非药物干预对老年痴呆患者的有效性:一项伞式综述OA

Objective:This umbrella review aimed to synthesize systematic reviews and meta-analyses to evaluate the effectiveness of non-pharmacological interventions(NPIs)on agitation,depression,anxiety,cognitive function,and quality of life in individuals living with dementia,and to examine the stability and methodological quality of the evidence base. Methods:Systematic searches of MEDLINE(via EBSCOhost),PubMed,CINAHL,PsycINFO,and Web of Science databases were conducted from inception to February 2025.Systematic reviews and meta-analyses evaluating NPIs for older adults with dementia were included.Methodological quality was assessed using A MeaSurement Tool to Assess Systematic Reviews 2(AMSTAR 2).Evidence overlap was quantified using the corrected covered area(CCA),and effect estimates reported in the included reviews were synthesized narratively. Results:Twelve systematic reviews,including 147 randomized controlled trials,were included.Meth-odological quality varied across reviews,and all reviews had at least one non-critical weakness.Review overlap was very slight(CCA=1.8％).Across reviews,NPIs were associated with small but consistent reductions in agitation(standardized mean difference([SMD]-0.25,95％CI:-0.36 to-0.13),depression([SMD]-0.20,95％CI:-0.29 to-0.11),and anxiety([SMD]-0.21,95％CI:-0.34 to-0.09).A modest improvement was observed in cognitive function([SMD]0.22,95％CI:0.11 to 0.34),whereas no sig-nificant effect was found for quality of life([SMD]0.08,95％CI:-0.15 to 0.32).The most consistent benefits were reported for information and communication technology-based interventions,massage and touch therapies,and physical exercise.Evidence certainty was moderate for agitation,depression,and anxiety,but low or very low for cognitive function and quality of life. Conclusion:NPIs were associated with small but consistent improvements in agitation,depression,anxiety,and cognitive function among older adults with dementia.Although effect sizes were modest and evidence certainty varied across outcomes,the findings support NPIs as key components of person-centered dementia care.Further high-quality research is needed to clarify optimal intervention mo-dalities,dosage,mechanisms of action,and implementation strategies across diverse care settings.