NotesFAQContact Us
Search Tips
Peer reviewed Peer reviewed
Direct linkDirect link
ERIC Number: EJ1041942
Record Type: Journal
Publication Date: 2014-Oct
Pages: 14
Abstractor: As Provided
Reference Count: 53
ISSN: ISSN-1090-1981
A Systematic Review of Strategies to Foster Activity Engagement in Persons with Dementia
Trahan, Maranda A.; Kuo, Julie; Carlson, Michelle C.; Gitlin, Laura N.
Health Education & Behavior, v41 n1 p70S-83S Oct 2014
Dementia is a growing public health issue. Activity, a positive therapeutic modality, has potential to enhance quality of life and reduce behavioral symptoms in persons with dementia--outcomes eluding pharmacological treatments. However, it is unclear how to effectively engage persons with dementia in activities for them to derive desired benefits. We present a systematic review of 28 studies involving 50 tests of different ways of modifying activities to enhance engagement and reduce behavioral and psychological symptoms for this group. Of 50 tests, 22 (44%) evaluated changes to objects and properties (e.g., introducing activities with intrinsic interest), 6 (12%) evaluated changes to space demands (e.g., lighting, noise levels), 8 (16%) evaluated changes to social demands (e.g., prompts, praise), and 14 (28%) combined two or more activity modifications. No modifications were made to the sequence and timing of activities. Although modifications to objects and properties were the most common, outcomes for engagement and behaviors were mixed. Modifications to space and social demands were less frequently tested, but consistently yielded positive outcomes. No modifications resulted in negative behavioral outcomes or decreased engagement. Methodological strengths of studies included direct observation of outcomes and fidelity assessments. Few studies however involved persons with dementia at home. Our review revealed a growing evidentiary base for different modifications to foster engagement in activities and reduce behavioral and psychological symptoms. Future studies should evaluate how contextual factors (e.g., physical environment, activity type) and caregiver ability to employ activity modifications affect engagement. [This article is part of an open access supplement "Fostering Engagement and Independence: Opportunities and Challenges for an Aging Society," published in SOPHE's "Health Education & Behavior." This supplement was supported by funding provided by the Centers for Disease Control and Prevention's (CDC) National Center for Chronic Disease Prevention and Health Promotion, Healthy Aging Program (Cooperative Agreement #U38HM000454) via the Association of State and Territorial Health Officials, and from a grant provided by the Retirement Research Foundation.]
SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail:; Web site:
Publication Type: Journal Articles; Information Analyses; Reports - Evaluative
Education Level: N/A
Audience: N/A
Language: English
Sponsor: National Institutes of Health (DHHS); National Institute on Aging (DHHS/NIH)
Authoring Institution: N/A
Grant or Contract Numbers: T32 AG000120|T32 AG000247|1R01AG041781