Synthèse des revues systématiques et méta-analyses traitant des interventions nonpharmacologiques chez des personnes souffrant de maladie d’Alzheimer, de démence vasculaire ou de démence mixte et vivant à domicile
With the aging of the population, the prevalence of major neurocognitive disorder is increasing. In Canada, 13 individuals out of one thousand are affected by the disorder (Tessier, 2016). Alzheimer’s disease, vascular diseases and mixed impairments are recognized to be the most frequent etiology of major NCD. Non-pharmacological interventions (NPI) are often considered in the treatment of people suffering from the disorder so they can maintain their autonomy in everyday life activities and their abilities, often by trying to reduce the functional impairments.  The objective of this work was to make a summary of the best non-invasive NPI to provide to therapists and caregivers the means to identify the best intervention to maintain the autonomy and quality of life depending on the particular needs of the individual. After a literature search on the University’s usual databases, 722 reviews were found. Out of those, 8 that responded to our PICOTS criteria were kept for the present analysis. Five of those were reviews of cognitive interventions and three were of physical exercises. The reviews reported a total of 57 different primary studies published between 1979 and 2015. All of the reviews analyzed the effects of the NPI on cognition, 5 looked at mood and 5 considered the adaptation of the ADL. Methodological quality of the reviews, as assessed by AMSTAR 2, was between low and moderate. Quality of confidence in the evidence as assessed by GRADE was between very low to high. The summary of the results was written in a narrative format. Most of the reviews included in this present work had important heterogeneity in their definition, methodology and outcomes. Therefore, it was impossible to have a clear picture of the outcomes concerning ADL and the quality of life associated with specific interventions. The definition of the physical exercises, albeit with some imprecision concerning the duration and intensity, were best described. Therefore, the results of our summary of reviews allows us to say that a physical exercises program seems to have significant positive effect on autonomy in ADL
Neurocognitive disorders Alzheimer’s disease Vascular dementia Mixed dementia Non-pharmacological interventions Cognitive interventions Physical exercises Neuropsychology