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Systematic review of the efficacy of pharmacological and non-pharmacological interventions for improving quality of life of people with dementia
Thorpe, Naomi Rajkumar, Anto P.
Thorpe, Naomi
Rajkumar, Anto P.
Abstract
Background
People with dementia (PwD) and their carers often consider maintaining good quality of life (QoL) more important than improvements in cognition or other symptoms of dementia. There is a clinical need for identifying interventions that can improve QoL of PwD. There are currently no evidence-based guidelines to help clinicians, patients and policy makers to make informed decisions regarding QoL in dementia.
Aims
To conduct the first comprehensive systematic review of all studies that investigated efficacy of any pharmacological or non-pharmacological intervention for improving QoL of PwD.
Method
Our review team identified eligible studies by comprehensively searching nine databases. We completed quality assessment, extracted relevant data and performed GRADE assessment of eligible studies. We conducted meta-analyses when three or more studies investigated an intervention for improving QoL of PwD.
Results
We screened 14 389 abstracts and included 324 eligible studies. Our meta-analysis confirmed level 1 evidence supporting the use of group cognitive stimulation therapy for improving QoL (standardised mean difference 0.25; P = 0.003) of PwD. Our narrative data synthesis revealed level 2 evidence supporting 42 non-pharmacological interventions, including those based on cognitive rehabilitation, reminiscence, occupational therapy, robots, exercise or music therapy. Current evidence supporting the use of any pharmacological intervention for improving QoL in dementia is limited.
Conclusions
Current evidence highlights the importance of non-pharmacological interventions and multidisciplinary care for supporting QoL of PwD. QoL should be prioritised when agreeing care plans. Further research focusing on QoL outcomes and investigating combined pharmacological and non-pharmacological interventions is urgently needed.
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Date
2025-04-01
Type
Article
Subject
Dementia, Cognitive therapy, Occupational therapy, Exercise therapy, Music therapy, Pharmacology, Quality of life
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Citation
Luxton, D., Thorpe, N., Crane, E., Warne, M., Cornwall, O., El-Dalil, D., Matthews, J. & Rajkumar, A. P. (2025). Systematic review of the efficacy of pharmacological and non-pharmacological interventions for improving quality of life of people with dementia. The British Journal of Psychiatry, DOI: 10.1192/bjp.2025.11.
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DOI
PMID
Publisher
Cambridge University Press
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Publisher’s statement
© The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited