Characteristics of complex non-pharmacological interventions for cognitive stimulation in people with mild to moderate dementia in nursing homes: A systematic review

• Reviews support complex interventions for cognitive stimulation in dementia care. • Key components include reminiscence, ADLs, and physical or relaxing exercises. • Group sessions prevail, though many elements fit into nurses’ daily 24/7 routines. • Detailed description of complex interventions inform development of 24/7 approaches. A literature search in February 2021, updated in July 2023, using MEDLINE, CENTRAL, PsycINFO, ALOIS, and CINAHL identified 49 studies involving 2,795 participants. We included randomized controlled trials (RCTs) and quasi-RCTs. Intervention components included reminiscence therapy, activities of daily living, physical exercises, cognitive exercises, music and art therapy, reality orientation, and multisensory stimulation. Variations were observed in procedures, materials, delivery modes, and durations, with a low overall risk of bias. Notably, no studies reported barriers to delivery, and only one included patient input. The findings suggest the need for improved intervention design and methodologies, including digital adaptations and individualization of group-based components. Future research should employ established frameworks to describe interventions and prioritize patient and public involvement throughout the research process.