Physical interventions for people with more advanced dementia \u2013 a scoping review

Abigail J Hall,Victoria A Goodwin,Samantha Febrey

doi:10.1186/s12877-021-02577-0

Abstract

BackgroundDementia is a neuro-degenerative condition resulting in cognitive and physical decline over time. In the early stages of the condition, physical decline may be slow, but in the later stages, it may become more pronounced. Physical interventions may be employed to try and reduce the physical decline that people experience, yet it is unclear what interventions may be effective. The aim of this study was to explore the breadth and quantity of evidence that exists in relation to the delivery of physical interventions for people with advanced dementia.MethodsWe undertook a scoping review in order to map the current literature. All types of study design were included in the search in order to gain a comprehensive scope of the literature. We searched a variety of databases from inception until March 2021, focusing on physical interventions. Double screening and data extraction were employed in order to increase the reliability of the results.ResultsOur review found four studies which focused on physical interventions aimed at improving physical outcomes for people with more advanced dementia. The majority of studies were excluded as their interventions were not specific to people with advanced dementia. The studies that were included incorporated functional activities and, despite small sample sizes, suggested statistically significant improvements in outcomes for people with advanced dementia.ConclusionThere is currently limited evidence relating to physical rehabilitation interventions for people with more advanced dementia, however, the evidence we presented suggests potential benefits for physical outcomes. Future research should focus on robust research to determine the most effective and cost-effective interventions that meet the needs of this population.

Highlights

Dementia is a neuro-degenerative condition resulting in cognitive and physical decline over time
The main reasons for exclusion at full text screening was the failure of the intervention to be specific for people with advanced dementia (n = 56)
Future research should focus on robust research to determine the most effective and cost-effective interventions that meet the needs of this population

Summary

Introduction

Dementia is a neuro-degenerative condition resulting in cognitive and physical decline over time. In the early stages of the condition, physical decline may be slow, but in the later stages, it may become more pronounced. It is recognized that the global population is ageing and with people living longer [1] health and care costs are likely to increase. The total annual cost of dementia in England was estimated to be £24.2 billion in 2015, of which 42% (£10.1 billion) was attributable to unpaid care. In the UK, it is estimated that there are 676,000 people living with dementia, with a predicted economic cost of approximately £26 million per year [5]. With the increased numbers of PLwD, it is proposed that there will be an increased burden on

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