Non-pharmacological Intervention for Wandering Behavior in Dementia: A Systematic Review and Meta-analysis

Purpose: The present study aimed to explore the types of non-pharmacological interventions and evaluate their effectiveness in reducing wandering behavior in patientis with dementia. Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline. Searching eight databases (Cochrane, Ovid-MEDLINE, EMBASE, CINAHL, PubMed, PsycInfo, RISS, KISS, and KMBASE) yielded 899 related studies. Two reviewers independently assessed the quality of these studies, using Revised Cochrane risk of bias for randomized trials (ROB) 2.0 and Risk of Bias Assessment tool for Non-randomised Study (ROBANS) 2.0, based on this study design. The Algase Wandering Scale related to wandering behavior reported the standardized mean differences and their 95% confidence intervals. Results: A total of seven studies, consisting of four randomized controlled trials (RCTs) and three quasi-experimental studies, met the inclusion criteria. Among non-pharmacological interventions, aromatherapy was the most common. However, therapeutic contact, therapeutic companion robot, tailored activity program, combining physical activity, memory recall, music therapy, and multisensory stimulation were also performed in one study, respectively. In a meta-analysis (RevMan 5.4), non-pharmacological interventions reduced wandering behavior in patients with dementia and mild to moderate functional impairments (p=.003). Conclusion: The result of this meta-analysis suggests that non-pharmacological interventions are generally associated with reduced wandering behavior among patients with dementia and mild-moderate functional impairment. However, it is necessary to develop a more detailed non-pharmacological intervention for patients with dementia and wandering behavior according to their disease stage and characteristics.