Person-centered non-pharmacological interventions for agitation in dementia: a meta-analysis with subgroup analysis...

This meta-analysis aimed to evaluate the overall efficacy of person-centered non-pharmacological interventions for agitation in dementia and to compare treatment effects across behavioral subtypes, specifically physical aggressive agitation, physical non-aggressive agitation, and verbal agitation.

A systematic literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to March 2026. Randomized controlled trials (RCTs) evaluating person-centered non-pharmacological interventions for agitation in individuals with dementia were included. The primary outcome was agitation, with subgroup analyses performed for behavioral subtypes. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Risk of bias was assessed using the Cochrane RoB 2.0 tool.

Six RCTs were included. Person-centered non-pharmacological interventions significantly reduced overall agitation compared with control conditions (SMD = -0.48, 95% CI: -0.84 to -0.13, p = 0.008; I ² = 81%). Subgroup analyses revealed a significant reduction in verbal agitation (SMD = -0.45, 95% CI: -0.73 to -0.17, p = 0.002; I ² = 0%), whereas reductions in physical non-aggressive agitation (SMD = -0.48, 95% CI: -1.06 to 0.11, p = 0.11; I ² = 84%) and physical aggressive agitation (SMD = -0.40, 95% CI: -1.63 to 0.83, p = 0.52; I ² = 86%) did not reach statistical significance. Substantial heterogeneity was observed for overall agitation and physical agitation subtypes, but not for verbal agitation.

Person-centered non-pharmacological interventions significantly reduce overall agitation in individuals with dementia, with the most consistent effects observed for verbal agitation. The lack of significant effects on physical agitation subtypes, coupled with substantial heterogeneity, highlights the critical need for further research and intervention development specifically targeting these physical behaviors. These findings support the use of personalized interventions as a first-line strategy, particularly for verbal symptoms, while emphasizing the importance of further research to optimize interventions for physical agitation.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420261363075, identifier PROSPERO (CRD420261363075).