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Speech-language pathologist interventions for communication in moderate–severe dementia: A systematic review

Swan, Katina
Hopper, Marie
Wenke, Rachel
Jackson, Claire
Till, Tracy
Conway, Erin
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Abstract
Purpose: The purpose of this study is to evaluate the evidence for direct and indirect interventions for communication in people with moderate-severe dementia. Method: A systematic search of the literature was conducted, as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysed guidelines, across 8 electronic databases. Studies were included if they included direct or indirect interventions, which could be administered by a speech-language pathologist to people with moderate-severe dementia (defined as having Mini-Mental State Examination of [less than or equal to] 15; Folstein, Folstein, & McHugh, 1975). Studies also were required to include outcome measures, which reported on communication function or participation and/or well-being related to communication. Included studies were evaluated for methodological quality using the McMaster critical appraisal tool (Law et al., 1998). Results: Eleven studies met the inclusion criteria. Ten of these studies related to direct interventions and included cognitive stimulation approaches using group ([pi] = 5) or individual therapy (n = 1); cognitive training, including naming therapy (n = 1) and spaced retrieval training (n = 1); and cognitive rehabilitation approaches using augmentative and alternative communication (n = 2). Onestudy reported an indirect intervention: conversation partner training. Due to the heterogeneity of studies, a meta-analysis was unable to be conducted. A descriptive synthesis of results indicated that interventions generally resulted in positive changes to communication and related quality-of-life outcomes compared with baseline or control groups. Conclusions: Preliminary evidence was found to support communication interventions for people with moderate-severe dementia. The use of cognitive stimulation approaches, which use a group treatment model and conversation, as a therapy medium show promise as direct intervention options. Implications for clinical practice for speech-language pathologists and future research are discussed.
Keywords
Date
2018
Type
Journal article
Journal
American Journal of Speech-Language Pathology
Book
Volume
27
Issue
2
Page Range
836-852
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
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Open Access Status
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File Access
Controlled
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