Review: sparse evidence supports non-pharmacological interventions for preventing wandering in people with dementia.

How effective and cost-effective are non-pharmacological interventions for preventing wandering in people with dementia?METHODSData sources: Cochrane Library, Medline, Current Contents, EMBASE/Excerpta Medica, Science Citation Index, Social Science Citation Index, CINAHL, PsycINFO, HEED, ADEAR, National Research Register, Ageline, Agelnfo, BIOME, Current Controlled Trials, ClinicalTrials.gov, Google, Zapmeta, ISI Science and Technology Proceedings, ZETOC, and Index to Theses (all up to March 2005); hand searches of dementia journals (2004); reference lists; and experts.Study selection and assessment: randomised controlled trials (RCTs), non-randomised controlled trials, controlled before and after studies, cohort studies, and case-control studies that compared non-pharmacological interventions to prevent wandering with usual care or sham therapy in people of any age with dementia or cognitive impairment living at home or in institutional environments. 10 studies (n=492, mean age 79 y, 59% women) met the inclusion criteria. Interventions assessed were multisensory environments (3 RCTs, n = 198), music therapy (1 RCT, n = 30), exercise (1 RCT, n= 30), aromatherapy (2 RCTs, n = 84), special care units (2 non-RCTs, n=129), and behavioural therapy (1 non-RCT, n=,21). Methodological quality of all studies was poor. No cost effectiveness studies were found.Outcomes: measures of wandering behaviour.MAIN RESULTSSome poor quality evidence was found for the effectiveness of multisensory environments, exercise, and aromatherapy in preventing wandering in people with dementia (table). No evidence of effectiveness was found for music therapy, special care units, or behavioural therapy (table).CONCLUSIONNo good quality evidence exists to support the use of non-pharmacological interventions for preventing wandering in people with dementia.