Poor evidence for non-drug dementia treatments

A German report has called for more studies into the effectiveness of non-pharmaceutical interventions to assist people living with dementia.

The evidence for non-drug treatments for Alzheimer’s disease is poor according to a German study.

A report from the Cologne-based Institute for Quality and Efficiency in Health Care says it is impossible to draw reliable, long-term conclusions about non-pharmacological methods due to a lack of “convincing” studies.

Small research budgets and underdeveloped study methodologies were the main reasons given for the shortage of reliable evidence.

The institute looked at 33 studies which together explored the effects of different treatments on 3,800 people with Alzheimer’s disease.

Four main non-drug treatments were identified in the studies. They were caregiver training, emotion-oriented interventions such as validation and reminiscence therapy, cognitive training procedures and activity-based interventions.

The researchers acknowledged that further treatment concepts existed but they did not find any studies evaluating their effectiveness.

According to the institute 29 of the 33 studies were prone to bias and had poor quality.

However there was some “relatively good” evidence for interventions based on caregiver training.

As many as 17 of the 33 studies investigated this type of intervention and many of them suggested it was beneficial. But these findings may not be statistically relevant.

The research suggests that caregiver training can delay nursing home placement for people with dementia.

However the researchers also found that caregiver training may be harmful. Patients whose caregivers participated in a training program were more likely to be admitted to hospital.

The researchers said funding for non-drug treatments lags behind the funding for drug trials.

“What is lacking in Germany is public research funding, independent of industry, for research questions relevant to the treatment of patients,” said the institute’s Peter Sawicki.

“This applies very specifically to non-drug treatment approaches. We must finally be allowed access to public financial sources for this type of research.”

Tags: non-pharmaceutical-interventions, research,

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