFO (1806 to October 2009).
SELECTION CRITERIA
Randomized, controlled trials of antidepressants (selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, trazodone, and other antidepressants), compared to either placebo or comparator medications (typical or atypical antipsychotics, anticonvulsants, benzodiazepines, cholinesterase inhibitors, memantine or other medications) for treatment of agitation or psychosis in older adults with dementia.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial quality and extracted trial data. We collected information on efficacy as measured by dementia neuropsychiatric symptom rating scales and adverse effects. Study authors were contacted for additional information.
MAIN RESULTS
Nine trials including a total of 692 individuals were included in the review. Five studies compared SSRIs to placebo and two studies were combined in a meta-analysis for the outcome of change in Cohen-Mansfield Agitation Inventory (CMAI) scores. There was a significant difference between antidepressants and placebo on measures of agitation as reported on the change in CMAI total score (mean difference (MD), -0.89, 95% CI, -1.22 to -0.57) although the results were heavily weighted by one large study. There were no significant differences in change in behavioral symptoms of dementia for SSRIs compared to placebo in the one study that reported on changes in the Neuropsychiatric Inventory and Behavioral Pathology in Dementia scales. One study comparing citalopram to placebo found a significant difference in NPS as measured on the Neurobehavioral Rating Scale (NBRS) after controlling for baseline severity NBRS score although the unadjusted mean difference was not statistically significant (MD - 7.70, 95% CI: -16.57 to 1.17). There was no difference in the rates of trial withdrawals due to adverse events for SSRIs compared to placebo for four studies reporting this outcome (relative risk (RR), 1.07, 95% CI: 0.55 to 2.11) or in the number of trial withdrawals due to any cause in the three studies reporting this outcome (RR, 0.91, 95% CI, 0.65 to 1.26). One study compared the SSRI citalopram to the atypical antipsychotic risperidone and found no difference in NBRS scores, trial withdrawals due to any cause or trial withdrawals due to adverse events although the rates of adverse events as measured on the UKU side effect scale total score were lower for citalopram (MD -2.82, 95% CI: -4.94 to -0.70). Three studies compared SSRIs to typical antipsychotics. In meta-analysis of two studies there was no statistically significant differences in changes in CMAI total scores (MD, 4.66, 95% CI: -3.58 to 12.90). There was also no difference in trial withdrawals due to any cause or due to adverse events for SSRIs compared to typical antipsychotics. One study of trazodone compared to placebo did not find any significant difference in change in CMAI total scores (MD, 5.18, 95% CI, -2.86 to 13.22) or trial withdrawals due to any cause (RR, 1.06, 95% CI, 0.54 to 2.09). Two studies comparing trazodone to haloperidol also failed to detect any difference in change in CMAI total scores (MD, 3.28, 95% CI, -3.28 to 9.85) or trial withdrawals due to any cause (RR, 0.79, 95% CI, 0.43 to 1.46).
AUTHORS' CONCLUSIONS
Currently there are relatively few studies of antidepressants for the treatment of agitation and psychosis in dementia. The SSRIs sertraline and citalopram were associated with a reduction in symptoms of agitation when compared to placebo in two studies. Both SSRIs and trazodone appear to be tolerated reasonably well when compared to placebo, typical antipsychotics and atypical antipsychotics. Future studies involving more subjects are required to determine if SSRIs, trazodone, or other antidepressants are safe and effective treatments for agitation and psychosis in dementia.
Topics: Adult; Antidepressive Agents; Citalopram; Dementia; Humans; Psychomotor Agitation; Psychotic Disorders; Randomized Controlled Trials as Topic; Risperidone; Selective Serotonin Reuptake Inhibitors; Trazodone
PubMed: 21328305
DOI: 10.1002/14651858.CD008191.pub2 -
Neuropsychopharmacology Reports Mar 2024This systematic review and frequentist network meta-analysis used random-effects models is conducted to determine whether there are differences in the efficacy,... (Meta-Analysis)
Meta-Analysis
AIM
This systematic review and frequentist network meta-analysis used random-effects models is conducted to determine whether there are differences in the efficacy, acceptability, tolerability, and safety profiles of brexpiprazole (BRE) and aripiprazole (ARI) for Japanese with major depressive disorder (MDD) who were inadequately responsive to antidepressants.
METHODS
Outcome measures were scores on the Montgomery Åsberg Depression Rating Scale (primary), the Clinical Global Impression severity scale, and social functioning scale; the non-response rate; the non-remission rate; all-cause discontinuation; discontinuation due to adverse events (DAE); at least one adverse event (1AE); serious adverse event, akathisia; tremor; weight gain.
RESULTS
A literature search identified three double-blind, randomized, placebo-controlled trials. These comprised one BRE study (with a 1 mg/day [BRE1] and a 2 mg/day [BRE2]) and two ARI studies (with a 3 mg/day arm and a flexible-dose arm[within the dosage range approved in Japan]) (n = 1736). Both BRE and ARI demonstrated better efficacy than the placebo. BRE but not ARI had a higher DAE than the placebo. ARI but not BRE had a higher 1AE than the placebo. BRE and ARI had a higher risk of akathisia and weight gain than the placebo. There were no significant differences between BRE and ARI for any of the outcomes. Although BRE1 had good efficacy, it carried risk of weight gain. Although BRE2 also had efficacy, it carried risks of DAE, akathisia, and weight gain. However, the risk of akathisia in BRE2 was reduced by an initial dose of 0.5 mg/day rather than 1.0 mg/day.
CONCLUSIONS
Overall BRE showed similar utility to ARI and a good risk-benefit balance.
Topics: Humans; Aripiprazole; Depressive Disorder, Major; Japan; Psychomotor Agitation; Network Meta-Analysis; Weight Gain; Randomized Controlled Trials as Topic; Thiophenes; Quinolones
PubMed: 38219278
DOI: 10.1002/npr2.12414 -
The Cochrane Database of Systematic... Apr 2017Dementia is a common and serious neuropsychiatric syndrome, characterised by progressive cognitive and functional decline. The majority of people with dementia develop... (Review)
Review
BACKGROUND
Dementia is a common and serious neuropsychiatric syndrome, characterised by progressive cognitive and functional decline. The majority of people with dementia develop behavioural disturbances, also known as behavioural and psychological symptoms of dementia (BPSD). Several non-pharmacological interventions have been evaluated to treat BPSD in people with dementia. Simulated presence therapy (SPT), an intervention that uses video or audiotape recordings of family members played to the person with dementia, is a possible approach to treat BPSD.
OBJECTIVES
To assess the effects of SPT on behavioural and psychological symptoms and quality of life in people with dementia.
SEARCH METHODS
We searched ALOIS (the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group), CENTRAL (The Cochrane Library) (9 February 2016), MEDLINE Ovid SP (1946 to 6 January 2017), Embase Ovid SP (1972 to 6 January 2017), PsycINFO Ovid SP (1806 to 6 January 2017), CINAHL via EBSCOhost (1980 to 6 January 2017), LILACS via BIREME (all dates to 6 January 2017), ClinicalTrials.gov (ClinicalTrials.gov) (all dates to 6 January 2017), and the World Health Organization (WHO) Portal (apps.who.int/trialsearch) (all dates to 6 January 2017). We also checked the reference lists of relevant articles to identify any additional studies.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials, including cross-over studies, that evaluated the efficacy of SPT, consisting of personalised audio or videotape recordings of family members, in people with any form of dementia.
DATA COLLECTION AND ANALYSIS
Two authors independently selected studies, assessed risk of bias and extracted data. No meta-analyses were conducted because of substantial heterogeneity among the included studies.
MAIN RESULTS
Three trials with 144 participants met the inclusion criteria. Two of the trials had a randomised cross-over design, one was a cross-over trial which we classified as quasi-randomised.Participants in the included studies were people with dementia living in nursing homes. They were predominantly women and had a mean age of over 80 years. SPT was performed using an audio or video recording prepared by family members or surrogates. It varied in its content, frequency of administration and duration. All the studies compared multiple treatments. In one study, SPT was compared with two other interventions; in the other two studies, it was compared with three other interventions. Specifically, SPT was compared to usual care, personalised music (two studies), a 'placebo' audiotape containing the voice of a person (two studies), and one-to-one social interaction performed by trained research assistants (one study). In terms of outcomes evaluated, one study considered agitation and withdrawn behaviour (both assessed with three methods); the second study evaluated verbal disruptive behaviour (assessed with three methods); and the third study evaluated physically agitated behaviour and verbally agitated behaviour (the method used was not clearly described).According to the GRADE criteria, the overall quality of the evidence was very low due to very small numbers of participants and risk of bias in the included studies; (none of the trials was at low risk of selection bias; all the trials were at high risk of performance bias; one trial was at high risk of attrition bias; and all had unclear selective reporting).Because of variation in the participants, the format of SPT, the comparison interventions, and the measures used to assess outcomes, we judged the results unsuitable for a meta-analysis.Within each trial, the effect of SPT on behaviour, compared to usual care, was mixed and depended on the measure used. Two trials which included a personalised music intervention reported no significant differences between simulated presence and music on behavioural outcomes. Because the overall quality of the evidence was very low, we were very uncertain regarding all the resultsNone of the studies evaluated quality of life or any of our secondary outcome measures (performance of activities of daily living, dropout and carer burden).
AUTHORS' CONCLUSIONS
We were unable to draw any conclusions about the efficacy of SPT for treating behavioural and psychological symptoms and improving quality of life of people with dementia. New high-quality studies are needed to investigate the effect of SPT.
Topics: Aged, 80 and over; Dementia; Depression; Family; Female; Humans; Male; Psychomotor Agitation; Randomized Controlled Trials as Topic; Tape Recording; Videotape Recording
PubMed: 28418586
DOI: 10.1002/14651858.CD011882.pub2 -
International Psychogeriatrics Jun 2021Nursing home residents with dementia are sensitive to detrimental auditory environments. This paper presents the first literature review of empirical research...
OBJECTIVES
Nursing home residents with dementia are sensitive to detrimental auditory environments. This paper presents the first literature review of empirical research investigating (1) the (perceived) intensity and sources of sounds in nursing homes, and (2) the influence of sounds on health of residents with dementia and staff.
DESIGN
A systematic review was conducted in PubMed, Web of Science and Scopus. Study quality was assessed with the Mixed Methods Appraisal Tool. We used a narrative approach to present the results.
RESULTS
We included 35 studies. Nine studies investigated sound intensity and reported high noise intensity with an average of 55-68 dB(A) (during daytime). In four studies about sound sources, human voices and electronic devices were the most dominant sources. Five cross-sectional studies focused on music interventions and reported positives effects on agitated behaviors. Four randomized controlled trials tested noise reduction as part of an intervention. In two studies, high-intensity sounds were associated with decreased nighttime sleep and increased agitation. The third study found an association between music and less agitation compared to other stimuli. The fourth study did not find an effect of noise on agitation. Two studies reported that a noisy environment had negative effects on staff.
CONCLUSIONS
The need for appropriate auditory environments that are responsive to residents' cognitive abilities and functioning is not yet recognized widely. Future research needs to place greater emphasis on intervention-based and longitudinal study design.
Topics: Aged; Aged, 80 and over; Dementia; Female; Homes for the Aged; Humans; Male; Noise; Nursing Homes; Psychomotor Agitation; Quality of Life; Sleep
PubMed: 32594932
DOI: 10.1017/S1041610220000952 -
The British Journal of Psychiatry : the... Jun 2009Early worsening of anxiety, agitation and irritability are thought to be common among people commencing antidepressants, especially for anxiety disorders. This... (Review)
Review
BACKGROUND
Early worsening of anxiety, agitation and irritability are thought to be common among people commencing antidepressants, especially for anxiety disorders. This phenomenon, which may be termed jitteriness/anxiety syndrome, is cited as an explanation for early treatment failure and caution in using selective serotonin reuptake inhibitors (SSRIs). However, we believe that it is inconsistently defined and that robust evidence to support the phenomenon is lacking.
AIMS
To review systematically all evidence relating to jitteriness/anxiety syndrome to identify: constituent symptoms; medications implicated; disorders in which it was reported; incidence; time course; management strategies; relationship of this syndrome to therapeutic response; distinction between syndrome and akathisia; relationship between syndrome and suicide; and genetic predispositions.
METHOD
A systematic search identified articles and these were included in the review if they addressed one of the above aspects of jitteriness/anxiety syndrome.
RESULTS
Of 245 articles identified, 107 articles were included for review. No validated rating scales for jitteriness/anxiety syndrome were identified. There was no robust evidence that the incidence differed between SSRIs and tricyclic antidepressants, or that there was a higher incidence in anxiety disorders. Published incidence rates varied widely from 4 to 65% of people commencing antidepressant treatment. Common treatment strategies for this syndrome included a slower titration of antidepressant and the addition of benzodiazepines. Conclusive evidence for the efficacy of these strategies is lacking. There was conflicting and inconclusive evidence as to whether the emergence of this syndrome had a predictive value on the response to treatment. It appears to be a separate syndrome from akathisia, but evidence for this assertion was limited. The effect of jitteriness/anxiety syndrome on suicide rates has not been evaluated. Three studies examined genetic variations and side-effects from treatment, but none was specifically designed to assess jitteriness/anxiety syndrome.
CONCLUSIONS
Jitteriness/anxiety syndrome remains poorly characterised. Despite this, clinicians' perception of this syndrome influences prescribing and it is cited to support postulated mechanisms of drug action. We recommend systematised evaluation of side-effects at earlier time points in antidepressant trials to further elucidate this clinically important syndrome.
Topics: Akathisia, Drug-Induced; Antidepressive Agents; Anxiety; Anxiety Disorders; Dose-Response Relationship, Drug; Genetic Predisposition to Disease; Humans; Risk Factors; Selective Serotonin Reuptake Inhibitors; Suicide; Syndrome; Time Factors; Treatment Refusal
PubMed: 19478285
DOI: 10.1192/bjp.bp.107.048371 -
International Journal of Environmental... Apr 2022Delirium and psychomotor agitation are relevant clinical conditions that may develop during COVID-19 infection, especially in intensive care unit (ICU) settings. The... (Review)
Review
Delirium and psychomotor agitation are relevant clinical conditions that may develop during COVID-19 infection, especially in intensive care unit (ICU) settings. The psychopharmacological management of these conditions is receiving increasing interest in psychiatry, considering hyperkinetic delirium as one of the most common neuropsychiatries acute consequences in COVID-19 recovery patients. However, there are no actual internationally validated guidelines about this topic, due to the relatively newly introduced clinical condition; in addition, a standardized psychopharmacologic treatment of these cases is a complex goal to achieve due to the risk of both drug-drug interactions and the vulnerable conditions of those patients. The aim of this systematic review and case series is to evaluate and gather the scientific evidence on pharmacologic handling during delirium in COVID-19 patients to provide practical recommendations on the optimal management of psychotropic medication in these kinds of patients. The electronic databases PubMed, Embase and Web of Science were reviewed to identify studies, in accordance with the PRISMA guidelines. At the end of the selection process, a total of 21 studies ( = 2063) were included. We also collected a case series of acute psychomotor agitation in COVID-19 patients hospitalized in ICU. Our results showed how the symptom-based choice of the psychotropic medication is crucial, and even most of the psychotropic drug classes showed good safety, one must not underestimate the possible drug interactions and also the possible decrease in vital functions which need to be strictly monitored especially during treatment with some kinds of molecules. We believe that the evidence-based recommendations highlighted in the present research will enhance the current knowledge and could provide better management of these patients.
Topics: Delirium; Humans; Intensive Care Units; Psychomotor Agitation; Psychotropic Drugs; SARS-CoV-2; COVID-19 Drug Treatment
PubMed: 35564372
DOI: 10.3390/ijerph19094978 -
The Cochrane Database of Systematic... Oct 2006Massage and touch have been suggested as a non-pharmacological alternative or supplement to other treatments offered in order to reduce or manage a range of conditions... (Review)
Review
BACKGROUND
Massage and touch have been suggested as a non-pharmacological alternative or supplement to other treatments offered in order to reduce or manage a range of conditions associated with dementia such as anxiety, agitated behaviour and depression. It has also been suggested that massage and touch may counteract cognitive decline.
OBJECTIVES
To assess the effects of a range of massage and touch therapies on conditions associated with dementia, such as anxiety, agitated behaviour and depression, identify any adverse effects, and provide recommendations about future trials.
SEARCH STRATEGY
We identified trials from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 12 July 2005 using the terms massage, reflexology, touch and shiatsu. This Register contains records from all major healthcare databases and many ongoing trials databases and is updated regularly. In addition, general and specific literature databases were searched and patient and therapist organizations contacted.
SELECTION CRITERIA
Randomized controlled trials (RCTs) in which a massage or touch intervention was given to persons suffering from dementia of any type, compared with other treatments or no treatment, and in which effect parameters included measures of behavioural problems, caregiver burden, emotional distress or cognitive abilities, were eligible for inclusion. Furthermore, we employed a set of minimal methodological quality criteria as a selection filter.
DATA COLLECTION AND ANALYSIS
We identified 34 references in the initial searches. Of these, seven were actual or possible RCTs, but only two were found to meet the requirements of the set of minimal methodological criteria.
MAIN RESULTS
The very limited amount of reliable evidence available is in favour of massage and touch interventions for problems associated with dementia. However, this evidence addresses only two specific applications: hand massage for the immediate or short-term reduction of agitated behaviour, and the addition of touch to verbal encouragement to eat for the normalization of nutritional intake. The existing evidence does not support general conclusions about the effect or possible side effects of such interventions. No severe side effects were identified.
AUTHORS' CONCLUSIONS
Massage and touch may serve as alternatives or complements to other therapies for the management of behavioural, emotional and perhaps other conditions associated with dementia. More research is needed, however, to provide definitive evidence about the benefits of these interventions.
Topics: Anxiety; Cognition Disorders; Dementia; Depression; Humans; Massage; Psychomotor Agitation; Randomized Controlled Trials as Topic; Touch
PubMed: 17054228
DOI: 10.1002/14651858.CD004989.pub2