Non-pharmacological approaches to dementia: An overview of foundations & considerations


  • Linda Carozza Pace University
  • Lisa-Marie Serrone Pace University
  • Lara Sugatan Pace University



Dementia is a syndrome characterized by the progressive degeneration of one's cognitive function. The syndrome inflicts one in every nine individuals 65 and older; and 200,000 individuals under the age of 65. Currently, no cure exists; thus, finding the highest quality treatment to reduce the symptoms of the disease must become priority. Maintaining or increasing one’s quality of life is the utmost goal of any therapy for individuals with dementia. Currently, non-pharmacological approaches for suppressing concomitant symptoms of the disease have become highly debated and researched for their usefulness and for their ability to achieve this goal. Several therapeutic methods that can be considered non-pharmacological - music therapy, narrative telling , poetry, art therapy, technological interventions, and exercise and dance movement programs. A literature review was completed in order to determine the role of theseapproaches on dementia. Findings indicate that there is a small effect on cognition during these therapies presently, but there is still insufficient research in the area to conclude a sufficient difference. Non-pharmacological treatments yield potential quality of life benefits while additionally being cost-effective compared to medical interventions. Due its prevalence, further research on this topic is warranted and necessary.

Author Biographies

Linda Carozza, Pace University

Dr. Linda Carozza is an Associate Professor and Program Director of Communication Sciences and Disorders at Pace University, NY, NY.

Lisa-Marie Serrone, Pace University

Lisa-Marie Serrone is a senior undergraduate student at Pace University majoring in Communication Sciences and Disorders hoping to go to graduate school for Speech-Language Pathology. 

Lara Sugatan, Pace University

Lara Sugatan is currently a senior in the Communication Sciences and Disorders undergraduate program at Pace University and hopes to become a Speech-Language Pathologist in the future.


Dementia. American Speech and Hearing Association Web site. Available at: Published 2014. Accessed September 22, 2016.

Alzheimer’s disease. Alzheimer’s Association Web site. Available at: Published 2016. Accessed September 22, 2016.

Olazarán J, Reisberg B, Clare L, et. al. Nonpharmacological therapies in Alzheimer’s disease: a systematic review of efficacy. Dement Geriatr Cogn Disorder. 2010; 30:161-178. doi: 10.1159/000316119.

Clark-McGhee K, Castro M. A narrative analysis of poetry written from the words of people given a diagnosis of dementia. Dementia. 2015; 14:9-26.

Woods B, Aguirre E, Spector AE, Orrell M. Cognitive stimulation to improve cognitive functioning. Cochrane Database Syst Rev. 2012; 2. doi: 10.1002/14651858.CD005562.pub2.

O’Neil ME, Freeman M, Christensen V, Telerant R, Addleman A, Kansagara D. A systematic evidence review of non-pharmacological interventions for behavioral symptoms of dementia. Washington, DC: Department of Veterans Affairs; 2011.

Buckley J, Salpeter S. A risk-benefit assessment of dementia medications: Systematic review of the evidence. Drugs & Aging, 2015; 32: 453-467. doi:10.1007/s40266-015-0266-9.

Brod M, Stewart A L, Sands L,Walton P. Conceptualization and measurement of quality of life in dementia: The dementia quality of life instrument (DQoL). Gerontologist. 1999; 39: 25-36.

Eum Y, Yim J, Choi W. Elderly health and literature therapy: a theoretical review. Tohoku J of Exp Med. 2014; 232: 79-83.

O’Connor D, Phinney A, Smith A, et. al. Personhood in dementia care Developing a research agenda for broadening the vision. Dementia, 2007; 6: 121-142.

Sjögren K, Lindkvist M, Sandman PO, Zingmark K, Edvardsson D. Person centredness and its association with resident well being in dementia care units. J Adv Nurs; 69:2196-2206. doi: 1111/jan.12085.

Mittelman MS, Bartels, SJ. Translating Research Into Practice: Case Study Of A Community-Based Dementia Caregiver Intervention. Health Affairs (Project Hope). 2014; 3: 587–595. doi: 10.13771hlthaff.2013.1334.

Hurd MD, Martorell P, Delavande A, Mullen, KJ, Langa KM. Monetary costs of dementia in the United States. N Eng Med. 2013; 368(14):1326-1334. doi: 10.10561NEJMsa1204629.

Husaini B, Gudlavalleti AS, Cain V, Levine R, Moonis M. Risk Factors and Hospitalization Costs of Dementia Patients: Examining Race and Gender Variations. Indian J Community Med, 2015; 40(4): 258–263. doi: 10.4103/0970-0218.164396

Alzheimer’s dementia residential facilities. Alzheimer’s Association Web site. Available at: Published 2016. Accessed September 22, 2016.

Hurd MD, Martorell P, Langa K. Future monetary costs of dementia in the United States under alternative dementia prevalence scenarios. J Popul Ageing. 2015; 8: 101-112.

Sköldunger A, Fastbom J, Wimo A, Fratiglioni L, Johnell K. The impact of dementia on drug costs in older people: results from the SNAC study. BMC Neurol. 2016; 16:1.

Medicaid eligibility issues. Alzheimer’s Association Web site. Available at: Published 2006. Accessed September 22, 2016.

Mozley CG, Huxley P, Sutcliffe C, Bagley H, Burns A, Challis D, Cordingley L. ‘Not knowing where I am doesn't mean I don't know what I like’: Cognitive impairment and quality of life responses in elderly people. J Geriatr Psychiatry. 1999;14: 776-783.

Foldes SS, Long KH. The Minnesota Economic Model of Dementia: Demonstrating Healthcare Cost Savings with the New York University Caregiver Support Intervention. Act of Alzheimer’s Web site. Available at: Published 2014. Accessed September 22, 2016.

What is music therapy? American Music Therapy Association Web site. Available at: Published nd. Accessed September 22, 2016.

Kemper KJ, Danhauer SC. Music as therapy. South Med J 2005; 98:282-8.

Education and care. Alzheimer’s Foundation of America Web site. Available at: Published 2015. Accessed September 22, 2016.

Tuppen J. The benefits of groups that provide cognitive stimulation for people with dementia. Nurs Older People. 2012; 24: 20-24.

Ray KD, Mittelman MS. Music therapy: A nonpharmacological approach to the care of agitation and depressive symptoms for nursing home residents with dementia. Dementia. 2015. doi: 10.1177/1471301215613779.

Matthews S. Dementia and the Power of Music Therapy. Bioethics. 2015; 29: 573-579.

Raglio A, Sospiro F. Music therapy in dementia. Non Pharmacol Ther Dem. 2010;1:1- 14.

Pavlicevic M, Tsiris G, Wood S, Powell H, Graham J, Sanderson, R, et. al. The ‘ripple effect’: Towards researching improvisational music therapy in dementia care homes. Dementia. 2015; 14: 659-679.

Vink AC, Zuidersma M, Boersma, F, de Jonge P, Zuidema SU, Slaets JJ. The effect of music therapy compared with general recreational activities in reducing agitation in people with dementia: a randomised controlled trial. J Geriatr Psychiatry. 2013; 28: 1031-1038. doi:10.1002/gps.3924

Hsu MH, Flowerdew R, Parker M, Fachner, J, Odell-Miller H.Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: A cluster randomised controlled feasibility study. BMC geriatrics. 2015; 15: 1.

Tamplin J, Clark I, Ridder HM, McDermott O, Odell-Miller H, Laitinen S, Gold C. Music therapy research in dementia: Fostering a global approach. Nordic J of Music Ther. 2016; 25(sup1): 94-95.

Blackburn R, Bradshaw T. Music therapy for service users with dementia: A critical review of the literature. J Psychiatr Ment Health Nurs. 2014; 21: 879-888. doi:10.1111/jpm.1216

Serrone L. Music therapy for dementia patients. ADVANCE for Speech and Hearing. 2016.

Storytelling. Alzheimer’s Foundation of America Web site. Available at: Published 2016.

TimeSlips History. TimeSlips Web site. Available at: Published nd.

Fritsch T, Kwak J, Grant S, Lang J, Montgomery RR, Basting AD. Impact of TimeSlips, a creative expression intervention program, on nursing home residents with dementia and their caregivers. Gerontologist. 2009; 49: 117-127.

Sullivan EL, Sillup GP, Klimberg RK. Timeslips—Comparing agitation and anxiety rating scales to evaluate the benefit of non-pharmacologic creative sessions in nursing home patients with dementia. Open J Nurs. 2014.

Phillips LJ, Reid-Arndt SA, Pak Y. Effects of a creative expression intervention on emotions, communication, and quality of life in persons with dementia. Nurs Res. 2010; 59: 417.

George DR, Houser WS. “I’ma Storyteller!” Exploring the benefits of TimeSlips creative expression program at a Nursing Home. Am J of Alzheimer's Dis Other Demen.

doi: 1533317514539725.

Wexler M. A poetry program for the very elderly—Narrative perspective on one therapeutic model. J Poet Ther. 2014; 27: 35-46.

American Art Therapy Association Web site. Available at: Published Accessed September 22, 2016.

Gross SM, Danilova D, Vandehey MA, Diekhoff GM. Creativity and dementia: Does artistic activity affect well-being beyond the art class?. Dementia. 2013; doi: 1471301213488899.

Chancellor B, Duncan A, Chatterjee A. Art therapy for Alzheimer's disease and other dementias. J Alzheimer's Disease. 2014; 39: 1-11.

Schmitt B, Frölich L. Creative therapy options for patients with dementia--a systematic review. Fortschr Neurol Psychiatr. 2007; 75: 699-707.

Blackman T, Van Schaik P, Martyr A. Outdoor environments for people with dementia: an exploratory study using virtual reality. Ageing Soc. 2007; 27: 811-825.

Kim GJ. A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence. 2005; 14: 119-146.

Schultheis MT, Rizzo AA. The application of virtual reality technology in rehabilitation. Rehab Psychology. 2001; 46: 296.

Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S. Exercise programs for people with dementia. Cochrane Database Syst Rev. 2015; 15: CD006489. doi: 10.1002/14651858.CD006489.pub4.

Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis. Arch Phys Med Rehabil. 2004; 85: 1694-1704.

Exercise and physical activity. Alzheimer’s Society Web site. Available at: Published 2015. Accessed September 22, 2016.

Karkou V, Meekums B. Dance movement therapy for dementia. The Cochrane Library. 2014; 3, doi: 10.1002/14651858.CD011022

Karkou, V. Arts therapies: A research-based map of the field. Elsevier Health Sciences.

Rogalski E, Khayum R, McKenna H, Wieneke C, Corden ME, Mesulam, MM. Communication bridge: Initial observations from an internet-based speech therapy program for individuals with aphasic dementias. Alzheimer's & Dementia: The Journal of the Alzheimer's Association. 2015; 11: P575.

Carozza, L. Communication and Aging: Creative Approaches to Improving the Quality of Life. Plural Publishing. 2015.





Full Length Articles