Effectiveness of Non-Pharmacological Interventions in Addressing Behavioral and Psychological Symptoms of Dementia and Reducing Caregiver Burden: A Narrative Review

AbstractBackground: Behavioral and Psychological Symptoms of Dementia(BPSD), are highly prevalent and significantly impact patient well-being and caregiver burden. Non-pharmacological interventions (NPIs) are increasingly recommended as first-line strategies due to the risks associated with pharmacological treatments.Objective: This narrative review aims to identify and classify traditional, recent, and modern NPIs for BPSD, summarize their outcomes and limitations, and discuss their effectiveness in reducing caregiver burden.Methods: Evidence from randomized controlled trials, systematic reviews, and meta-analyses was synthesized. Interventions were categorized as traditional (cognitive stimulation, reminiscence, music therapy), recent (aromatherapy, physical exercise, animal-assisted therapy, caregiver psychoeducation), and modern (virtual reality, robotic companions, COMPAs app). Key findings, populations, benefits, and limitations were summarized in a comparative table.Results: Traditional NPIs are accessible and effective for improving cognition, mood, and social interaction. Recent interventions, including animal-assisted therapy and psychoeducation, target relational and emotional dimensions, reducing agitation, depression, and caregiver stress. Modern technological approaches show promise for enhancing communication, engagement, and emotional well-being, though usability, accessibility, and long-term evidence remain limited. NPIs collectively improve caregiver self-efficacy, reduce burnout, and enhance patient outcomes.Conclusion: A blended, patient-centered approach combining traditional, recent, and modern NPIs appears most effective in managing BPSD and supporting caregivers. Future research should focus on large-scale trials, standardization, cost-effectiveness, and implementation strategies to integrate NPIs into routine Alzheimer’s care.