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Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series
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  • Published on:
    RE: Epistemonikos: A database not to be missed while searching systematic reviews
    • Iosief Abraha, Methodologist Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
    • Other Contributors:
      • Antonio Cherubini, Director

    The authors would like to thank Dr. Singh and colleagues for their positive comment on the findings of the review. Dr. Singh and colleagues correctly point out that an eligible review[1] was not included in our comprehensive set of systematic reviews on non-pharmacological interventions to treat behavioural disturbances in older patients with dementia[2].
    We revised our search archive and find out that the review was indeed identified from all the four electronic databases (MEDLINE, the Cochrane Library, CINAHL and PsychINFO) that generated 4 duplicates that were all erroneously deleted. We apologize to the readers for this error.
    After retrieving the review, we assessed it according to the methodology described in our original paper[2]. The review by Kong et al. (AMSTAR 6) identified 14 studies (with overall 586 participants) published between 1998 and 2003. All were randomised trials, seven of which had a cross-over design. Five of the trials [3-7] were already included in other systematic reviews identified in our original manuscript.
    The remaining studies investigated thermal bath (15 participants) [8]; platform style rocking chairs (25 participants) [9]; therapeutic recreation activities (10 participants)[10]; individualized recreational therapy interventions (29 participants)[11]; bright light therapy (8 participants)[12]; educational program on delivering abilities-focused morning care (40 participants)[13]; "stimulation-retreat" model...

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    Conflict of Interest:
    None declared.
  • Published on:
    Epistemonikos: A database not to be missed while searching systematic reviews
    • Ambrish Singh, Independent Researcher Independent Researcher
    • Other Contributors:
      • Salman Hussain, PhD Research Scholar
      • Abul Kalam Najmi, Associate Professor

    We have read the article, “Systematic review of systematic reviews of non-pharmacological interventions to treat behavioral disturbances in older patients with dementia. The SENATOR-OnTop series” by Abraha et al. published in BMJ Open in March 2017 with a lot of interest. This systematic review study presents very important findings on the use of non-pharmacological interventions to treat behavioral disturbances in elderly dementia population.

    However, we have a specific concern about the database searched and relevant articles included in this systematic review of systematic reviews study. An important omission we found in this study was the systematic review by Kong et al.1 published in Aging & Mental Health Journal in July 2009. This systematic review and meta-analysis assessed the effectiveness of the nonpharmacological interventions for agitation in the older adults with dementia. It qualifies all the criteria for inclusion in the present study since it is published within the range of search duration (2009-2015 March) used in the present study. Furthermore, the present study has included the systematic reviews by Yu et al.2 published in March 2009 along with other systematic reviews such as Kverno et al.3 and Lai et al.4 published in the same year.

    Also, the systematic review by Kong et al.1 assessed the effect on agitation (a type of behavioral disturbance) not assessed by many of the other systematic reviews included in the present study hence m...

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    Conflict of Interest:
    None declared.
  • Published on:
    Comment on Abraha, I., Rimland, J.M., Trotta, F.M. et al. (2017), "Systematic review of systematic reviews of non-pharmacologic interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series".
    • Barry Reisberg, M.D., Professor of Psychiatry; Director, Fisher Alzheimer's Disease Program; Clinical Director, Aging & Dementia Clinical Research Ctr New York University Langone Medical Center
    • Other Contributors:
      • Jaspreet Sangha, Fisher Alzheimer's Disease Program, Department of Psychiatry
      • Munther Alshalabi, Fisher Alzheimer's Disease Program, Department of Psychiatry
      • Jaskirat Sidhu, Fisher Alzheimer's Disease Program, Department of Psychiatry
      • Sunnie Kenowsky, DVM, Co-Director, Fisher Alzheimer's Disease Program, Clinical Instructor, Department of Psychiatry

    March 31th, 2017

    Dear authors and concerned readers,

    We are writing in reference to Abraha, I., Rimland, J.M., Trotta, F.M., et al. (2017), “Systematic review of systematic reviews of non-pharmacologic interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series”. The authors are to be commended for their effort to summarize the results of 38 systematic reviews and 142 primary studies.

    In addition to summarizing the results of these studies the authors also, very usefully proposed a categorization of these studies. Unfortunately, at least for the first two categories of non-pharmacologic interventions, the categorizations presented in the abstract differ from the categorizations presented in the text. These differences raise questions about the number of systematic reviews and associated primary studies reported for each category in the abstract and cloud scientific efforts to report on the results of this important scientific project.

    Specifically, the abstract states in part in the Results, “38 SR’s [systematic reviews] and 142 primary studies were identified, comprising the following categories of non-pharmacological interventions: (1) sensory stimulation interventions (12 SR’s, 27 primary studies) that encompassed: acupressure, aromatherapy, massage/touch therapy, light therapy and sensory gardens; (2) cognitive/emotion-oriented interventions ( 33 SR’s; 70 primary studies) that included cognitiv...

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    Conflict of Interest:
    None declared.