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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
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Non-pharmacological interventions (NPIs) should be the first line of treatment for the behavioural and psychological symptoms of dementia (BPSD).
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Multicomponent NPIs tailored to individual and caregiver needs can reduce BPSD in community settings.
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Current instruments that measure BPSD lack precision, diluting the observed effect of NPIs; more precise outcome measures are needed.
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Quality-of-life indicators may be more sensitive measures of NPI benefits than reduction in negative behaviours.
Context
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 …