• Iosief Abraha, Joseph M Rimland, Fabiana Mirella Trotta, Giuseppina Dell'Aquila, Alfonso Cruz-Jentoft, Mirko Petrovic, Adalsteinn Gudmundsson, Roy Soiza, Denis O'Mahony, Antonio Guaita, and Antonio Cherubini.
• Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy.
• BMJ Open. 2017 Mar 16; 7 (3): e012759.

ObjectiveTo provide an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD).DesignSystematic overview of reviews.Data SourcesPubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL and PsycINFO (2009-March 2015).Eligibility CriteriaSystematic reviews (SRs) that included at least one comparative study evaluating any non-pharmacological intervention, to treat BPSD.Data ExtractionEligible studies were selected and data extracted independently by 2 reviewers.The AMSTAR checklist was used to assess the quality of the SRs.Data AnalysisExtracted data were synthesised using a narrative approach.Results38 SRs and 129 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (25 SRs, 66 primary studies) that encompassed: shiatsu and acupressure, aromatherapy, massage/touch therapy, light therapy, sensory garden and horticultural activities, music/dance therapy, dance therapy, snoezelen multisensory stimulation therapy, transcutaneous electrical nerve stimulation; (2) cognitive/emotion-oriented interventions (13 SRs; 26 primary studies) that included cognitive stimulation, reminiscence therapy, validation therapy, simulated presence therapy; (3) behaviour management techniques (6 SRs; 22 primary studies); (4) Multicomponent interventions (3 SR; four primary studies); (5) other therapies (5 SRs, 15 primary studies) comprising exercise therapy, animal-assisted therapy, special care unit and dining room environment-based interventions.ConclusionsA large number of non-pharmacological interventions for BPSD were identified. The majority of the studies had great variation in how the same type of intervention was defined and applied, the follow-up duration, the type of outcome measured, usually with modest sample size. Overall, music therapy and behavioural management techniques were effective for reducing BPSD.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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