Summary of findings 3. Reminiscence therapy compared to no treatment for people living with dementia (setting).
| Reminiscence therapy compared to no treatment for people living with dementia (setting) | ||||||
| Patient or population: people living with dementia (setting) Setting: community and care home 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 | |||||
| Care home: quality of life (self‐reported) at end of treatment assessed with: QoL‐AD, SR‐QoL follow‐up: range 1 day to 6 weeks | ‐ | SMD 0.46 higher (0.18 higher to 0.75 higher) | ‐ | 193 (3 RCTs) | ⊕⊕⊕⊝ Moderate1 | Higher score on quality of life measures indicated a more positive outcome. |
| Care home: cognition at end of treatment assessed with: MMSE, AMI‐PSS follow‐up: range 1 day to 2 weeks | ‐ | SMD 0.29 higher (0.03 higher to 0.56 higher) | ‐ | 230 (6 RCTs) | ⊕⊕⊕⊝ Moderate1 | Higher score on cognitive measures indicated a more positive outcome. |
| Care home: communication at end of treatment assessed with: SES, Communication Scale for Cognitively Impaired follow‐up: range 1 day to 2 weeks | ‐ | SMD 0.52 lower (1.29 lower to 0.24 higher) | ‐ | 184 (3 RCTs) | ⊕⊝⊝⊝ Very low2,3 | Lower score on communication measures indicated a more positive outcome. |
| Community: quality of life (self‐reported) at end of treatment assessed with: QoL‐AD (self‐report) Scale from: 13 to 52 follow‐up: range 1 day to 6 weeks | ‐ | MD 0.57 points lower (1.37 lower to 0.22 higher) | ‐ | 867 (5 RCTs) | ⊕⊕⊕⊕ High | Higher score on quality of life measures indicated a more positive outcome. 3.0 points may be the minimum clinically important difference. |
| Community: cognition at end of treatment assessed with: MMSE, AMI‐PSS, AMI‐E‐PSS, ADAS‐Cog follow‐up: range 1 day to 6 weeks | ‐ | SMD 0.07 higher (0.05 lower to 0.20 higher) | ‐ | 989 (8 RCTs) | ⊕⊕⊕⊕ High | Higher score on cognitive measures indicated a more positive outcome. |
| Community: communication and interaction at end of treatment assessed with: Holden Communication Scale and MOSES (withdrawal subscale) follow‐up: range 1 day to 7 days | ‐ | SMD 0.57 lower (1.08 lower to 0.06 lower) | ‐ | 65 (3 RCTs) | ⊕⊕⊕⊝ Moderate1 | Lower score on communication measures indicated a more positive outcome. |
| *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). ADAS‐Cog: Alzheimer's Disease Assessment Scale Cognitive subscale; AMI‐PSS: Autobiographical Memory Interview ‐ Perceived Stress Scale; AMI‐E‐PSS: Autobiographical Memory Interview ‐ Extended Version ‐ Perceived Stress Scale; MD: mean difference; MMSE: Mini‐Mental State Examination; MOSES: Multidimensional Observation Scale for Elderly Subjects; QoL‐AD: Quality of Life in Alzheimer's Disease; RCT: randomised controlled trial; SES: Social Engagement Scale; SMD: standardised mean difference; SR‐QoL: Self‐Report Quality of Life. | ||||||
| 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. | ||||||
1Downgraded 1 level for imprecision because of small sample size (< 400 participants).
2Downgraded 2 levels for imprecision because of small sample size (< 400) and the confidence interval including a null effect and a lower limit crossing ‐0.5.
3Downgraded 2 levels for inconsistency due to considerable unexplained heterogeneity.