Evid Based Nurs 16:67-68 doi:10.1136/eb-2012-101113
  • Care of older person
  • Systematic review and meta-analysis

Community-based non-pharmacological interventions delivered by family caregivers reduce behavioural and psychological symptoms of dementia

  1. Nikki Lynn Hill
  1. School of Nursing, Pennsylvania State University, University Park, Pennsylvania, USA
  1. Correspondence to: Dr Ann M Kolanowski
    School of Nursing, Pennslylvania State University, 106 Health & Human Development East, University Park, PA 16802, USA; amk20{at}

Commentary on: Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012;169:946–53.

Implications for practice and research

  • Non-pharmacological interventions (NPIs) should be the first line of treatment for the behavioural and psychological symptoms of dementia (BPSD).

  • Multicomponent NPIs tailored to individual and caregiver needs can reduce BPSD in community settings.

  • Current instruments that measure BPSD lack precision, diluting the observed effect of NPIs; more precise outcome measures are needed.

  • Quality-of-life indicators may be more sensitive measures of NPI benefits than reduction in negative behaviours.


Behavioural and psychological symptoms of dementia (BPSD) are prevalent, impose a high burden on caregivers and greatly increase the cost of care. The use of pharmacological treatments is a common practice, but these drugs have not demonstrated efficacy and they carry a substantial risk for increased …

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