TY - JOUR
T1 - Clinical effectiveness of pharmacological and non-pharmacological treatments for the management of anxiety in community dwelling people living with dementia
T2 - A systematic review and meta-analysis
AU - Nimmons, Danielle
AU - Aker, Narin
AU - Burnand, Alice
AU - Jordan, Kelvin P.
AU - Cooper, Claudia
AU - Davies, Nathan
AU - Manthorpe, Jill
AU - Chew-Graham, Carolyn A.
AU - Kingstone, Tom
AU - Petersen, Irene
AU - Walters, Kate
N1 - Funding Information:
Danielle Nimmons was supported by a Fellowship award from the Alzheimer's Society , UK (grant number 584 ) .
Publisher Copyright:
© 2023 The Authors
PY - 2024/2
Y1 - 2024/2
N2 - People living with dementia commonly experience anxiety, which is often challenging to manage. We investigated the effectiveness of treatments for the management of anxiety in this population. We conducted a systematic review and meta-analysis of randomised controlled trials, and searched EMBASE, CINAHL, MEDLINE and PsycInfo. We estimated standardised mean differences at follow-up between treatments relative to control groups and pooled these across studies using random-effects models where feasible. Thirty-one studies were identified. Meta-analysis demonstrated non-pharmacological interventions were effective in reducing anxiety in people living with dementia, compared to care as usual or active controls. Specifically, music therapy (SMD–1.92(CI:−2.58,−1.25)), muscular approaches (SMD-0.65(CI:−1.02,−0.28)) and stimulating cognitive and physical activities (SMD–0.31(CI:−0.53,−0.09)). Pharmacological interventions with evidence of potential effectiveness included Ginkgo biloba, probiotics, olanzapine, loxapine and citalopram compared to placebo, olanzapine compared to bromazepam and buspirone and risperidone compared to haloperidol. Meta-analyses were not performed for pharmacological interventions due to studies’ heterogeneity. This has practice implications when promoting the use of more non-pharmacological interventions to help reduce anxiety among people living with dementia.
AB - People living with dementia commonly experience anxiety, which is often challenging to manage. We investigated the effectiveness of treatments for the management of anxiety in this population. We conducted a systematic review and meta-analysis of randomised controlled trials, and searched EMBASE, CINAHL, MEDLINE and PsycInfo. We estimated standardised mean differences at follow-up between treatments relative to control groups and pooled these across studies using random-effects models where feasible. Thirty-one studies were identified. Meta-analysis demonstrated non-pharmacological interventions were effective in reducing anxiety in people living with dementia, compared to care as usual or active controls. Specifically, music therapy (SMD–1.92(CI:−2.58,−1.25)), muscular approaches (SMD-0.65(CI:−1.02,−0.28)) and stimulating cognitive and physical activities (SMD–0.31(CI:−0.53,−0.09)). Pharmacological interventions with evidence of potential effectiveness included Ginkgo biloba, probiotics, olanzapine, loxapine and citalopram compared to placebo, olanzapine compared to bromazepam and buspirone and risperidone compared to haloperidol. Meta-analyses were not performed for pharmacological interventions due to studies’ heterogeneity. This has practice implications when promoting the use of more non-pharmacological interventions to help reduce anxiety among people living with dementia.
KW - Anxiety
KW - Dementia
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85180598101&partnerID=8YFLogxK
U2 - 10.1016/j.neubiorev.2023.105507
DO - 10.1016/j.neubiorev.2023.105507
M3 - Review article
C2 - 38097097
AN - SCOPUS:85180598101
SN - 0149-7634
VL - 157
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
M1 - 105507
ER -