Home › Research › Disparities
Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: a systematic review
Ayalon L, Gum AM, Feliciano L, Areán PA.. Archives of internal medicine, 2006-11-01
Topic: Risk, prevention and care in population studies
Background Recent reports documenting limited evidence supporting the use of pharmacological interventions for neuropsychiatric symptoms (NPS) and increased risk of death, the black box warnings against the use of atypical antipsychotic drugs in older adults, and Omnibus Budget Reconciliation Act regulations suggest the need to evaluate the usefulness of nonpharmacological interventions in the management of NPS of dementia. Methods To determine the evidence base of nonpharmacological interventions for the management of NPS in patients with dementia, we reviewed MEDLINE, PsycINFO, the Cochrane library, and relevant bibliographies published from January 1966 to December 2005, using the American Psychological Association Guidelines. Results Three randomized controlled trials (RCTs) and 6 single-case designs (SCDs; N of 1 trials) met inclusion criteria. Under unmet needs interventions, 1 SCD found a moderate reduction in problem behaviors. Under behavioral interventions, based on observational data, all 4 SCDs reported a relative reduction of 50% to 100% in neuropsychiatric symptoms. Under caregiving interventions, there were 3 RCTs. At the 6-month follow-up, 1 RCT found a reduction in 4 neuropsychiatric symptom subscales: ideation disturbance score (0.3 vs 0.5; range, 0-8; P = .005); irritability score (18.8 vs 23.0; range, 8-38; P = .008); verbal agitation, as measured by mean frequency of 20-minute outbursts (0.5 vs 0.8; P = .005); and physical aggression score (11.4 vs 12.9; range, 6-42; P Conclusions The cumulative research to date on the impact of nonpharmacologic interventions for NPS among patients with dementia indicates that interventions that address behavioral issues and unmet needs and that include caregivers or bright light therapy may be efficacious. More high-quality research is necessary to confirm these findings.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Ayalon, L., Gum, A. M., Feliciano, L., & Areán, P. A. (2006). Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: a systematic review. Archives of internal medicine. https://doi.org/10.1001/archinte.166.20.2182
Vancouver
Ayalon L, Gum AM, Feliciano L, Areán PA. Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: a systematic review. Archives of internal medicine. 2006. doi:10.1001/archinte.166.20.2182. PMID: 17101935.
BibTeX
@article{ayalon2006-17101935,
author = {Ayalon, L. and Gum, A. M. and Feliciano, L. and Areán, P. A.},
title = {{Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: a systematic review}},
journal = {Archives of internal medicine},
year = {2006},
doi = {10.1001/archinte.166.20.2182},
pmid = {17101935},
url = {https://doi.org/10.1001/archinte.166.20.2182}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Background Recent reports documenting limited evidence supporting the use of pharmacological interventions for neuropsychiatric symptoms (NPS) and increased risk of death, the black box warnings against the use of atypical antipsychotic drugs in older adults, and Omnibus Budget Reconciliation Act regulations suggest the need to evaluate the usefulness of nonpharmacological interventions in the management of NPS of dementia.
- Results Three randomized controlled trials (RCTs) and 6 single-case designs (SCDs; N of 1 trials) met inclusion criteria.
- At the 6-month follow-up, 1 RCT found a reduction in 4 neuropsychiatric symptom subscales: ideation disturbance score (0.3 vs 0.5; range, 0-8; P = .005); irritability score (18.8 vs 23.0; range, 8-38; P = .008); verbal agitation, as measured by mean frequency of 20-minute outbursts (0.5 vs 0.8; P = .005); and physical aggression score (11.4 vs 12.9; range, 6-42; P<.001).
- More high-quality research is necessary to confirm these findings.
Why it matters
This review found limited evidence from a small number of studies on nonpharmacological interventions for neuropsychiatric symptoms in dementia. It does not test any treatment, cure, or prevention for Alzheimer's disease itself.
New to this subject? Start with our plain-English guide: Disparities →
Study details
- Evidence strengthHigh
How this study scored 57/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of internal medicine) |
| Journal's citation record | 3 / 4 | Archives of Internal Medicine: journal h-index 462 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question (from PubMed type “Systematic Review”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 212 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.6 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 4 / 6 | Cited 9.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Liat Ayalon: h-index 57 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Bar-Ilan University: institution h-index 553 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17101935) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 57 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
3 studies in the alzhub library list this one in their references.
Related studies in Disparities
Also tagged “prevalence”
1,224 studies in the library carry the topic tag “prevalence”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 1,224 tagged studies.