Toward a theory-based specification of non-pharmacological treatments in aging and dementia: Focused reviews and methodological recommendations.

Thomas Holland, Alex Bahar-Fuchs, Zara Thompson, Jeanette Tamplin, Jenny T van der Steen, Aimee Spector, Gemma Ridel, Ruth Peters, Kimberly D Mueller, Martha Clare Morris, Franka J M Meiland, Susan M McCurry, Nicola T Lautenschlager, Antoine Lutz, Kate Laver, Amit Lampit, Sietske A M Sikkes, Benjamin M Hampstead, Rose-Marie Dröes, Hiroko Dodge, Klodian Dhana, Sophie Dautricourt, Gaël Chételat, Kay L Cox, Erin Cassidy-Eagle, Linda Clare, Henry Brodaty, Lyn S Turkstra, Linda M P Wesselman, Roos J Jutten, Yi Tang

Journal: Alzheimer's & dementia : the journal of the Alzheimer's Association 2021;17(2):255-270

PMID: 33215876

Abstract

INTRODUCTION

Non-pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks methodological rigor and continues to produce mixed results.

METHODS

In the current position paper, experts in NPT research have specified treatment targets, aims, and ingredients using an umbrella framework, the Rehabilitation Treatment Specification System.

RESULTS

Experts provided a snapshot and an authoritative summary of the evidence for different NPTs based on the best synthesis efforts, identified main gaps in knowledge and relevant barriers, and provided directions for future research. Experts in trial methodology provide best practice principles and recommendations for those working in this area, underscoring the importance of prespecified protocols.

DISCUSSION

We conclude that the evidence strongly supports various NPTs in relation to their primary targets, and discuss opportunities and challenges associated with a unifying theoretical framework to guide future efforts in this area.

© 2020 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

Address: Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands.; Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands.; Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China.; School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.; Centre for Healthy Brain Ageing and Dementia Centre for Research Collaboration, School of Psychiatry, UNSW, Sydney, Australia.; Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University of Exeter, Exeter, UK.; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA.; Medical School, University of Western Australia, Perth, Western Australia, Australia.; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France.; Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA.; Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.; Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.; Department of Psychiatry, Amsterdam University Medical Center, VUmc, Amsterdam, the Netherlands.; Department of Psychiatry, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.; Department of Rehabilitation, Aged and Extended Care, College of Medicine and Public Health, Flinders University, Adelaide, Australia.; Lyon Neuroscience Research Center INSERM U1028, CNRS UMR5292, Lyon University, Lyon, France.; NorthWestern Mental Health, Melbourne Health, Melbourne, Australia.; Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA.; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.; Department of Psychology, University of New South Wales, Randwick, Sydney, Australia.; Neuroscience Research Australia, Sydney, Australia.; The University of East Anglia, Norwich, UK.; Department of Clinical, Educational & Health Psychology, University College London, London, UK.; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands.; Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Victoria, Australia.; Centre for Research on Ageing, Health, and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia.
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