Key result
Non-pharmacological interventions and cholinesterase inhibitors yielded similar improvements in cognition and affective behaviour in demented elderly (effect size d' = 0.32 vs 0.31).
Why the study?
Do non-pharmacological interventions improve cognition and behaviour similarly to cholinesterase inhibitors in cognitively impaired and demented elderly patients?
Meta-Analysis
Do non-pharmacological interventions improve cognition and behaviour similarly to cholinesterase inhibitors in cognitively impaired and demented elderly patients?
Non-pharmacological interventions such as bright light, physical activity, and tactile stimulation provide similar effect sizes for improving cognition and affective behavior as cholinesterase inhibitors in demented elderly patients.
Non-pharmacological interventions match cholinesterase inhibitors for cognition and behavior in dementia; supports their use as alternatives and extends comparative evidence.
The present paper reviews studies examining the effects of non-pharmacological stimulation, i.e. bright light, physical activity and tactile stimulation (touch), on cognition, affective behaviour, and the sleep-wake rhythm of impaired and demented elderly, both in a qualitative (narrative) and quantitative (meta-analytic) manner. An extensive search through eight bibliographic data bases (PubMed, Web of Science, ERIC, PsychINFO, Psyndex, Cinahl, Biological Abstracts and Rehabdata) was performed up to August 2002. The primary criterion for inclusion in this review was that studies provided sufficient data to calculate effect-sizes. In the qualitative analysis, all three types of stimulation appeared to improve cognitive functioning. Disturbances in behaviour react positively to bright light and tactile stimulation. Bright light was also beneficial to sleep. Tactile stimulation had, moreover, a beneficial influence on the patient-caretaker relationship. A comparison was made with several representative papers published since 1991 on the effects of acetylcholinesterase inhibitors on cognition and behaviour with representative papers on non-pharmacological stimulation interventions. Data indicated that improvements in cognition and affective behaviour by non-pharmacological interventions (d' = 0.32) and by cholinesterase inhibitors (d' = 0.31) were of similar effect-size. Possible mechanisms underlying the non-pharmacological stimulation effects are discussed and suggestions offered for future research.
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Luijpen et al. (2003) conducted a meta-analysis in Cognitively impaired and demented elderly. Non-pharmacological stimulation (bright light, physical activity, tactile stimulation) vs. Cholinesterase inhibitors was evaluated on Cognition and affective behaviour (d' = 0.32 vs 0.31). Non-pharmacological interventions and cholinesterase inhibitors yielded similar improvements in cognition and affective behaviour in demented elderly (effect size d' = 0.32 vs 0.31).
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