Table 2.
Efficacy of interventions for reducing symptoms of depression in people with dementia without a diagnosis of major depressive disorder
| Intervention v usual care | Studies in pairwise treatment comparison (participant*) | Network meta-analysis | Meta-analysis† | |||||
|---|---|---|---|---|---|---|---|---|
| SMD (95% CrI) | SMD re-expressed as MD on CSDD (95% CrI) | Probability of MD >0.4 SDs‡ (%) | SMD (95% CrI) | SMD re-expressed as MD on CSDD (95% CrI) | Probability of MD >0.4 SDs‡ (%) | |||
| Animal therapy44 | 1 (23) | −0.45 (−1.24 to 0.39) | −2.30 (−6.34 to 1.97) | 55.6 | −0.94 (−1.76 to −0.16) | −4.82 (−8.97 to −0.8) | 90.9 | |
| Cognitive stimulation34 45-56 | 13 (805) | −0.57 (−0.85 to −0.30) | −2.93 (−4.35 to −1.52) | 90.4 | −0.67 (−1.02 to −0.33) | −3.42 (−5.19 to −1.69) | 94.1 | |
| Cognitive stimulation+cholinesterase inhibitor | - | −2.23 (−3.60 to −0.77) | −11.39 (−18.38 to −3.93) | 99.3 | - | - | - | |
| Exercise57-62 | 6 (581) | −0.27 (−0.58 to 0.03) | −1.39 (−2.94 to 0.14) | 21.9 | −0.47 (−0.89 to −0.07) | −2.42 (−4.55 to −0.34) | 63.9 | |
| Exercise+social interaction+cognitive stimulation63 | 1 (14) | −2.43 (−3.73 to −1.05) | −12.37 (−19.01 to −5.36) | 99.8 | −2.40 (−3.41 to −1.43) | −12.28 (−17.41 to −7.30) | 100 | |
| Massage and touch therapy64-66 | 3 (219) | −1.77 (−2.41 to −1.15) | −9.03 (−12.28 to −5.88) | 100 | −1.77 (−2.42 to −1.12) | −9.05 (−12.35 to −5.70) | 100 | |
| Multidisciplinary care67-73 | 7 (838) | −0.39 (−0.74 to −0.03) | −1.98 (−3.80 to −0.16) | 49.1 | −0.48 (−0.90 to −0.05) | −2.44 (−4.62 to −0.23) | 63.9 | |
| Occupational therapy74-78 | 5 (497) | −0.51 (−0.92 to −0.08) | −2.59 (−4.70 to −0.40) | 69.0 | −0.5 (−1.02 to 0.02) | −2.56 (−5.20 to 0.12) | 64.8 | |
| Psychotherapy+reminiscence therapy+environmental modification79 | 1 (51) | −1.00 (−2.05 to 0.08) | −5.12 (−10.46 to 0.40) | 87.2 | −0.99 (−1.53 to −0.45) | −5.06 (−7.82 to −2.28) | 98.4 | |
| Reminiscence therapy14 22 80-91 | 14 (1163) | −0.45 (−0.72 to −0.18) | −2.30 (−3.68 to −0.93) | 65.8 | −0.50 (−0.81 to −0.21) | −2.57 (−4.12 to −1.06) | 75.1 | |
CSDD=Cornell scale for depression in dementia; MA=pairwise meta-analysis; MD=mean difference; CrI=credible interval; SMD=standardised mean difference.
*
Sample sizes adjusted for clustering effect, when appropriate.
†
Pairwise meta-analysis.
‡
Minimum clinically important difference estimated to be 2.0 at 0.4 standard deviations (SDs) and 2.5 at 0.5 SDs.