1 INTRODUCTION 3 -- 1.1 BACKGROUND OF THE STUDY 3 -- 1.2 DEMENTIA 3 -- 1.2.1 A disease with consequences 3 -- 1.2.2 Diagnostic process 3 -- 1.2.3 Prevalence of dementia 4 -- 1.2.4 Types of dementia in Europe 4 -- 1.3 RESEARCH QUESTION 5 -- 2 METHODS 6 -- 2.1 INCLUSION CRITERIA 6 -- 2.2 LITERATURE SEARCH STRATEGY 8 -- 2.2.1 Phase I : systematic reviews 8 -- 2.2.2 Phase II : randomised controlled trials 9 -- 2.3 ASSESSING METHODOLOGICAL QUALITY AND RISK OF BIAS 9 -- 2.3.1 Systematic reviews 9 -- 2.3.2 Randomised controlled trials 10 -- 2.4 DATA EXTRACTION 10 -- 3 RESULTS 11 -- 3.1 METHODOLOGICAL CONSIDERATIONS 11 -- 3.1.1 Systematic reviews 11 -- 3.1.2 Randomised controlled trials 13 -- 3.2 RESULTS BY INTERVENTION 16 -- 3.2.1 Cognition 16 -- 3.2.2 Emotion 19 -- 3.2.3 Sensory enhancement 20 -- 3.2.4 Daily activities 23 -- 3.2.5 Physical activity 23 -- 3.2.6 Communication/interaction/relationship interventions 24 -- 3.2.7 Environmental changes 25 -- 3.2.8 Nutrition 26 -- 3.2.9 Interventions primarily focused on caregivers 26 -- 3.2.10 Interventions for the informal caregivers and patients at home 27 -- 4 SUMMARY OF THE MAIN FINDINGS 31 -- 4.1 QUALITY OF EVIDENCE: SUMMARY TABLE 31 -- 4.2 MODERATE QUALITY OF EVIDENCE FOR SIX GROUPS OF INTERVENTIONS 33 -- 4.2.1 Multicomponent psychoeducation/psychosocial interventions : impact on caregivers -- outcomes and on institutionalisation 33 -- 4.2.2 Physical activity 33 -- 4.2.3 Staff education 33 -- 4.2.4 Cognitive stimulation / training 34 -- 4.3 LOW QUALITY OF EVIDENCE FOR SIXTEEN INTERVENTIONS 34 -- 4.4 NO RCT FOR SIX INTERVENTIONS 34 -- 5 DISCUSSION 35 -- 5.1 STRENGTHS OF THE SYSTEMATIC REVIEW 35 -- 5.2 LIMITATIONS IN THE INTERPRETATION OF RESULTS 35 -- 5.3 LACK OF EVIDENCE: SOME HYPOTHESES 35 -- 5.4 RESULTS: APPLICABLE TO ALL PATIENT SUBGROUPS ? 36 -- 5.5 RESULTS APPLICABLE TO ALL SETTINGS ? 36 -- 5.6 INTERVENTIONS TAILORED TO THE PATIENT AND INFORMAL CAREGIVER ARE MORE -- SUCCESSFUL 36 -- 5.7 ADAPTATION TO THE CULTURAL AND HEALTH CARE CONTEXT 37 -- 5.8 PERSPECTIVES 37 -- 5.9 SUGGESTIONS FOR FURTHER RESEARCH 37 -- 6 APPENDICES 38 -- 6.1 APPENDIX 1 MESH TERM : DEMENTIA 38 -- 6.2 APPENDIX 2 SEARCH STRATEGIES SYSTEMATIC REVIEWS 38 -- 6.3 APPENDIX 3. WEBSITES ADDITIONAL HANDSEARCHING 50 -- 6.4 APPENDIX 4 QUALITY APPRAISAL FOR INCLUDED SYSTEMATIC REVIEWS 52 -- 6.5 APPENDIX 5 DATA EXTRACTION TABLE FOR INCLUDED SYSTEMATIC REVIEWS -- (WITH A LOW RISK OF BIAS) 55 -- 6.6 APPENDIX 6 SYSTEMATIC REVIEWS EXCLUDED (HIGH RISK OF BIAS) 65 -- 6.7 APPENDIX 7 RCT SEARCH STRATEGIES 69 -- 6.8 APPENDIX 8 QUALITY APPRAISAL FOR RCTS 77 -- 6.9 APPENDIX 9. DATA EVIDENCE TABLES FOR THE 30 INCLUDED RCTS 95 -- 7 REFERENCES 114