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Systematic review and meta-analysis
Community-based non-pharmacological interventions delivered by family caregivers reduce behavioural and psychological symptoms of dementia
  1. Ann M Kolanowski,
  2. 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}

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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

  • 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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  • Funding None.

  • Competing interests None.