Research Article  |   July 2017
Effectiveness of Environment-Based Interventions That Address Behavior, Perception, and Falls in People With Alzheimer’s Disease and Related Major Neurocognitive Disorders: A Systematic Review
Author Affiliations
  • Lou Jensen, OTD, OTR/L, is Assistant Professor of Occupational Therapy, Creighton University, Omaha, NE; loujensen@creighton.edu
  • René Padilla, PhD, OT/L, FAOTA, LMHP, is Vice Provost for Global Engagement and Associate Professor of Occupational Therapy, Creighton University, Omaha, NE
Article Information
Alzheimer's Disease and Dementia / Evidence-Based Practice / Neurologic Conditions / Special Issue: Evidence Review
Research Article   |   July 2017
Effectiveness of Environment-Based Interventions That Address Behavior, Perception, and Falls in People With Alzheimer’s Disease and Related Major Neurocognitive Disorders: A Systematic Review
American Journal of Occupational Therapy, July 2017, Vol. 71, 7105180030p1-7105180030p10. doi:10.5014/ajot.2017.027409
American Journal of Occupational Therapy, July 2017, Vol. 71, 7105180030p1-7105180030p10. doi:10.5014/ajot.2017.027409
Abstract

OBJECTIVE. This systematic review evaluated the effectiveness of environment-based interventions that address behavior, perception, and falls in the home and other settings for people with Alzheimer’s disease (AD) and related major neurocognitive disorders (NCDs).

METHOD. Database searches were limited to outcomes studies published in English in peer-reviewed journals between January 2006 and April 2014.

RESULTS. A total of 1,854 articles were initially identified, of which 42 met inclusion criteria.

CONCLUSION. Strong evidence indicates that person-centered approaches can improve behavior. Moderate evidence supports noise regulation, environmental design, unobtrusive visual barriers, and environmental relocation strategies to reduce problematic behaviors. Evidence is insufficient for the effectiveness of mealtime ambient music, bright light, proprioceptive input, wander gardens, optical strategies, and sensory devices in improving behavior or reducing wandering and falls. Although evidence supports many environment-based interventions used by occupational therapy practitioners to address behavior, perception, and falls in people with AD and related major NCDs, more studies are needed.