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Effects of multimodal nondrug therapy on dementia symptoms and need for care in nursing home residents with degenerative dementia: a randomized-controlled study with 6-month follow-up


Luttenberger, Katharina, Donath, Carolin, Uter, Wolfgang, Graessel, Elmar


Journal Of The American Geriatrics Society, Volume: 60, No.: 5, Pages.: 830-840

Year of Publication



Objectives: To determine the efficacy of multimodal, nondrug therapy on symptoms of dementia and need for care in institutionalized individuals with degenerative dementia.; Design: Randomized, controlled, longitudinal trial. Data were analyzed using multiple linear regression.; Setting: Five German nursing homes.; Participants: One hundred thirty-nine nursing home residents with primary degenerative dementia (Mini-Mental State Examination score < 24).; Intervention: The 6-month intervention comprised three components: motor stimulation, activities of daily living, and cognitive stimulation (MAKS). Groups of 10 patients led by two therapists participated in the standardized intervention for 2 hours, 6 days a week. The intervention was described in detail in an intervention manual. Adherence to the manual was high. Controls received treatment as usual.; Measurements: Overall geriatric symptoms were recorded using the Nurses' Observation Scale for Geriatric Patients, functional independence using the Barthel Index, and care time using the Resource Utilization in Dementia-Formal Care.; Results: Of 646 individuals screened, 146 were eligible, and 130 were included in the intention-to-treat analysis. At 6 months, results of the per-protocol analysis (n = 119) showed improvement in overall dementia symptoms in the MAKS group and no change in the control group (adjusted mean difference (AMD) = -6.8, 95% confidence interval (CI) = -10.3 to -3.3; P < .001, Cohen d = 0.66). This effect was greatest on the social behavior (AMD = -1.9, 95% CI = -2.9 to -0.8; P < .001; Cohen d = 0.54) and instrumental activity of daily living (IADL) (AMD = -1.4, 95% CI = -2.5 to -0.30; P = .01; Cohen d = 0.43) subscales. No effect was seen on functional independence or total care time.; Conclusion: This 6-month nondrug multimodal intervention improved dementia symptoms in nursing home residents, especially in social behavior and IADL capabilities.; © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Bibtex Citation

@article{Luttenberger_2012, doi = {10.1111/j.1532-5415.2012.03938.x}, url = {}, year = 2012, month = {apr}, publisher = {Wiley-Blackwell}, volume = {60}, number = {5}, pages = {830--840}, author = {Katharina Luttenberger and Carolin Donath and Wolfgang Uter and Elmar Graessel}, title = {Effects of Multimodal Nondrug Therapy on Dementia Symptoms and Need for Care in Nursing Home Residents with Degenerative Dementia: A Randomized-Controlled Study with 6-Month Follow-Up}, journal = {Journal of the American Geriatrics Society} }


aged, 80 and over, alzheimer disease, combined, combined modality therapy, female, followup studies, health services needs and demand, homes for the aged, humans, longitudinal studies, male, motor, nondrug, nursing homes, singleblind method, stimulation, therapy, time factors

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

ADLs/IADLs, Cognition, Service use or cost reductions (incl. hospital use reduction, care home admission delay)


Nursing Homes

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Adult safeguarding and abuse detection/prevention, Other