Contents lists available at ScienceDirect Neurology, Psychiatry and Brain Research journal homepage: www.elsevier.com/locate/npbr Interventions aimed to increase independence and well-being in patients with Alzheimer’s disease: Review of some interventions in the Italian context Alessandro Lanzoni a , Andrea Fabbo b , Donatella Basso c , Patrizia Pedrazzini d , Elena Bortolomiol e , Marc Jones f , Omar Cauli g, ⁎ a NODAIA Unit, Private Hospital Villa Igea, Modena, Italy b Cognitive Disorders and Dementia Unit, Local Authority for Health and Services, Modena, Italy c Gruppo Anchise, Milan, Italy d Social Services Area Manager Soncino (Cremona, Italy), Social Services at the University of Milano Bicocca, Italy e Ottimasenior (Gentlecare Paradigm), Treviso, Italy f Moyra Jones Resources (Gentlecare Paradigm), Vancouver, Canada g Department of Nursing, University of Valencia, c/ Jaume Roig s/n,46010, Valencia, Spain ARTICLE INFO Keywords: Occupational therapy Communication Aggressive behavior Nursing homes Dementia ABSTRACT Background: Alzheimer's disease (AD) represents a huge social and economic burden for the society and caring for individuals with AD is a complex and challenging task that requires a multidisciplinary approach. Studies have shown that several interventions provide beneficial results, but some non-pharmacological interventions have not yet been studied in depth and clinical trials using them are still pending. This review provides a summary of interventions based on paradigms aimed to increase independence and well-being in people with AD, as well as those interventions that decrease caregiver burden in long-term facilties for AD patients in Italy. Methods: Narrative review regarding the theoretical bases and analysis of available studies related to new in- terventions implemented in long-term facilities for AD patients in Italy. Results: Community Occupational Therapy in Dementia (COTiD), and clinical interventions based on the ‘en- abling approach’, the Gentlecare paradigms, have been implemented and suggest their utility to decrease caregiver burden and improve quality of life of patients. A major role of social workers for patients withADand their caregivers should also encouraged. A need of clinical trials is warranted in order to support the effec- tiveness of these interventions on a large scale. Conclusions: The best care of patients with AD and families requires a multidisciplinary approach which should take into account all these methodologies. Furthermore, clinical studies will be required to validate these in- terventions using different paradigms, both alone or in combination, in order to improve the care of thepatients and their families. 1. Introduction Dementias encompass a group of chronic and degenerative diseases that cause behavioral problems and difficulties in participating in social activities, and disorders/loss of memory, initiative, and independent functioning in daily activities; Alzheimer disease (AD) is the most prevalent form of dementia (Winblad et al., 2016). The worldwide prevalence of dementia has recently been estimated at 47 million people (Winblad et al., 2016). Recent epidemiological studies on se- cular trends in dementia incidence showed a moderately consistent evidence to suggest that the incidence of dementia may be declining and the number of people with dementia can remain stable despite population ageing in high-income countries. However, the declining incidence may be balanced by longer survival with dementia with a huge social burden and costs. There is some evidence to suggest in- creasing prevalence in East Asia, consistent with worsening cardiovas- cular risk factor profiles, although secular changes in diagnostic criteria may also have contributed to such increase (Hall et al., 2009; Hebert et al., 2013; Melis et al., 2014; Prince et al., 2016). The huge number of people affected by AD or other kinds of degenerative cognitive https://doi.org/10.1016/j.npbr.2018.10.002 Received 17 September 2018; Received in revised form 9 October 2018; Accepted 15 October 2018 ⁎ Corresponding author. E-mail addresses: alessandro.lanzoni.mo@gmail.com (A. Lanzoni), a.fabbo@ausl.mo.it (A. Fabbo), basso.donatella@gmail.com (D. Basso), patrizia.pedrazzini@libero.it (P. Pedrazzini), e.bortolomiol@gmail.com (E. Bortolomiol), moyrajonesresourcesltd@shaw.ca (M. Jones), Omar.Cauli@uv.es (O. Cauli). Neurology, Psychiatry and Brain Research 30 (2018) 137–143 Available online 25 October 2018 0941-9500/ © 2018 Elsevier GmbH. All rights reserved. T