Health Impacts of Nonpharmacologic Interventions Among People Living With Dementia: A Systematic Review and Network Meta-Analysis

Background: The study compares the health impacts of various nonpharmacologic interventions on cognitive function, daily functioning, depression, and quality of life among people living with dementia. Methods: A comprehensive search was conducted across three databases—PubMed, Airiti Library, and Scopus—to identify eligible randomized controlled trials published in English or Chinese within the past decade, up to December 2023. This study included a systematic review and a network meta-analysis focusing on various health outcomes. Results: Analysis encompassed 26 studies with a total of 3,403 people living with dementia. Interventions that significantly influencing cognitive function included aerobic exercise combined with resistance exercise (SMD = 1.53, 95% CI: 1.13-1.93), resistance exercise alone (SMD = 1.53, 95% CI: 1.12-1.93), and reminiscence therapy (SMD = 1.25, 95% CI: 0.70-1.80). Resistance exercise had the greatest impact on daily functioning (SMD = 0.95, 95% CI: 0.57-1.33), while reminiscence therapy (SMD = 0.65, 95% CI: 0.20-1.10) and music therapy (SMD = 0.56, 95% CI: 0.31 - 0.81) had the most significant effect on depression. A significant effect on quality of life was not found in this study. Conclusions: Resistance exercise, multicomponent exercise incorporating resistance training, and reminiscence therapy as well as music therapy were found to positively impact the health of people living with dementia. These findings suggest that integrating nonpharmacologic practices could enhance dementia care.