Review Article
A Systematic Review of Montessori-Based Activities for Persons With Dementia

https://doi.org/10.1016/j.jamda.2015.10.006Get rights and content

Abstract

Objectives

Montessori-based activities are becoming a popular approach for the care of older adults living with dementia. The aim of this study was to systematically assess the quality of the research examining the benefits of Montessori-based activities for persons with dementia.

Methods

Six peer-reviewed databases were systematically searched for all relevant articles published until April 2015. Included articles were peer-reviewed studies published in English that employed Montessori-based activities with persons with dementia. Methodological quality was assessed by 2 independent raters using the Physiotherapy Evidence Database Scale or the Downs and Black evaluation tool. Levels of evidence were assigned to the study design using a modified Sackett scale.

Results

One hundred fifty articles were identified, and 14 were selected for inclusion. Level-2 evidence examining the impact of Montessori-based activities on eating behaviors suggested that difficulties with eating could be reduced with Montessori training. There was limited level-4 evidence for the benefits of Montessori-based activities on cognition, wherein benefits appeared to be specific to lower-level cognitive abilities including memory and attention. Finally, there is level-1 (n = 1), level-2 (n = 3), and level-4 (n = 6) evidence for the benefits of Montessori-based activities on engagement and affect, whereby constructive engagement and positive affect were heightened.

Discussion

Overall, there is a strong level of evidence for the benefits of Montessori-based activities on eating behaviors and weak evidence for the benefits on cognition. Evidence for the benefits of Montessori-based activities on engagement and affect are mixed. Future research is needed to examine the long-term benefits of Montessori-based activities.

Section snippets

Search Strategy and Inclusion Criteria

A systematic search for studies evaluating the effectiveness of Montessori-based activities for persons with dementia was conducted in April 2015. In consultation with an expert librarian, a combination of the search terms “dementia,” “Alzheimer's disease”, “Montessori Methods,” and “Montessori” were used to search the following databases: PsycINFO, AgeLine, MEDLINE, CINAHL, Applied Social Science Index and Abstracts, and ERIC. See Appendix 1 for a copy of the full electronic search strategy

Results

As shown in Figure 1, 73 unique records were identified, of which 44 articles were selected for full-text review based on the relevance of the title and abstract. Following a full-text review, 14 articles were found to meet the full inclusion criteria. Levels of evidence were assigned to all included articles, wherein level-1 evidence represented studies of high methodological quality and level-5 evidence represented studies of low methodological quality (Table 1).

Discussion

In efforts to provide meaningful activities for persons with dementia that reflect individual interests and abilities, many care providers have implemented Montessori-based programming. Given the increasing popularity of these activities in dementia care, it is imperative to understand the quality of the existing evidence examining the benefits of Montessori-based activities. The findings from our systematic review identified 14 articles addressing 3 main categories of functioning: (1)

Conclusions

Overall, for persons with dementia, there was strong evidence for the benefits of Montessori-based activities on eating behaviors, but weak evidence for the benefits on cognition. The level of evidence for the benefits of Montessori-based activities on engagement and affect varied from strong to weak. The dose-response characteristics of the Montessori interventions, including duration, session frequency, and facilitation format varied highly across studies, suggesting that more research is

Acknowledgments

We would like to thank Sara Glass for her assistance in conducting the literature search.

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    The authors declare no conflicts of interest.

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