Effects of Nonpharmacological Interventions on Disruptive Vocalisation in Nursing Home Patients With Dementia-A Systematic Review.

No meta-analysis was possible, so there is no pooled estimate of how well any of these interventions work, and the conclusions rest on counting how many trials were positive. The search covered only English-language studies from 2005 to 2019 indexed in four databases, so relevant work in other languages or published earlier is missing. Vocally disruptive behaviour and dementia were defined differently across the trials, so their results may not all be measuring the same thing. The paper reports 23 included trials in one place and '16 randomised controlled trials' when discussing how far the results generalise, so the number of trials behind some conclusions is unclear. Everyone studied was over 65, had dementia and was a permanent nursing home resident, so these findings do not carry over to people with dementia living at home, and the authors warn that results may not transfer between countries with different health care systems. Each individual intervention was tested in only one to six trials, and the trials differed in the number, length, content and intensity of sessions.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be seen as a potential conflict of interest. The text supplied does not say who funded the review or whether any funder had a role in it.

Do not take this review as proof that nonpharmacological approaches work for vocally disruptive behaviour in general. The results were never pooled into a single estimate, the same type of intervention produced opposite findings in different trials, two trials found the behaviour got worse, and the reviewers' own conclusion is that no clear guidelines emerge for clinicians and carers.