Effectiveness of home-based activity interventions on behavioral and psychological symptoms of dementia: a systematic...

People living with dementia often face challenges related to behavioral and psychological symptoms (BPSD). Activity-based interventions have been proposed as a means to address these issues, but the overall effectiveness of such interventions implemented in home settings requires systematic evaluation. This study aimed to determine the effectiveness of home-based activity interventions for improving BPSD-related outcomes.

A systematic literature search was performed across six English databases and four Chinese databases, covering articles published from database inception to December 2024. Randomized controlled trials published in English or Chinese that assessed the effects of home-based activity interventions on BPSD-related outcomes were included. Pooled effect sizes were calculated using random-effects meta-analysis models with standardized mean differences (SMDs) serving as the effect size metric.

Thirteen eligible studies (published 2002-2024) were included, involving eight types of home-based activity interventions. Meta-analysis demonstrated that these interventions significantly reduced overall BPSD-related outcomes with a small effect size (SMD = -0.27, 95% CI: -0.39 to -0.15, p < .05), and yielded symptom-specific benefits. Subgroup analyses revealed similar small efficacy for interventions delivered by professionals versus trained family caregivers, and for short-duration (≤12 weeks) versus long-duration (>12 weeks) programs.

Home-based activity interventions represent an effective non-pharmacological strategy for the management of BPSD. However, the limited number of included studies and inherent methodological weaknesses reduce the certainty of the evidence. Further high-quality research is warranted to strengthen the evidence base.