Table 4.
Summary of characteristics and results of 12 included behavioural interventions, reported in 10 studies (for further detail see Additional file 2)
| Study | Design | Setting, intervention type | No. of participants | Dementia diagnosed | Dementia stage | Dementia type | Effects on nutrition and/or hydration status | Effects on intake of food, drinks and/or nutrients | Quality effect (including QoL or meaningful activity) and other outcomes | Duration |
|---|---|---|---|---|---|---|---|---|---|---|
| Beattie 2004 [51] USA | BA | Dementia specific unit. Behavioural conditioning |
3 | Yes | Severe | AD | → Weight | → % Food intake → % Fluid intake |
NR | 2 weeks (total 5 weeks) |
| Coyne 1988 [52] USA | RCT | Dementia unit in nursing home. Verbal prompting and positive reinforcement by staff |
I = 12 C = 12 |
Yes | Severe | AD & others | NR | NR | ↑ Eating independence for solid foods → Eating independence for liquid foods → Frequency of eating solid and liquid foods |
2 weeks |
| Eaton 1986 [53] USA | RCT | Skilled care facility. Gentle mealtime touch & verbal prompting |
I = 21 C = 21 |
NR | NR | NR | NR | ↑ E intake ↑ Protein intake |
NR | 5 days |
| Huang 2009 [54] Taiwan | BA | Older person care facility. Reminiscence cooking therapy |
12 | Yes | Mild- mod | NR | NR | NR | ↑ Feeling of happiness → Positive communication ? Participatory feeling → Cognitive function |
8 weeks |
| Lin 2010 [55] Spaced retrieval Taiwan | RCT | Dementia unit. Spaced retrieval |
I = 32 C = 24 |
Yes | Various | NR | → Weight → BMI ↑ MNA |
→ Food intake | ↑ Improved eating difficulty | 8 weeks |
| Lin 2010 [55] Montessori Taiwan | RCT | Dementia unit, Montessori activities | I = 29 C = 24 |
Yes | Various | NR | → Weight → BMI → MNA |
↓ Food intake | ↑ Improved eating difficulty | 8 weeks |
| Lin 2011 [56] Taiwan | RCT | Dementia unit. Montessori-based activities |
29 | Yes | Mild-severe | NR | → BMI → MNA |
NR | ↑ Eating functional ability ↑ Eating ability → Eating time ↑ Self-feeding frequency |
8 weeks |
| McHugh 2012 [58] USA | RCT | Memory support unit/care facility. Vocal re-creative music therapy |
I = 8 C = 7 |
Yes | Mild-Mod | AD & others | NR | → Proportion food eaten | ? Participation | 3 weeks |
| Santo Pietro 1998 [59] USA | CCT | Dementia unit within a nursing home. Breakfast club (communication therapy) |
I = 20 C = 20 |
Yes | Mild-Mod | AD | NR | NR | ↑ Interest &involvement, ↑ Procedural memory ? Functional status ? Cognitive status ? Used humour & empathic statements, remembered names, responded to non-verbal cues, spontaneous singing, decreased distractibility & wandering. |
12 weeks |
| Van Ort 1995 [28] Behavioural intervention USA | BA | Secure nursing unit. Systematic prompting, cuing, behavioural guidance & reinforcement |
7 | Yes | Severe | NR | → Weight | ? | ? Self-feeding behaviour ? Longer meal-times ? Increased independence |
2 weeks |
| Wu 2013 [57] Fixed intervention Taiwan | CCT | Dementia unit. Spaced retrieval & Montessori activities |
I = 25 C = 27 |
Yes | Mild-severe | NR | ↑ BMI ↑ MNA |
NR | → Depression | 6 months |
| Wu 2013 [57] Individualised intervention Taiwan | CCT | Dementia units. Individualised spaced retrieval & Montessori activities |
I = 38 C = 27 |
Yes | Mild-severe | NR | ↑ BMI ↑ MNA |
NR | ↓ Depression | 6 months |
For abbreviations see below Table 2