[Evaluation of psychosocial interventions for dementia: what to learn from the Cochrane Library?]. / Évaluation des interventions psychosociales pour la maladie d'Alzheimer : quelles leçons tirer des méta-analyses de la Cochrane Library ?

Psychosocial interventions for people with dementia have expanded in the last decades, and have been subject to an important number of evaluation attempts that often lead to scientifically flaw results. To study these failures we analysed the meta-analyses of the Cochrane Library. Among 18 meta-analyses, 11 were selected for the purpose of this study. These papers were analysed on the basis of the Cochrane selection criteria, methodological quality and biases, principal outcomes and implication for practice and research. Results are discussed and analysed according to the clinical practice and scientific literature of the matter of concern. Main outcomes of this review point that: (1) it is necessary to adopt an investigation methodology adapted to specific characteristics of psychosocial interventions; (2) methodological weaknesses of randomised control trials are prejudicial to quality of research and clinical practice; (3) implementation of randomised control trials call for necessary fundamental prerequisites; and (4) other research methods than randomised control trials are susceptible to give as much, if not more, informative results. A research and practice implementation strategy is suggested.

[Night support in special care units]. / L'accompagnement de nuit en unité spécifique.

People with Alzheimer's disease and related disorders in nursing homes are also subject to sleep disorders. An in-depth study was therefore carried out to install a familiar setting that is based on the architectural environment and on specific support taking into account the size of healthcare teams.

Sharing meals with institutionalized people with dementia: a natural experiment.

Nutritional deficiency can have dramatic effects on the physical and psychological status of older adults. Although food supplements can enhance nutritional status, several authors suggest that more ecological means could also have beneficial impacts. Therefore, a natural experiment was conducted to study the impact of changed mealtime experiences for people with Alzheimer-type dementia. Two special care units (in separate facilities) in France were included in this study: one implemented shared meal times between residents and caregivers and the other served as a comparison group. Weight was measured and staff observations were collected. Positive outcomes were observed for the experimental group. Implications for practice are discussed.