Twenty trials were included in the review. Eighteen trials included 1,793 participants and two trials did not state participant numbers as interventions were directed at residential homes or clinics rather than individuals. Sixteen trials were rated as high quality. There was no evidence of publication bias.
People with dementia living at home: Four high quality trials assessed family carer interventions. Individually the trials did not show statistically significant differences in quality of life between intervention and control group but the pooled result was statistically significant (standardised effect size 0.24, 95% CI 0.03 to 0.45; 420 participants) in favour of the interventions, which were diverse in nature. Two trials assessed combined activity and family carer coping strategies and the pooled result showed the superiority of this intervention (standardised effect size 0.84, 95% CI 0.54 to 1.14; 191 participants).
Two high quality trials found insufficient evidence to determine that group cognitive stimulation therapy (CST) improved quality of life in people with dementia and one lower quality trial found that individual CST did not improve quality of life. A higher quality trial found carer-rated quality of life improved in participants receiving a care management system. In a lower quality trial evidence was conflicting about whether discussion groups for people with dementia and their family carers improved quality of life. A higher quality trial found that individual cognitive rehabilitation did not improve patient or carer-rated quality of life. In one higher quality trial exercise did not improve patient or care-rated quality of life.
People with dementia living in care homes: In one trial, group CST improved quality of life. There was no evidence that individualised care plans increase quality of life (two higher quality trials and one lower quality). In lower quality trials aromatherapy with lemon balm and an non-standardised psychosocial intervention were associated with improved quality of life immediately post-intervention. Higher quality trials that evaluated the impact of reminiscence groups and kit-based activities did not report a statistically significant effect.