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☐ ☆ ✇ Journal of Clinical Nursing

A Systematic Review and Meta‐Analysis of Randomised Controlled Trials on the Effect of Cognitive Behavioural Therapy for People With Dementia

ABSTRACT

Background

Cognitive Behavioural Therapy (CBT) has demonstrated positive effects on emotional well-being and quality of life in individuals with dementia. Limited evidence constrains the generalisability of these findings.

Methods

This review was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) that implemented CBT and assessed cognitive function, depressive symptoms, anxiety and quality of life in individuals with dementia were included. Seven databases—APA PsycINFO, CINAHL, Cochrane Library, Embase, MEDLINE, PubMed and Web of Science—were searched up to 10 October 2024. The Risk of Bias 2 (RoB-2) tool was used to evaluate the methodological quality of included studies. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.

Results

A total of 10 RCTs, involving 1412 individuals with dementia and published between 2011 and 2024, were included in the analysis. CBT was associated with a reduction in anxiety (pooled SMD = −0.94; 95% CI = −1.33 to −0.55; I 2 = 0.00%; p < 0.04). No significant differences were found in cognitive function, depression or quality of life between those receiving CBT and those in the control groups.

Conclusions

This study suggests that CBT alleviates anxiety in people with dementia. However, further investigation is required to clarify its effects on cognitive function, depressive symptoms and quality of life. Future research should focus on the development of CBT protocols, alongside the exploration of relevant outcome measures.

Relevance to Clinical Practice

CBT has shown potential in improving emotional well-being and quality of life in individuals with dementia. The findings inform healthcare professionals about its clinical utility and effectiveness in dementia care.

Patient or Public Contributions

The findings suggest that traditional CBT may not fully address the needs of people with dementia, emphasising the importance of incorporating multisensory stimulation and caregiver involvement to enhance therapeutic outcomes.

☐ ☆ ✇ Journal of Nursing Scholarship

Virtual Reality Intervention for Fall Prevention in Older Adults: A Meta‐Analysis

Por: Ita Daryanti Saragih · Yao‐Mei Chen · Ira Suarilah · Herry Susanto · Bih‐O. Lee — Junio 19th 2025 at 06:29

ABSTRACT

Purpose

Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promising strategy for fall prevention by improving balance, reducing fear of falling, and enhancing confidence. However, the impact of VR interventions on specific outcomes such as fear of falling, balance, and postural control in older adults remains insufficiently synthesized.

Design

Systematic review and meta-analysis.

Methods

A comprehensive systematic search of six databases was conducted from inception to January 20, 2025. Randomized controlled trials (RCTs) evaluating VR interventions targeting fear of falling, balance, and postural control in older adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB-2). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.

Findings

Seventeen RCTs involving 988 older adults, published between 2016 and 2025, met the inclusion criteria. VR interventions demonstrated significant effects in reducing fear of falling (SMD = −0.40; 95% CI: −0.72 to −0.08; I 2 = 45.10%; p = 0.02), improving balance (SMD = 0.45; 95% CI: 0.07–0.83; I 2 = 73.54%; p = 0.02), and enhancing postural control (SMD = 0.50; 95% CI: 0.13–0.86; I2 = 46.89%; p = 0.01).

Conclusion

This meta-analysis highlights the effectiveness of VR interventions in reducing fear of falling and improving balance and postural control among older adults.

Clinical Relevance

VR represents a valuable tool in fall prevention strategies, addressing key outcomes essential for maintaining independence and mobility in this population.

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