Summary of findings for the main comparison. Reminiscence Therapy compared to no treatment for people living with dementia.
| Reminiscence Therapy compared to no treatment for people living with dementia | ||||||
| Patient or population: people living with dementia Setting: Care home and community settings Intervention: Reminiscence Therapy Comparison: no treatment | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with no treatment | Risk with Reminiscence Therapy | |||||
| Quality of Life (self‐report) at end of treatment assessed with: QOL‐AD, SRQoL follow up: range 1 days to 6 weeks | SMD 0.11 higher (0.12 lower to 0.33 higher) | ‐ | 1060 (8 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | A higher score is indicative of improved quality of life. Subgroup analysis by setting likley explains the variation in effect size across the studies. | |
| Cognition at end of treatment assessed with: MMSE, AMI‐PSS, AMI(E)‐PSS, ADAS‐COG follow up: range 1 days to 6 weeks | SMD 0.11 higher (0 to 0.23 higher) | ‐ | 1219 (14 RCTs) | ⊕⊕⊕⊕ HIGH | A higher score is indicative of improved cognition | |
| Communication and Interaction at end of treatment assessed with: Social Engagement Scale, Communication Observation Scale, MOSES Withdrawal sub‐scale, Holden Communication Scale follow up: range 1 days to 2 weeks | SMD 0.51 lower (0.97 lower to 0.05 lower) | ‐ | 249 (6 RCTs) | ⊕⊕⊝⊝ LOW 1 2 | A lower score is indicative of improved communication | |
| Functional behaviour at end of treatment assessed with: MDS‐ADL, FIM, ADL, BADLS, ADCS‐ADL, DAD follow up: range 1 days to 6 weeks | SMD 0.24 lower (0.69 higher to 0.21 higher) | ‐ | 1030 (6 RCTs) | ⊕⊝⊝⊝ VERY LOW 3 4 | A lower score is indicative of improved functional behaviour | |
| Agitation/irritability at end of treatment assessed with: CMAI, MOSES (irritability subscale) follow up: range 1 days to 6 weeks | SMD 0.03 higher (0.17 lower to 0.24 higher) | ‐ | 359 (3 RCTs) | ⊕⊕⊕⊝ MODERATE 2 | A lower score is indicative of improved agitation/irritability | |
| Depressed mood at end of treatment assessed with: CSDD, GDS, GDS‐SF,MOSES (depression subscale), HADS (depression subscale), MADRS follow up: range 1 days to 6 weeks | SMD 0.03 lower (0.15 lower to 0.1 higher) | ‐ | 973 (10 RCTs) | ⊕⊕⊕⊕ HIGH | A lower score is indicative of improved mood | |
| Stress related to caring (caregiver) assessed with: ZBI‐SF, RSS, NPI, Modified ZBI, ZBI follow up: range 1 days to 6 weeks | SMD 0.03 SD higher (0.21 lower to 0.14 higher) | ‐ | 1155 (7 RCTs) | ⊕⊕⊕⊝ MODERATE 5 | A lower score is indicative of less caregiver stress | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Downgraded one point for inconsistency due to substantial heterogeneity
2 Downgraded one point for imprecision due to small sample size (<400 participants)
3 Downgraded one point for imprecision as the confidence interval contains null effect and the lower limit passes ‐0.5
4 Downgraded two points for inconsistency due to considerable heterogeneity
5 Downgraded one point for inconsistency due to moderate heterogeneity