Mechanism of action for nonpharmacological therapies for individuals with dementia: Implications for practice and research

The current review addresses the need for increased use of evidence-based, nonpharmacological therapies for individuals with dementia. To facilitate understanding of the potential efficacy of nonpharmacological therapies on cognitive functioning for individuals with dementia, the mechanisms of action for selected therapies are described, including the assessment method used to identify the mechanism. The strength of evidence supporting each therapy was evaluated, with some therapies demonstrating strong support and others only moderate support for their effectiveness and mechanism of action. Therapieswith the strongest support include (a) cognitive training/stimulation, (b) physical exercise, and (c) music. Therapies with moderate support include (a) biofield, (b) meditation, (c) engagement with a naturally restorative environment, and (d) social engagement. Although the strength of evidence varies, together these therapies offer treatments designed to improve cognitive functioning, have low risks and adverse effects, and have the potential for widespread accessibility, thereby increasing the potential range of therapies for individuals with dementia.