Dementia is a chronic and progressive neurodegenerative disease that leads to severe cognitive impairment and functional dependence in its advanced stages. Despite the growing need for palliative care for individuals with advanced dementia, traditional palliative approaches have largely focused on patients with cancer. This review updates previous findings to assess the effects of palliative care interventions in advanced dementia.

The review included nine studies with a total of 2,122 participants, focusing on two main comparisons: the organization and delivery of care vs usual care, and advance care planning interventions vs usual care. While changes in care delivery may slightly improve comfort at the end of life, the evidence remains of very low certainty. Conversely, advance care planning interventions likely enhance the documentation of advance directives and increase discussions about care goals, although they do not seem to significantly improve symptom management. Overall, the evidence on palliative care for advanced dementia is limited and characterized by high uncertainty, indicating a need for further research to clarify these interventions’ effectiveness.

Reference: Walsh SC, Murphy E, Devane D, et al. Palliative care interventions in advanced dementia. Cochrane Database Syst Rev. 2021;9(9):CD011513. doi: 10.1002/14651858.CD011513.pub3.