Meta-analysis finds non-pharmacological interventions are more effective for easing behavioural symptoms.

An analysis of studies involving more than 23,000 people with dementia has found outdoor activities and massage are more effective than drugs in treating aggression and agitation.

The authors, led by geriatrician Jennifer Watt from St. Michael’s Hospital and the University of Toronto in Canada, have called on policymakers to prioritise non-drug treatments for the behavioural and psychological symptoms of dementia.

Dementia affects 50 million people worldwide with up to 75% experiencing so-called neuropsychiatric symptoms, including aggressive behaviour, agitation and anxiety.

The triad bodes ill for sufferers, who are marked out for earlier institutionalisation, greater cognitive decline and worse quality of life, the authors write.

The symptoms also mean misery for caregivers, who report lower quality of life than carers of dementia patients without those behaviours.

Despite the fact that drugs such as antidepressants and antipsychotics can increase the risk of falls, broken bones and death, the authors note their prescribing rates remain high.

At the same time, a lack of reliable data on the relative merits of drug and non-drug treatments for neuropsychiatric symptoms has stymied informed decision-making about treatment options.

“Unfortunately, our understanding of the comparative efficacy of medication versus non-medicine interventions for treating psychiatric symptoms has been limited due to a lack of head-to-head randomised controlled trials of the two routes,” says Watt.

To fill the knowledge gap Watt’s team trawled a raft of databases to collect information for a multi-study analysis.

Read the full story in Cosmos magazine here