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Meta-Analysis
. 2019 Jan 24;19(1):41.
doi: 10.1186/s12888-018-2009-z.

Effects of dog-assisted therapy in adults with dementia: a systematic review and meta-analysis

Jessica Hanae Zafra-Tanaka  1 , Kevin Pacheco-Barrios  2 , Walter Andree Tellez  3 , Alvaro Taype-Rondan  4
Affiliations
Meta-Analysis

Effects of dog-assisted therapy in adults with dementia: a systematic review and meta-analysis

Jessica Hanae Zafra-Tanaka et al. BMC Psychiatry. .

Abstract

Background: Dog-assisted therapy (DAT) is a non-pharmacological intervention based on the interaction between patients and dogs, which has been proposed to help adults with dementia. However, evidence to support it is lacking. Thus, we aim to evaluate the effects of DAT on this population and to assess the certainty of the evidence of the RCTs estimates.

Methods: A systematic search was performed. We included randomized controlled trials (RCTs) and quasi-experimental (QE) controlled studies published up to March 2018, which evaluated the beneficial and deleterious effects of DAT in adults with dementia. Mean differences (MD) or standardized mean differences (SMD) and their 95% confidence intervals (95% CI) were calculated and random effects meta-analyses were performed. Certainty of evidence was assessed for RCTs estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol has been registered in PROSPERO (CRD42018090434).

Results: Ten studies (six RCTs and four QE controlled studies) were eligible for inclusion. Meta-analysis of RCTs showed no effect of DAT in daily life activities (SMD: 0.16; 95% CI: -0.80 to 1.12), depression (SMD: -0.45; 95% CI: -2.81 to 1.91), agitation (SDM: -1.12; 95% CI: -2.67 to 0.43), quality of life (SDM: 0.16; 95% CI: -0.41 to 0.73), and cognitive impairment (SDM: -0.52; 95% CI: -1.33 to 0.30), but it found a beneficial effect in apathy (1 study, n = 37, MD: 1.81; 95% CI: 1.26 to 2.36). All outcomes had a very low certainty of evidence according to GRADE methodology.

Conclusions: RCTs evidence of very low certainty suggests that, in adults with dementia, DAT has no effect in daily life activities, depression, agitation, quality of life, and cognitive impairment, although one small study found an apparent beneficial effect in apathy. More well-designed and correctly reported studies are needed in order to provide a conclusion.

Trial registration: CRD42018090434 (PROSPERO).

Keywords: Animal-assisted therapy; Cognitive dysfunction; Dementia; Meta-analysis.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flow diagram (study selection)
Fig. 2
Fig. 2
Risk of bias. a. Risk of bias of RCTs (Olsen (1): Olsen C, et al. 2016 [32]. Olsen (2): Olsen C, et al [20]). b. Risk of bias of QE studies
Fig. 3
Fig. 3
Forest plot on dog-assisted therapies for assessed outcomes. a Forest plot on dog-assisted therapies for the improvement in daily life activities. Right favors DAT, left favors control. b Forest plot on dog-assisted therapies for the improvement in depression. Right favors control, left favors DAT. c Forest plot on dog-assisted therapies for the improvement in quality of life. Right favors DAT, left favors control. d Forest plot on dog-assisted therapies for the improvement in agitation. Right favors control, left favors DAT. e Forest plot on dog-assisted therapies for the improvement in cognitive impairment. Right favors DAT, left favors control
See this image and copyright information in PMC

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