Intervention Review

Reminiscence therapy for dementia

  1. Bob Woods1,*,
  2. Aimee E Spector2,
  3. Catherine A Jones1,
  4. Martin Orrell3,
  5. Stephen P Davies4

Editorial Group: Cochrane Dementia and Cognitive Improvement Group

Published Online: 20 APR 2005

Assessed as up-to-date: 5 FEB 2005

DOI: 10.1002/14651858.CD001120.pub2


How to Cite

Woods B, Spector AE, Jones CA, Orrell M, Davies SP. Reminiscence therapy for dementia. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001120. DOI: 10.1002/14651858.CD001120.pub2.

Author Information

  1. 1

    University of Wales Bangor, Dementia Services Development Centre Wales, Bangor, Gwynedd, UK

  2. 2

    Chesham, Buckinghamshire, UK

  3. 3

    University College London, Department of Mental Health Sciences, London, UK

  4. 4

    Princess Alexandra Hospital, Services for Older People, Harlow, Essex, UK

*Bob Woods, Dementia Services Development Centre Wales, University of Wales Bangor, Ardudwy, Holyhead Road , Bangor, Gwynedd, LL57 2PX, UK. b.woods@bangor.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 20 APR 2005

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結

Background

Reminiscence Therapy (RT) involves the discussion of past activities, events and experiences with another person or group of people, usually with the aid of tangible prompts such as photographs, household and other familiar items from the past, music and archive sound recordings. Reminiscence groups typically involve group meetings in which participants are encouraged to talk about past events at least once a week. Life review typically involves individual sessions, in which the person is guided chronologically through life experiences, encouraged to evaluate them, and may produce a life story book. Family care-givers are increasingly involved in reminiscence therapy.

Reminiscence therapy is one of the most popular psychosocial interventions in dementia care, and is highly rated by staff and participants. There is some evidence to suggest it is effective in improving mood in older people without dementia. Its effects on mood, cognition and well-being in dementia are less well understood.

Objectives

The objective of the review is to assess the effects of reminiscence therapy for older people with dementia and their care-givers.

Search methods

The trials were identified from a search of the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group on 4 May 2004 using the term "reminiscence". The CDCIG Specialized Register contains records from all major health care databases (MEDLINE, EMBASE, PsycLIT, CINAHL) and many ongoing trials databases and is regularly updated. We contacted specialists in the field and also searched relevant Internet sites. We hand-searched Aging and Mental Health, the Gerontologist, Journal of Gerontology, Current Opinion in Psychiatry, Current Research in Britain: Social Sciences, British Psychological Society conference proceedings and Reminiscence database.

Selection criteria

Randomised controlled trials and quasi-randomized trials of reminiscence therapy for dementia.

Data collection and analysis

Two reviewers independently extracted data and assessed trial quality.

Main results

Five trials are included in the review, but only four trials with a total of 144 participants had extractable data. The results were statistically significant for cognition (at follow-up), mood (at follow-up) and on a measure of general behavioural function (at the end of the intervention period). The improvement on cognition was evident in comparison with both no treatment and social contact control conditions. Care-giver strain showed a significant decrease for care-givers participating in groups with their relative with dementia, and staff knowledge of group members' backgrounds improved significantly. No harmful effects were identified on the outcome measures reported.

Authors' conclusions

Whilst four suitable randomized controlled trials looking at reminiscence therapy for dementia were found, several were very small studies, or were of relatively low quality, and each examined different types of reminiscence work. Although there are a number of promising indications, in view of the limited number and quality of studies, the variation in types of reminiscence work reported and the variation in results between studies, the review highlights the urgent need for more and better designed trials so that more robust conclusions may be drawn.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結

Inconclusive evidence of the efficacy of reminiscence therapy for dementia

RT involves the discussion of past activities, events and experiences, with another person or group of people. This is often assisted by aids such as videos, pictures, archives and life story books. Four randomized controlled trials suitable for analysis were found. Several were very small studies, or were of relatively low quality, and each examined different types of reminiscence work. Taking studies together, some significant results were identified: cognition and mood improved 4 to 6 weeks after the treatment, care-givers participating with their relative with dementia in a reminiscence group reported lower strain, and people with dementia were reported to show some indications of improved functional ability. No harmful effects were identified on the outcome measures reported. However, in view of the limitations of the studies reviewed, there is an urgent need for more quality research in the field.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結

治療失智症的懷舊療法

背景

懷舊療法(Reminiscence Therapy;RT)的內容為:與另一人或一群人討論過去發生的活動、事件與經驗,且通常輔以實體刺激物,如照片、居家物品及其他過往的熟悉物件、音樂,以及錄音紀錄。懷舊治療團體通常會舉行團體集會,並鼓勵參加者於集會中至少一週談論一次過往事件。生命回顧(life review)則特別牽涉的是個人的療程;療程中會按照時序複習個案的生命經驗、鼓勵個案加以評估,且可能藉此寫出一本生命故事書。有越來越多的親屬照護者採用懷舊療法。

懷舊療法是失智症(dementia)照護中最廣為使用的一種心理社會介入療法,施行者與接受治療者對其評價也相當高。目前有些證據顯示:懷舊療法能針對未罹患失智症的老年人有效改善其情緒。但針對失智症患者,此療法對其情緒、認知能力與福祉的影響,則尚未獲得釐清。

目標

本篇回顧的目標,為針對失智症老年患者及其照護者,評估懷舊療法所帶來的影響。

搜尋策略

我們利用「懷舊」(reminiscence)一詞於2004年5月4日搜尋了Specialised Register of the Cochrane Dementia and Cognitive Improvement Group(簡稱CDCIG Specialized Register)資料庫而找到各項試驗。CDCIG Specialized Register內含所有主要醫療資料庫(MEDLINE、EMBASE、PsycLIT、CLINAHL)及許多執行中試驗之資料庫的紀錄,而且會定期更新。我們也聯繫了該領域之專家,並搜尋相關網站。另外,我們還人工搜尋了《Aging and Mental Health》、《the Gerontologist》、《Journal of Gerontology》、《Current Opinion in Psychiatry》、《Current Research in Britain: Social Sciences》、英國心理學會(British Psychological Society)會議手冊,以及懷舊相關資料庫。

選擇標準

我們只收納以懷舊療法治療失智症的隨機對照試驗(randomized controlled trials;RCTs)及準隨機(quasi-randomized)試驗。

資料收集與分析

2位作者獨立地萃取資料,並評估試驗品質。

主要結論

本回顧中納入5項試驗,但只有4項試驗(共144名受試者)具有可萃取之資料。在認知功能(追蹤時)、情緒(追蹤時)及一項針對整體行為功能的量測指標(介入治療期結束時)方面,結果均達統計上顯著。相較於無治療或僅有社交接觸的對照組,認知功能方面的改善相當明顯。對於和其失智症親屬一同參與治療團體的照護者而言,照護者負荷(care-giver strain)出現顯著的下降,而且治療施行人員對團體成員背景的認識也顯著改善。各試驗所報告的成效指標上,並未發現任何有害效應。

作者結論

雖然我們找到了4項合格的、探討治療失智症之懷舊療法的隨機對照試驗,但是另外還有數項極小型、或品質相對較差的研究,而且這些研究都分別檢視了不同類型的懷舊療法。雖然存在一些具有潛力的適應症,但是有鑑於研究的數量及品質有限、通報的懷舊療法類型互異,且各研究的結果也互異,因此本篇回顧凸顯出:我們迫切需要數量更多、設計更佳的試驗,方能做出較為穩當的結論。

譯註

East Asian Cochrane Alliance 翻譯
翻譯由 台灣衛生福利部/台北醫學大學實證醫學研究中心 資助

 

一般語言總結

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 一般語言總結

治療失智症的懷舊療法

治療失智症的懷舊療法尚無確切證據

雖然我們找到了4項合格的、探討治療失智症之懷舊療法的隨機對照試驗,但是另外還有數項極小型、或品質相對較差的研究,而且這些研究都分別檢視了不同類型的懷舊療法。雖然存在一些具有潛力的適應症,但是有鑑於研究的數量及品質有限、通報的懷舊療法類型互異,且各研究的結果也互異,因此本篇回顧凸顯出:我們迫切需要數量更多、設計更佳的試驗,方能做出較為穩當的結論。

譯註

East Asian Cochrane Alliance 翻譯
翻譯由 台灣衛生福利部/台北醫學大學實證醫學研究中心 資助