Psychosocial interventions to increase social participation for people with dementia living in the community: a systematic review

Background: People with dementia participate less socially, with associated adverse outcomes. It is unclear whether existing psychosocial interventions effectively improve social participation in this population.Aims: To identify interventions that may improve social participation for community-dwelling people with dementia.Methods: We searched Medline, Embase, and PsycInfo databases until 4 November 2024 for controlled trials of psychological or social interventions targeting social participation (e.g., social contact, leisure activities, and loneliness). Two researchers independently screened studies and extracted data. We assessed study quality and assigned GRADE certainty of evidence. We registered our review on PROSPERO (CRD42023445176).Results: Fifteen of 5913 studies, including 1,965 participants with dementia, met inclusion criteria. Nine (60%) were full trials and six (40%) feasibility or pilot studies across six intervention domains. A single small study on intervention using social robots in a group setting indicated immediate efficacy in reducing loneliness, suggesting benefits from the robot or group. A single high-quality rehabilitation study reported no benefits to participants. Physical activity interventions yielded conflicting results from two moderate-quality studies. Evidence for cognitive training, art-based therapy and multi-component interventions was largely inconsistent and of low quality, limiting conclusions. Feasibility and pilot studies of intervention using technology and multi-component interventions reported them as feasible and acceptable.Conclusion: Fully powered trials with social participation as the primary outcome are needed to build robust evidence. They should use standardised, validated dementia-adapted measures and include adequate follow-up to establish the long-term impact of promising interventions and address current uncertainty around improving social participation.