Effect of Doll Therapy in Behavioral and Psychological Symptoms of Dementia: A Systematic Review

Abstract

(1) Background: Behavioral and psychological symptoms of dementia (BPSD) are a threat for people with dementia and their caregivers. Doll therapy is a non-pharmacological person-centered therapy to promote attachment, company, and usefulness with the aim of minimizing challenging behaviors. However, the results are not clear. (2) Objective: To know the effectiveness of doll therapy in reducing behavioral and psychological symptoms of people with dementia at a moderate-severe phase. (3) Methodology: The systematic review was informed according to the criteria established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Searches were conducted in eight databases: Cochrane, PubMed, Web of Science, Cinahl, Embase, Lilacs, PeDro, and Scopus before October 2021. Studies were selected when they accomplished the simple majority of Consolidated Standards of Reporting Trials (CONSORT). The risk of bias was appraised with the Cochrane Collaboration Risk of Bias Tool. The review protocol was recorded in Inplasy:1539. (4) Results: The initial search strategy showed 226 relevant studies, 7 of which met the eligibility criteria. In the included studies, a total number of 295 participants (79% female) with a mean age of 85 years were enrolled. There was found to be a reduction in challenging and aggressive behaviors, the participants were less rough and irritable, and their communication skills and emotional state were also improved. (5) Conclusion: Our findings suggest that doll therapy improves the emotional state of people with dementia, diminishes disruptive behaviors, and promotes communication. However, randomized studies with a larger sample size and higher methodological rigor are needed, as well as follow-up protocols in order to reaffirm these results.

Keywords: behavioral and psychological symptoms of dementia; dementia; doll-therapy.

Figure 1

The PRISMA diagram for the records search and study selection.

Figure 2

Risk of bias of studies included in the systematic review (Balzotti, 2018 [31], Cantarella, 2018 [28], Cohen Mansfield, 2014 [32], Mackenzie, 2006 [33], Moyle, 2018 [29], Shin, 2015 [20], Ylmaz, 2020 [30]).

Figure 3

Risk of bias: systematic review authors’ judgments about each risk of bias item presented as percentages across all included trials using the Cochrane risk of bias tool (n = 7).

Figure 4

Intervention protocol with Doll Therapy.