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Systematic review article, fostering the resilience of people with dementia: a narrative literature review.

dementia literature review dissertation

  • 1 School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
  • 2 Centre for Economic and Social Research on Dementia, National University of Ireland, Galway, Ireland

Background: Resilience is a process through which people use resources to adapt to adversity. Interventions aiming to support resilience in people with dementia have been developed. However, the optimal content, structure and impact of these interventions is unclear. This literature review explores the factors through which interventions foster resilience in people with dementia and examines their efficacy.

Methods: Eight databases were searched systematically, for literature published from 2000 to 2019. Following the removal of duplicate articles, the titles and abstracts of 6,749 articles were screened. Articles were selected if they: reported empirical studies in English; focused on resilience; involved people with dementia and psychosocial interventions. The full text of 53 articles were examined and three studies, reported in six papers, were included in the final review. Data were systematically extracted, and two authors critiqued the studies using the Critical Appraisal Skills Programme check lists. The studies were examined to determine how resilience was defined and operationalized and their findings were synthesized using the theoretical resilience framework.

Results: Five interventions aiming to foster resilience were identified: Dementia Advisors; Peer Support Network Services; Visual Arts Enrichment Activities; Memory Makers; and Early-Stage and Beyond Community Activities. All studies defined resilience as a process and most involved people with mild dementia who had family carers. The interventions impacted resilience by reducing the adversity of stigma and social isolation; increasing personal and social resources, providing stigma-free space and reciprocal support. Interventions empowered people with dementia, increasing their self-esteem and self-worth. Resilience can be fostered both during, and after interventions. However, the efficacy of interventions could not be determined because the research designs utilized did not measure efficacy.

Conclusions: Interventions need facilitators to ensure they are strength-based, person-centered and they enable reciprocal social interactions. Future research needs to develop interventions that aim to foster the resilience of people with dementia who lack family carers and/or have more advanced dementia through meaningful activities that are identified by people with dementia as important to their resilience. Robust methodologies, including randomized controlled trials should be used to measure effectiveness and explore the impact of interventions regarding the: interplay between individual and community resources; the importance of reciprocity; and temporal aspects of resilience.


Dementia is a chronic progressive syndrome, which currently affects 50 million people worldwide ( 1 ). Having dementia can negatively impact the person's cognitive functioning, memory, thinking, orientation, language, and emotional control ( 1 ). Dementia can cause anxiety ( 2 ), and it may be linked to depression ( 3 ). Every year, as more people live into old age, there are 10 million people newly diagnosed with dementia ( 1 ). Consequently, it is increasingly important to develop strategies that facilitate and support people with dementia to remain independent and functioning well for as long as possible ( 4 ).

Resilience is important for people with dementia ( 5 ) because it can help with the challenges of living with the condition ( 6 , 7 ). Resilience has been defined as a dynamic “process of effectively negotiating, adapting to, or managing significant sources of stress or trauma” [( 8 ), p. 2]. Resilience has also been described in terms of a resilience framework ( 9 ) which draws upon the ecological systems theory ( 10 ). This framework regards resilience as occurring within a complex interacting multi-layered system, in the presence of a significant adversity, which can be acute or chronic in nature ( 8 , 11 ). A person's response to adversity is facilitated by use of, and access to, resources that can be internal and/or external to the individual in their environment. There are a range of possible resilience outcomes, from vulnerability to flourishing ( 12 ). Outcomes of resilience can include maintaining normal development or competence in the presence of mental or physical health difficulties ( 9 ). Therefore, resilience can be present when a person with a chronic disease adapts to the condition and demonstrates processes that include acknowledging the condition, gaining a sense of control over it and integrating it into their life and lifestyle ( 13 ).

In the context of dementia, resilience is complex and multifaceted ( 4 ). It involves the use of resources to negotiate living with the challenges of dementia ( 14 ) and the compensatory practices of other people who are close to the individual with dementia (significant others), who act as a resource to support the person, as the dementia progresses ( 4 ). Resilience in dementia is strongly related to being socially connected with other people ( 15 ) and the participation of individual people with dementia in purposeful activity ( 16 ). Harris ( 17 ) applied the theoretical framework of resilience using in-depth case study methodology and the qualitative interviewing of people with dementia ( n = 2) who were “doing okay” and managing to live well with their dementia. Harris ( 17 ) found that positive adaptation in dementia involved overcoming negative influences and having assets and protective factors that outweighed the risks and vulnerabilities experienced by individuals with dementia. They identified that in dementia assets included: having effective coping strategies; acceptance of the dementia diagnosis; accepting changes to life and the need to accept help from available support networks; a positive attitude; and productivity. Whereas, protective factors included: positive relationships with other people that supported personhood ( 18 ); and having positive role models. Other researchers have also emphasized the importance of acceptance ( 19 ) and of having positive thoughts and feelings ( 20 ). In addition, resilience in dementia has been characterized as a process of continual adjustment through which people with dementia learn to live with progressive limitations in their lives ( 21 , 22 ).

Core outcome sets ( 23 ) for resilience in dementia have not yet been established but there has been a small amount of research focusing on outcome measures. Stoner et al. ( 24 , 25 ) developed and validated with people with dementia ( n = 126), the Positive Psychology Outcome Measure (PPOM) which measures capacity for resilience, and hope. PPOM has to our knowledge yet to be utilized in research, but Stoner et al. ( 25 ) found that PPOM may assist with the future development of asset–based approaches and interventions for dementia. From this literature, and that described above, it can be determined that the capacity of people with dementia for resilience can be improved through the presence of protective factors and that outcomes for resilience in dementia include: having capacity for resilience and protective factors; having the ability to cope effectively and recover from stress; having the ability to adjust and adapt attitudes and behavior to respond positively to dementia; and the ability to accept the challenges and limitations of life with dementia.

Psychosocial interventions aiming to support resilience in people with dementia need to be informed by factors that support and limit resilience ( 4 ). However, to date no published literature has examined the existing evidence concerning the content, structure and impact of interventions that aim to support resilience in people with dementia. This narrative literature review aims to explore the evidence concerning interventions that aim to foster resilience in people with dementia: to identify and examine how the concept of resilience is defined and operationalized in these investigations, the efficacy of interventions and the factors through which they impact resilience.

The objectives of this research were to:

• Identify and describe the psychosocial interventions designed to foster the resilience of people with dementia.

• Describe how the interventions were perceived and experienced by people with dementia.

• Critically appraise the methodologies used to design and investigate the interventions.

• Apply the empirical findings of the studies reviewed to the resilience process and framework.

• Describe the efficacy and impact of the interventions on the resilience process of people with dementia.

• Examine the factors that impacted the effectiveness of the interventions.

Search Strategy

A comprehensive and systematic search of the literature published from 2000 to 2019 was conducted with the guidance of an expert librarian. Eight databases: Scopus, Web of science, EBSCO-CINAHL, Ageline, PsycINFO, Cochrane, OpenGrey, and Proquest were utilized. Abstracts and titles were searched using keywords, MeSH terms and subject headings ( Table 1 ), which were selected as they corresponded to the key characteristics of resilience in dementia that have been described above. An example of the search strategy outcomes is provided in Appendix i ( Supplementary Material ). In addition, the references of relevant papers were hand searched and their citations were examined using Google Scholar.


Table 1 . Search terms.

Inclusion and Exclusion Criteria

Papers were screened for eligibility by SW, the lead author. To be included, items needed to report empirical studies that involved people with dementia with any type of dementia of any severity. Studies also needed to involve non-pharmacological psychosocial interventions that addressed resilience or where this was named as an outcome measure. Interventions were defined as any physical, cognitive or social activities that aimed to maintain or improve “functioning, interpersonal relationships and well-being in people with dementia” ( 26 ). All comparators to the interventions were included: treatment as usual, no-treatment control, comparison with other interventions, usual treatment/care as were all design methods. Studies were excluded if they involved non-psychological interpretations of resilience, such as resilience in relation to the physical health or the geographical environment, and if they involved people with mild cognitive impairment or involved pharmacological interventions. They were also excluded if the studies used proxy terms for resilience such as self-efficacy, sense of coherence, hardiness, or quality of life. This ensured that the review focused on interventions which explicitly aimed to foster resilience.

Data Extraction and Quality Assessment

Data from the selected papers were extracted systematically, by SW, using an extraction form relevant to the research objectives. This form captured the key features of the included studies ( Table 2 ). As critical appraisal of studies has been strongly recommended when performing narrative reviews ( 33 – 35 ), the methodological strengths and limitations of the studies were assessed independently by two reviewers (SW, ÁT) using the Critical Appraisal Skills Programme (CASP-uk.net) qualitative checklist. The CASP checklist is a widely used tool for qualitative evidence synthesis and is recommended by World Health Organization guidelines ( 36 ). No study was excluded as a result of this quality assessment.


Table 2 . Key features of the studies.

Review Findings

The PRISMA diagram in Figure 1 summarizes the selection and screening process ( 37 ). The initial search identified 6,977 items. After removing duplicates, the abstract and titles of 6,749 items were screened according to the inclusion and exclusion criteria. Three additional papers were identified through hand searching the reference lists of relevant studies. This resulted in 53 studies being retained for full-text review, against the inclusion criteria. The final review included six papers that reported five interventions ( 27 – 32 ).


Figure 1 . Prisma flow diagram describing the identification, screening, eligibility, and inclusion criteria of the studies identified under the scope of this review.

An overview of the studies and the interventions is provided below. Enough detail is provided in this overview to enable readers to make sense of studies' context and findings ( 33 ), as has been strongly recommended in narrative literature reviews ( 34 , 35 ). Following the overview, this review then focuses on how the concept of resilience was defined and operationalized within the included studies. After this, the findings of the studies are interpreted in relation to the resilience framework ( 9 ).

Overview of the Studies and the Interventions for Resilience

Dementia advisors and peer support network services.

Clarke et al. ( 27 , 28 ) conducted a study which evaluated a national programme in the UK that aimed to compare the influence of dementia advisers (DA's) and peer support network (PSN) services on the well-being and resilience of people with dementia and their family carers, living in a community setting. The DA's provided information and an ongoing point of contact for service users. They aimed to provide information about dementia and signpost other services, such as social groups, legal or financial supports. The PSN provided emotional and social support to people with dementia and carers through Alzheimer Society support groups and dementia cafes. Both DA's and PSN facilitators were lay health workers, and many were volunteers ( 28 ). At the time of the Clarke et al.'s evaluation, the interventions had been operating for 10 years at 40 demonstrations sites.

Clarke et al. used a mixed methods design which emphasized qualitative methodology ( 28 ). An organizational survey was conducted along with case studies of some demonstration sites ( n = 8). People with dementia were interviewed, at their convenience, alone or with their family carers 1–3 times. These semi-structured interviews lasted up to 2 h. At the time of interview, quantitative questionnaires were also administered. These included the adult social care outcomes toolkit (ASCOT) ( 38 ) which collected data on unmet needs and the DEMQoL ( 39 ), that recorded health related quality of life. In addition, staff and stakeholders ( n = 82) were interviewed. Participants were recruited through key staff working at the chosen demonstration sites and a sampling matrix was used to select a range of staff and stakeholders who had accessed the services. Participants included family carers ( n = 54) and people with dementia ( n = 47), the majority of whom were aged 65–85 years and had early stage (mild) dementia. The quantitative data were analyzed using SPSS, to ascertain statistical representation of frequency and modal responses for each respondent and all people with dementia as a group. All the interview data was uploaded into NVIVO and descriptive content analysis was conducted on 25 of the interview transcripts from which the research team developed a coding framework which was used to analyse the remaining data into themes.

Clarke et al. identified three themes: addressing the needs of individual and communities; promoting choice, control and independence; and getting a life back. The findings included in the first theme revealed that both interventions operated through identifying and responding to the needs of their users. The DA and PSN were informed and shaped by the needs and expressed desires of the people with dementia and their carers. The carers wished to remain well and both the carer and person with dementia wished that the stigma surrounding dementia could be reduced. The data also revealed that the PSN and DA's responded to the needs of the people with dementia by providing a wider range of services than those offered by traditional providers, including for example, gardening clubs and music groups. Also, the PSN and DA facilitators raised awareness about dementia with the wider public through providing training and information. This was illustrated by a carer who said:

‘ I think people need a lot more training on it [dementia], because it's something that is not to be frightened of.' (Beth, daughter of couple who had accessed DA service) [( 28 ), p. 389].

The second theme, incorporated findings concerning how the services promoted independence, through providing information directly and through signposting access to further support. As one care partner stated:

‘ It [the PSN] allows him to feel independent, and it allows me to be myself, or more myself .' (Nancy, care partner from PSN site) [( 28 ), p. 390].

The third theme illustrated how the PSN and DA service users considered that they had been enabled to establish a new, improved life with dementia. Self-esteem and self-worth were increased, and participants commented that they had been able to replace the social life and activities that they had lost due to dementia. One participant said:

‘ It's [the PSN] been the best thing that's happened to me for a few years now. I've been going to an art class for Alzheimer's and meeting people. It's fantastic because we can all talk to each other .' (Lillian, person with dementia who had accessed PSN site) [( 28 ), p. 391].

Visual Arts Enrichment Activities

The second study included in this review was conducted between 2013 and 2017 in the UK ( 29 ). This study aimed to evaluate the impact of visual arts enrichment activities (VAEA) on opportunities for the resilience of people with dementia. This study was part of a wider mixed methods study on dementia and imagination ( 30 ) that prioritized qualitative methodology. Papers reporting on the wider study were excluded from this review because they did not focus on resilience.

During the VAEA intervention, experienced participatory artists who had received training in dementia, used a person-centered approach to organize activities around the interests, abilities and energy of people with dementia ( n = 48), aged 70–99 years, living in care homes ( n = 4). The Clinical Dementia Rating scale ( 40 ) was used to rate the severity of participants' dementia. This found that the participants' dementia was borderline normal ( n = 6), mild ( n = 18), moderate ( n = 8) and severe ( n = 16).

The VAEA sessions lasted 2 h and were held weekly, for 3 months. The VAEA aimed to engage the senses of the participants in activities that could be, for example, individual collage painting or collective, film making, sculpture, or poetry. Participants also visited a contemporary arts center and a celebratory event was held that included their family and carers. Data was captured at 3 time points: baseline, when the activity sessions finished and 3 months after their cessation. Data was collected from people with dementia ( n = 3) and family carers ( n = 3) who were interviewed separately and the participatory artists ( n = 2) who completed structured notes after each session. In addition, sessions were videoed, and recordings were observed to verify the study's findings. The data was analyzed in NVIVO, where multiple readings were used to identify emergent codes which were collated into themes.

This study found that the resilience of people with moderate and advanced dementia can be supported through VAEA. Newman et al. ( 29 ) found that VAEA provided a platform which facilitated creative expression; increased communication and self-esteem and that the intervention enhanced the relationships between participants with dementia, their carers and relatives. For example, collectively creating a poem relied upon participants expressing their emotional responses to their individual memories, of being at the sea. The first four lines of this poem were:

The Cruel Sea

The beautiful sea goddess

Godiva Pearl

Beautiful ruffles

The ripples [Poem Created by participants, ( 29 ), p. 8]

Creating the poem was facilitated by participants being of similar age and possessing compatible attitudes. Newman et al. ( 29 ) argue that in order to produce this adaptive response, participants drew on both personal and collective resources. These resources were cognitive, emotional, imaginative, and aspects of their social selves, including being able to perceive and interpret the thoughts and feelings of others in the group.

Participants were more resilient during the activity than they would have been without it. Newman et al. ( 29 ) describes how one person with dementia who was usually solitary and uncommunicative, was poised and passionate when painting. And, as a result of group singing, her interactions with others were observed to increase and be more socially engaging. Newman et al. ( 29 ) suggested that the VAEA increased her selfhood and therefore supported her resilience. A carer reported:

‘ It really did feel quite different to me all of the activities were bringing everybody together…. She was really connecting with other people as well in the group as well. Her whole body language seemed to be different.' [Care home Director, ( 29 ), p. 11].

Self-esteem of participants was also increased, through participants' mastery of the activity and their success being praised by other people. However, self-esteem could also be undermined if a person was not able to accomplish the task or participate within the group and if the person's attention was drawn to their lack of ability and they became frustrated. Yet, when this occurred, participants demonstrated their ability to adapt because they still found the sessions enjoyable and wanted to participate in them. One man was able to participate, despite his communication difficulties, because he had developed a good relationship with the facilitators. It was argued that his resilience was supported through the social context of the VAEA.

Researchers also found that VAEA supported resilience through promoting personhood. VAEA enabled people to attain their potential without being inhibited by the assumptions other people made about their capabilities. In addition, VAEA increased the knowledge of carers and family members about the capabilities of people with dementia. One care home director said:

‘ I loved hearing people read and was surprised how confident the readers were. I suppose I'd underestimated how capable people with dementia are and had assumed they would find this difficult. You underestimate people don't you, you think ‘Oh they're not going to do that' . [Care home director, ( 29 ), p. 13].

Improving the knowledge of significant others of the individuals' personhood meant VAEA had the potential to increase resilience in a sustained way in future interactions. This potential was also increased through VAEA giving residents, carers and relatives, an opportunity to celebrate and enjoy the activities together, in an atmosphere of positive equal relationships:

‘ It just felt like any social occasion/party-friends enjoying themselves, no distinction between those who were experiencing dementia and carers, family and friends.' [Care home director, ( 29 ), p. 13].

Memory Makers

The fourth intervention, “Memory Makers,” started in the USA in 2012 and was investigated in a study that aimed to explore its impact on resilience, using an observational descriptive study design ( 31 , 32 ). This community-based intervention recruited people with dementia from memory clinics, medical practices and the Alzheimer's Association. To participate, people with dementia needed to be: in the early stage of their disease; aware of their diagnosis; able to discuss their feelings and experiences about dementia; have no behavioral psychiatric medical difficulties that would cause them to disrupt the group; have transport to the group and a care partner who was able to attend the majority of sessions. Participants included people with dementia ( n = 35), aged 56–93 and family carers ( n = 35).

“Memory Makers” provided structured education about dementia and psychosocial support in a group setting for people with dementia and their family carers. The groups were facilitated by master's educated social workers (two per group) who were trained with information from the Alzheimer's Association early stage group facilitators manual. Memory Maker sessions lasted 3 h and were conducted weekly for 8 weeks. During each session, people with dementia and carers ( n = 12 dyads) were separated into two groups for 75 min, where they discussed different topics related to living with dementia. After this time, the groups joined. On the final session, the participants wrote a communal poem about their group bonding which aimed to capture the spirit of their resilience.

Data for the study was collected from consecutive groups ( n = 4), at the end of each group of sessions, via an emailed online evaluation survey. This recorded perceived outcomes anecdotally. This study's findings, which will be described after the fifth intervention is introduced, were also derived from the facilitators' observations. Details as to how data analysis was conducted is not provided by the authors.

Early-Stage and Beyond Community Activities

The fifth intervention was the Early-Stage and Beyond Community Activities (ESBCA) ( 31 ). This involved a range of activities (see Table 2 ) for people with dementia and family carers who were graduates from the Memory Maker program. ESBCA aimed to build resilience by developing community support. ESBCA was facilitated by trained social workers ( 31 ). Data was collected from family units ( n = 1,799), that included people with dementia ( n = 166), aged 49–93 years, and family carers ( n = 178). The authors do not provide details as to how data was collected or analyzed.

The impact on resilience of the Memory Makers programme ( 32 ) and the ESBCA ( 31 ) will now be discussed together because the interventions involved similar participants and the findings of their investigations concur with one another. Matchar et al. ( 31 ) describes themes that were derived separately from people with dementia and their family carers. Here however, in keeping with the aims of this review only the themes identified for people with dementia will be reported. The eight themes identified were: acceptance; disclosure; significant others; sense of purpose; faith; routines, familiar environments, and memory aids; showing up/the value of a support group. The theme of acceptance relates to evidence in which participants described that they were resigned to having dementia, living with limitations and that they accepted this with a determination to make the best of life. One gentleman with dementia said:

‘ There's no changing it [having dementia]. I'm just rolling with it…. I want to find some strategy to best function…' [Person with dementia, ( 31 ), p. 273].

Participants also identified that disclosure to others about their dementia was important to them as a source of support. This allowed them to continue with activities that they enjoyed. For example, one lady continued playing golf as her friends kept score for her. The second theme recognized that the support of significant others was crucial to people with dementia. Participants also highlighted the importance of having a sense of purpose and taking opportunities to stay engaged and socially active. Several participants adapted their activities to accommodate the dementia. Sometimes adaptation to continue activities occurred facilitated by friendships developed through Memory Makers. This happened when one person who could no longer drive was facilitated to continue with voluntary work, delivering donated food, because a Memory Maker friend, who also had dementia, drove them.

The theme, routines, familiar environments, and memory aids, revealed the ways in which participants benefitted from sharing strategies with one another. Doing so increased their knowledge and independence about managing daily life with dementia. Such strategies included keeping objects in the same place, keeping to the same routine including using the same shops or recreational facilities. The final theme illustrated clearly the beneficial impact of the Memory Makers group. Members valued attending the group. One person said it gave her “ renewed meaning ” in life [Person with dementia, Matchar et al. ( 31 ), p. 274]. Matchar et al. ( 31 , 32 ) also reported that participants thoroughly enjoyed the “bubbly ambience” of Memory Maker, and ESBCA which were filled with fun, humor and laughter. One participant said:

‘ It's like a party…. Everyone's laughing, and everyone is happy' [Participant with Dementia, ( 31 ), p. 274].

The atmosphere of the groups meant that participants could relax, be themselves, focus on their strengths rather than losses ( 32 ), in an environment which was free from stigma and one in which they felt safe to make mistakes ( 32 ). In the activities offered by both these interventions, participants were treated with “ acceptance, kindness, and respect ” and the study authors argue that this helped participants to build and maintain their resilience ( 31 ). One participant illustrated these findings saying:

‘ Everyone in the group ‘got it' and that was a very liberating experience……I felt less like complaining and more inclined towards positive planning and living one day at a time' [Person with dementia, ( 32 ), p. 174].

Being a member of the group provided participants with a sense of belonging. One participant said they had gained a new family, and this empowered them as individuals. The power of the group and the bonds created within them was captured in a poem that participants created:

‘ You are not alone .

I felt the group was a life saver

It brought a life, empowering us all' [( 32 ), p. 173].

Key features of the studies and interventions are summarized in Table 2 .

Having provided an overview description of the studies, this paper now focuses on how the concept of resilience was defined and operationalized during the investigations.

Definition and Operationalization of Resilience

To address the aims of this review to fully examine and integrate the findings of the studies it is important to establish how resilience was defined and operationalized. This is because historically resilience has been defined in different ways ( 8 ). Newman et al. ( 29 ) and Matchar et al. ( 31 , 32 ) state that they defined resilience as a dynamic process that encompasses positive adaptation in the presence of adversity. Although a definition of resilience is not expressly stated by Clarke et al. ( 28 ), the study's design supports the supposition that resilience was defined as a process. This is because resilience is reported to be an outcome of the DA and PSN interventions, and yet quantitative outcome measures of well-being and quality of life are used in the study, rather than scales that aim to measure the psychological capacity for resilience.

The studies identified in this review were informed by different research paradigms and theoretical backgrounds including, social constructivism and social disability ( 28 ); the ecological theory of human development and the ecological framework of resilience ( 29 ); and the social context perspective ( 31 , 32 ). Newman et al. ( 29 ) explicitly stated that the ecological view of resilience underpins their investigation, but all the studies included in this review appear to endorse the view that the resilience of people with dementia is impacted by resources that are accessed at individual, social and community level ( 8 ). This supposition is supported because the interventions target both people with dementia and their family carers and the wider community.

Because resilience has been operationalized in this way it is appropriate to apply the resilience framework ( 9 ) to the studies' findings to facilitate a more in depth examination as to how the interventions impacted the resilience of people with dementia. This is relevant because resilience can potentially be supported through: reducing the adversity and via improving the provision or access to resources. In applying the framework in this review, community level resources that support resilience are defined as being people in direct contact with people with dementia (significant others) and societal level resources are defined as referring to people outside immediate contact with individual service users.

The results of applying the framework to the included studies are discussed below and summarized in Table 3 .


Table 3 . The impact of interventions applied to the Resilience Process ( 8 ) and Framework ( 9 ).

The Impact of the Five Interventions on the Resilience of People With Dementia

Da and psn services (27, 28).

The DA and PSN services supported resilience by helping to identify the adversity and needs of people with dementia. This included identifying participants' needs and desires to have a wide range of activities to help them stay well. The adversity experienced by individuals through the stigma of dementia was also combated through DA facilitators providing education to groups of people (other than the participants) about dementia and the needs of people with dementia.

The interventions enabled access to resources that occurred at individual, community and societal levels. Individual resources included the activities that were applicable to people's individual strengths, needs and desires. Indeed, access to these was supported through the participants' increased independence and sense of control. One participant referred to how the services empowered her make choices with her partner:

‘ It gave us the confidence to move in the directions we wanted to move in' (Jilly, care partner who had accessed DA service) [( 27 ), p. 392].

At community level, the interventions impacted the resilience of the people with dementia through providing support to their carer and through providing participants with access to social peer support. Lillian, a participant with dementia said of the PNS:

‘ It's fantastic because we can all talk to each other' [( 27 ), p. 391].

Having access to resources appeared to impact the outcomes of resilience. The theme, “getting a life back” speaks to participants having achieved a “new normal” and improved quality of life. One of the participants said:

‘ We've sort of got back some normality now. He's got quite a week of things happening most days .' (Carer) [( 27 ), p. 391].

Memory Maker and ESBCA (31, 32)

The Memory Maker and ESBCA, did not use a specific tool to identify the needs of the people with dementia as part of the investigation. Never-the-less, it can be extrapolated from the study's data, that participants were experiencing adversity particularly regarding social isolation as a result of the dementia and stigma.

The interventions provided participants with time with others who shared their experiences as people with dementia and family carers. Having time to bond as a group was a resource for individuals and the community through which resilience could be supported and sustained ( 31 ).

The outcomes of these interventions for resilience, were improved communication between people with dementia and care partner dyads ( 32 ), increased capacity for empowerment, independence, and positivity going forward into the future. The data also suggested a more global outcome, that group membership helped move individuals toward a more normal life with dementia, which included being themselves and having a social life with friendships that reduced social isolation. In this regard, their lives with dementia were normalized and the dementia was reframed as being part of their lives. The findings further revealed that participants had more confidence to disclose their dementia to other people ( 31 ). This suggests that not only do these outcomes have the potential to be sustained within this community of participants, but outcomes could potentially develop as a result of individuals seeking and benefiting from the support of others outside this immediate peer group community. However, evidence that this occurred is not provided by Matchar et al. ( 31 , 32 ).

In terms of reducing adversities, the VAEA intervention highlighted that participants had cognitive and communication difficulties, that were more severe than those experienced by participants in the other studies. The severity of difficulties was variable both in and between individuals ( 29 ). Newman et al. ( 29 ) also identified that the beliefs and actions of carers and relatives, regarding the person with dementia's capabilities, impacted how adversity was experienced by people with dementia. Newman et al. ( 29 ) found that seeing people with dementia involved in VAEA increased their awareness. This could potentially change the behavior of carers and relatives resulting in them acting in way that supported resilience and did not cause excessive disability. However, no evidence of this change was reported by the study.

In contrast to the other studies, Newman et al. ( 29 ) argue that participating in the VAEA increased access to resources but these resources could not be separated into distinct individual and community categories. Instead, resources were used in a complex interplay which was enabled by VAEA. VAEA had no visible impact on resilience through wider societal issues but the impact was through individual, and community issues as described above.

VAEA resulted in people doing better than would otherwise be expected and this can be regarded as an outcome of resilience, during the intervention. In addition, their communication and interaction with others increased in quality and their self-esteem improved.

The findings of this review are now discussed in relation to the wider literature and then recommendations for future research are proposed.

The studies reported the perceptions and experiences of people with dementia and the findings reveal that the interventions were well-received by participants who engaged with them voluntarily. Many people with dementia reported the interventions to be beneficial and their views concurred with the observations and opinions of significant others ( 27 , 28 , 31 , 32 ). Newman et al. ( 29 ) reported the experiences of people with dementia using the intervention as being beneficial to their resilience but did so using the observations and verbal reports of significant others, rather than directly from people with dementia. This raises questions about the challenges involved in assessing the resilience of people with moderate and advanced dementia. As dementia progresses it is important to find ways to accurately capture the perspectives of people with dementia about their resilience. Not to do so is potentially problematic because the perspectives of people with dementia and carers can differ regarding perceptions of quality of life ( 41 ) and what makes activities meaningful ( 42 ).

One of the benefits of the interventions, was that they empowered people with dementia to disclose their diagnosis to other people ( 27 , 28 , 32 ). Disclosure of dementia diagnosis to friends and family is beneficial ( 43 ) and it is logical that informing significant others may be a gateway to the person gaining support from significant others. This finding was less pertinent in the study population living in residential care, but it is notable that involvement with VAEA also improved communication with other people ( 29 ). The latter could improve the possibility of compensatory support which may increase the resilience of people with dementia ( 4 ).

It is noticeable that only the study reporting VAEA described any weakness or disadvantages to the interventions. VAEA was reported as enjoyable despite some people with dementia experiencing frustration, if they were unable to master certain activities.

The results of this review reveal that most studies to date have focused on people with dementia who are “doing okay” ( 44 ). Participants with dementia who were recruited for Memory Makers and ESBCA were relatively well-supported, and those accessing PSN and DA services had the capacity to reach out to the services and engage with them. Although participants involved with VAEA all had significant vulnerabilities, only people without severe communication difficulties were involved in the study. Clarke et al. ( 28 ) acknowledges that not accessing people with dementia who did not use the service, was a limitation of their investigation. In addition, except for some participants, involved with VAEA, most participants had early stage dementia. Therefore, the findings of the community-based studies reflect the impact of the interventions on the resilience of people with dementia who have a relatively high ability to access and use resources to support their resilience. This is a situation common to other studies conducted regarding resilience in people with dementia where participants were deemed to be “doing okay” ( 15 , 44 ), living with people who were supportive and willing to participate in research ( 22 , 45 , 46 ), had contact with support groups ( 16 , 47 , 48 ), and were in receipt of support services ( 19 ). However, Harris ( 44 ) investigated the resilience of people with dementia including some who were not “doing okay” ( n = 5). Therefore, it is possible to examine the resilience with people with dementia who are adapting less well to the challenges of living with dementia. Accessing and recruiting participants who are in the most need can be challenging ( 49 ). It may take more time to convince gatekeepers that such individuals would be able to participate and to gain participants' consent ( 50 ). It may also be challenging to convince funders that recruitment time and study duration in the context of dementia research may need to be extended to facilitate the inclusion of individuals who are in most need.

This review identified that a small number of studies have examined interventions that aimed to support the resilience of people with dementia, who live in both community and residential care settings. The studies were undertaken within the last decade and three of the papers reporting their evaluations were published in 2018. This suggests that the investigation of interventions to support resilience in dementia is a relatively recent and developing field of research and practice. This novelty is reflected in the research designs used to evaluate the interventions. The assessment of the studies methodological strengths and weaknesses during this review found that all the studies produced valuable results in terms of their contribution to knowledge and regarding the aims of this review. However, only Clarke et al. ( 27 , 28 ) and Newman et al. ( 29 , 30 ) rated highly in terms of methodological quality. This result was obtained by the two reviewers whose independent assessments, which initially revealed a high degree of consensus, achieved full consensus following discussion (Appendix ii in Supplementary Material ).

The research designs of all the studies do not seek to measure change in well-being but instead seek to describe how the services were used and experienced by people with dementia and to identify what stakeholders perceived their impact to be. Matchar et al. ( 31 , 32 ) and Newman et al. ( 29 ) focused on describing details of the perceived process and outcomes of the interventions. Their investigations infer that outcomes are as a result of the interventions, and there was no attempt to isolate variables and measure change. Newman et al. ( 29 ) did obtain data at multiple time points in relation to participation in VAEA, including data obtained 3 months after the intervention, but their findings concerning potential changes in well-being beyond the VAEA sessions were not reported. Without alternative study designs providing control group comparisons, it is impossible to ascertain effectiveness and whether participation was beneficial due to the components of each intervention per say, or due to them being offered in the absence of another viable activity. Therefore, it cannot be determined to what degree the social component of the group interventions were important. Never-the-less, it should be noted that the varied interventions examined here all supported resilience through socially related characteristics namely, their positive impact on stigma, social contact, and social support.

The stigma associated with dementia was highlighted as an adversity in that it contributed to excessive disability ( 29 ) and social isolation ( 28 , 31 , 32 ). This concurs with findings elsewhere, that the actions of other people in applying negative stereotypes increase the difficulties of living with dementia ( 43 ). It is therefore significant that the interventions reduced these adversities through providing stigma free, psychosocially safe platforms ( 29 ) in which people were free from the fear of potential embarrassment ( 43 , 51 ).

Social contact and support from other people are also important for resilience ( 5 , 15 , 22 ), as is the quality of the relationships that people with dementia have with other people ( 52 ). It appears that the quality of relationships within all the group interventions were improved because they involved people who shared the experience of living with dementia. The interventions provided the opportunity for participants to interact and belong to a peer group and this was hugely valued by participants ( 28 , 29 , 31 , 32 ). Belonging to a peer group is known to positively impact resilience in dementia ( 16 , 19 , 53 ) by empowering people, providing opportunities to share practical information strategies to increase their repertoire of adaptive coping strategies ( 54 ) and enhancing positivity, which is important for resilience ( 15 , 55 ).

The quality of relationships between people with dementia and the interventions' facilitators were also important to the success of the interventions. It is notable that all the interventions involved facilitators who played key roles conducting and creating both the content of the interventions and their processes. The artists created the VAEA intervention, enabled participation and ameliorated the impact on self-esteem for individuals who were not able to master the activity ( 29 ). The lay health advisors of the DA intervention had ongoing in-depth interactions with service users throughout their journeys with dementia and they shaped the service in response to needs ( 27 , 28 ). In order to be effective, these facilitators had direct personal knowledge of dementia and intimate knowledge of communities ( 27 ) and had training in dementia care as social workers ( 31 ) or as researchers ( 29 ). This reveals that successful resilience building interventions requires skilled facilitation. In addition, as dementia progresses the way facilitators facilitate interventions is likely to differ and require additional skills.

The interventions also impact resilience through being supportive of the personhood ( 56 ) of individuals with dementia, by providing them with meaningful activities ( 29 , 31 ). Meaningful activities are likely to contribute to the increased self-worth and self-esteem that resulted from the interventions ( 27 – 29 ). Indeed, the activities may support resilience through providing a sense of continuity in identity ( 55 , 57 ) which can be balanced against the changing perceptions of identity that occur due to the dementia. Successfully managing this balance is important for resilience in dementia ( 53 , 58 ). The proposition that the interventions may support this important “task” of resilience in dementia is supported by participants in the studies who said the interventions helped them adjust to dementia, to reframe and normalize living with the condition ( 27 , 31 , 32 ).

Another characteristic of the interventions is that they were strength-based in that they built upon the assets and resources that people with dementia already possessed. The interventions required participants to have and use personal and social skills in order to participate. For example, the group interventions required communication and cooperation skills and when participating in the VAEA interventions, participants used aspects of their personal and shared cultural, previous and present identities ( 29 ). This implies that people with dementia did not just receive the interventions, but they contributed of themselves, to the intervention and to other group members. Indeed, because their participation involved reciprocity, questions can be raised as to how the positive impact on the resilience of individuals might be increased through the interventions providing opportunities to contribute to communal resilience. People with dementia want to give support to others and contribute ( 16 , 59 , 60 ) and doing so provides them with opportunities for increased self-worth through reinforcing positive self-identity ( 43 ). It appears that when the interventions impacted as resources to support resilience, the lines between individual and community resources are blurred regarding reciprocity. Lines between these resource categories were also blurred because two out of three interventions aimed to support the resilience of both people with dementia and family carers. Indeed, carers can be regarded as a community support for people with dementia and family carers with greater well-being may have greater capacity to support the resilience of the people with dementia. It is also noteworthy that Newman et al. ( 29 ) identified there was interplay between individual and community resources during VAEA.

The findings of the review revealed that resilience can be fostered “in the moment” during an intervention and/or sustained after the intervention has finished. “In the moment” increased adaptation was highlighted during VAEA, whereas the community-based interventions placed greater emphasis on supporting resilience with the goal of attaining sustainable outcomes ( 31 ), through increased independence and on-going well-being ( 27 , 28 ). However, fostering of resilience “in the moment” was implied during all the interventions through the reports of humor, joy, and release reported by participants. These positive emotions equate to what have been described as “good moments” ( 61 ) of happiness. It appears logical that interventions that create opportunities for small moments of happiness are likely to increase positivity and hope which are very important for resilience in people with dementia ( 16 , 19 , 21 ).

The studies in this review provide some evidence that the effects of interventions on resilience can be sustained. Some people with dementia reported and recalled the effects of the interventions when data was obtained ( 27 , 28 ) and after they had occurred ( 32 ) and effects of ESBCA were on-going ( 31 ). On-going sustained effect was not highlighted in the findings of VAEA, but the potential for this exists if carers were to act differently due to improvements in relationships and increased awareness concerning the capabilities of people with dementia. Potential for sustained effect on resilience also exists regarding the other interventions due to their empowerment effects and the potential for increased support from other people due to disclosure.

Implications for Future Research

Applying the resilience process ( 8 ) and framework ( 9 ) to the interventions discussed in this review, facilitated in-depth understanding as to how these interventions impacted resilience of people with dementia. Therefore, it would be useful for future research to include a resilience perspective using the framework. Doing so would be particularly beneficial to investigations concerning interventions that aim to support people with dementia in any purposeful activity. This is because purposeful activity, chosen by a person ( 57 , 62 ) and compatible with their tacit norms ( 63 ), is important to the resilience of people with dementia ( 48 , 55 , 57 , 63 , 64 ). For example, spirituality can be an important resource for the resilience of many people with dementia ( 5 , 19 , 48 , 51 , 59 , 65 – 67 ). But to date interventions targeting spirituality have not, to our knowledge, focused on resilience even through spirituality based interventions have been found to impact well-being ( 68 – 70 ). Applying the resilience process when examining such interventions may increase understanding of how they impact well-being.

This review also found that although supporting resilience was beneficial to people with dementia, only a limited number of interventions have been developed and these have been assessed predominantly with people in early dementia in community settings who are currently “doing okay.” Future research should focus on interventions that have the potential to support resilience through facilitating communication opportunities for people with more advanced dementia to interact with other people ( 58 , 71 , 72 ). Indeed, touchscreen technology has been found to enhance personhood of people with dementia ( 73 ) and robotic technologies can positively impact quality of life ( 74 , 75 ) and improve mood ( 76 ). The potential of these interventions to support resilience could be investigated. Indeed, focusing on people with moderate dementia and those not “doing okay” might reveal the need to target different areas and develop different strategies to support their resilience.

This review highlights gaps in current knowledge concerning how interventions support the resilience of people with dementia and their carers differently, similarly, and jointly. This warrants further investigation, as joint interventions may not suit all dyads and could even harm the resilience of either party. Furthermore, if it is found that the resilience of people with dementia can be enhanced by interventions that also support family carers, then the potential for interventions that jointly target the resilience of people with dementia and professional carers should be investigated in residential care settings.

The findings of this review suggest that resilience can be supported “in the moment” and/or sustained after interventions. This suggests that resilience in relation to time needs further examination. Further investigation is also warranted concerning the interplay between individual and community resources ( 29 ), particularly regarding reciprocity and how reciprocity can be used in interventions to support resilience in people with dementia.

It is difficult assess the impact of interventions that occur in clinical environments ( 77 ), particularly when investigating them in the context of dementia, which is a progressive disease and where the symptoms of the disease and the adversity caused vary within and between individuals ( 29 ). Therefore, in order to potentially influence policy and practice, future research ideally needs to use methodologies that elucidate changes that occur both during and as a result of interventions. Furthermore, tools such as Dementia Care Mapping ( 78 ) and the Observational measurement of Engagement ( 79 ), may be needed to accurately capture behavioral responses to stimuli and measure changes in resilience. In addition, because the resilience of individuals is impacted by significant others, it is important that future investigations examine the social context into which interventions are introduced and their impact on resilience in the light of this.


This review has limitations and its findings should be considered in the light of these. The search was limited to items published in English and in order to focus on resilience, it excluded proxy terms for resilience. Therefore, intervention investigations reported in different languages and those that explored alternative well-being outcomes, which may have impacted resilience, were omitted. In addition, the search process and data extraction were conducted by one reviewer therefore some relevant articles might have been erroneously excluded. However, the review utilized a theoretically informed systematic approach and the included studies were subjected to in-depth analysis applying resilience theoretical constructs.

This review used a systematic approach to identify and examine research that investigated psychosocial interventions that aimed to support the resilience of people with dementia. The findings revealed a variety of interventions conducted in both residential care and community living settings. The interventions were found to impact all the components of the resilience process ( 8 ) and sometimes there was interplay between the individual and social resource components of resilience. The findings reveal that interventions can support resilience, both during and after the intervention sessions, although evidence of their effectiveness is limited because studies are descriptive and do not measure change. This review found there is a need for further research in this developing field. However, interventions that successfully build resilience in people with dementia need skilled facilitators to ensure that they are supportive of personhood and that they enable reciprocal social interactions to occur. It is also important that interventions are provided within a stigma-free context.

Author Contributions

SW conceived, planned, and conducted all aspects of the review including writing the manuscript. ÁT conducted critical appraisal of the included papers, reviewed the drafts, and the final paper. DC provided guidance, critically reviewed drafts, and the final paper.

This work was supported by a Ph.D. scholarship from the College of Medicine, Nursing and Midwifery, and Health Sciences, at the National University of Ireland Galway.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The authors would like to acknowledge the contribution of John Ivory and Michael Smalle for their advice on planning the literature search strategy and Catherine Houghton who provided advice regarding the use of the CASP qualitative check list.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fmed.2020.00045/full#supplementary-material

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79. Cohen-Mansfield J, Dakheel-Ali M, Marx MS. Engagement in persons with dementia: the concept and its measurement. Am J Geriatr Psychiatry . (2009) 17:299–307. doi: 10.1097/JGP.0b013e31818f3a52

Keywords: dementia, Alzheimer's, resilience, systematic review, aging, interventions

Citation: Whelan S, Teahan Á and Casey D (2020) Fostering the Resilience of People With Dementia: A Narrative Literature Review. Front. Med. 7:45. doi: 10.3389/fmed.2020.00045

Received: 06 November 2019; Accepted: 29 January 2020; Published: 25 February 2020.

Reviewed by:

Copyright © 2020 Whelan, Teahan and Casey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Sally Whelan, s.whelan7@nuigalway.ie

This article is part of the Research Topic

Active and Healthy Ageing: A Multifocal Novel Trend To Increase Resilience In Elderly

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Literature review: technological interventions and their impact on quality of life for people living with dementia

David sanders.

1 School of Computing, University of Portsmouth, Portsmouth, Hampshire, UK

Philip Scott

2 Centre for Healthcare Modelling and Informatics, University of Portsmouth Faculty of Technology, Portsmouth, UK

Rapid technology-driven innovation in the healthcare sector has led to an increasing ability to effectively respond to health challenges. However, the cognitive challenges faced by a person with dementia exacerbate the difficulty of designing enduring technological dementia care solutions. Despite this, and in the absence of a cure, facilitating well-being and improved quality of life becomes pivotal for those living with dementia and their caregivers. This review aimed to identify and consolidate the provision of technological solutions for dementia care, and how these are perceived to impact the quality of life of a person with dementia.

Articles and journals were identified using keywords including those relating to quality of life, assistive technologies and technology adoption and acceptance. Greater priority was given to resources published after 2010 due to the speed of technological advancement, and peer-reviewed articles were preferred.

91 resources were identified, with 38 contributing to the final review. In addition to multiple quality of life measurement tools, the literature identified a large variety of solutions that fell into three categories: those used ‘by’, ‘with’ or ‘on’ a person with dementia.


This review concludes that the ‘one size fits all’ approach to many solutions reflects the lack of supporting evidence, negatively impacting trust in their usefulness among caregivers and their subsequent adoption rates. This could be attributed to limited involvement of people with dementia in studies of effectiveness and adoption. Additional research is recommended to further consolidate research on quality of life and to understand the individuality and progression of dementia and its influence on dementia care solutions.


Dementia care is arguably one of the most challenging domains in an already highly complex healthcare environment. Despite the rapid progression of technological advancements in healthcare, the cognitive decline experienced by a person with dementia places new demands on the ability to provide effective and enduring dementia care solutions.

The ageing population has led to an increasing number of people with dementia, with over 850 000 believed to be living with the condition in the UK, at a cost of over £26 billion. 1 Although such figures can help appreciate the scale and widespread impact of dementia, they are unable to represent the personal impact on the individuals living with the condition and those around them.

As generations age and technology becomes more widely familiar, people are more likely to place trust in technology for their healthcare. The potential is already starting to become recognised, with the widespread adoption of electronic health records and its ability to reduce costs and increase efficiency. 2 3 Despite this, Greenhalgh et al 4 highlighted the unrealistically rapid implementation of healthcare technology expected by policymakers, often due to the need for establishing such services in busy and financially stretch organisations, while Nair and Dreyfus 3 identified the disparity between healthcare technology investment and its limited subsequent adoption by service providers.

The WHO, who have endorsed the ‘Global action plan on the public health response to dementia 2017–2025’, highlight the importance of technology to improve dementia care. 5 In the absence of a cure, facilitating well-being and improving quality of life of someone with dementia becomes arguably even more important. ‘Beyond the Pill’ care (ie, non-pharmacological care interventions) is pivotal in achieving this, with techniques such as reminiscence therapy proven to improve mood and cognition. 6

With 60% of people with dementia living at home 1 and 700 000 informal caregivers in the UK, 7 there is a need for ‘beyond the pill’ solutions to reduce the burden on caregivers. This need is unlikely to decrease, with the number of people living with dementia expected to rise from 850 000 to over 2 million people by 2050. 7 Despite this, 63.5% of caregivers believe they are not given enough support from the healthcare service. 7 However, with caregivers reporting higher levels of emotional strain when not using any beyond-the-pill solutions, compared with those who used both in home (eg, meals on wheels) and out of home (eg, transportation), 8 the importance of ‘beyond the pill care’ cannot be overstated.

This review will explore and consolidate the provision of technological solutions available for people with dementia. Additionally, it will consider how the domains deemed important to quality of life are impacted by the technological solutions discussed. This will be structured around the following research questions:

  • How is quality of life for people with dementia defined and measured?
  • What technologically based solutions are currently available to assist people with dementia with their quality of life, and how do these contribute to the domains deemed important to quality of life?

Search and selection strategy

The following tools were chosen for the identification of literature, as they were deemed most relevant to the topic: University of Portsmouth Discovery service, Sage Journals, British Journal of Healthcare Computing and PubMed. It was decided the Discovery Service would be the primary source of literature due to the higher probability of accessing full text, as it is the direct library service with access to all university journal subscriptions. This search primarily took place between October and December 2017 and was expanded between November 2018 and March 2019. The following keywords were used as a search basis:

  • Technology in dementia.
  • Assistive technology in dementia.
  • Technology limitations in dementia.
  • Dementia Technology acceptance/adoption.
  • Quality of life in dementia.
  • Dementia self-image.
  • Dementia therapeutic methods.

Therapeutic methods were included in keywords due to their relevancy in ‘Beyond the Pill’ care and quality of life.

To ensure as much relevant literature as possible was covered, there were also searches conducted with the phrase ‘mild cognitive impairment’ in place of ‘dementia’. As some searches were returning tens of thousands of results, database filters were used to refine results, including:

  • Date published.
  • Language of literature.
  • Source (journal type and publication type).
  • Full text only.

Initially, abstracts, contents and conclusions were reviewed to determine the suitability to this report, before a more in-depth analysis was undertaken. Literature that was subsequently used was stored in Mendeley reference management software for easy retrieval and reference purposes.

Quality appraisal

There were several considerations made in the decision process for determining appropriate literature; this was to ensure the validity and relevance to the topic. Publication type was used as a gauge of validity, with a preference for peer-reviewed articles. However, books and other online resources were considered to ensure a holistic view of the topic was gained.

Due to the exponential growth in technological advancement, the date of material was an important factor in the decision process. For this reason, there was a greater emphasis on material published after 2005. However, peer-reviewed literature from before this year was considered, to build a better understanding of the progression of technology in dementia. In addition to this, research on the provision of technological solutions was primarily focused on material published after 2013, to build on a similar review conducted by Cook et al . 9 This approach ensured that the literature review was focused on the most recent advancements.

Further consideration was given to the clarity of text, and the substantiation of points made, to ensure the accuracy and relevance to the topic.

Figure 1 shows a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart 10 of results following the search. Table 1 shows a matrix of relevancy for the selected literature against the keywords detailed in the Search and Selection Strategy section. Table 2 shows a breakdown of selected literature by year. Table 3 illustrates the provision of technological solutions and their relation to the domains defined in Dementia Quality of Life Instrument (DQoL). Solutions used ‘on’ a person with dementia, despite often causing feelings of resentment, 11 are assumed to improve self-esteem due to their ability to allow an individual to live independently.

Literature relevancy matrix

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Selected literature results by year of publication

Matrix of solution effectiveness in relation to the DQoL model

DQoL, Dementia Quality of Life Instrument; GPS, Global Positioning System.

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Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart of literature search result. 10

Determining the quality of life for a person living with dementia

Determining quality of life is a difficult task due to the subjectivity and individuality involved. This challenge is exacerbated as a person’s opinion of their own quality of life adapts along with cognitive diseases such as dementia, 12 with changing priorities through the progression of the disease. 13 For example, a person might value intellectual capacity highly during the early stages of dementia, whereas safety and comfort may take precedence as the condition progresses.

Despite the publication of many instruments designed to measure quality of life in dementia, each with differing approaches, Lawton’s model, defined in 1994, appears to have had the most influential impact on subsequent instruments. 14 It argues the importance of subjective and objective factors as well as defining four overarching contributing areas to quality of life: psychological well-being, behavioural competence, objective environment and perceived quality of life. 15 Researchers have interpreted Lawton’s model differently, with some considering them as predictors of quality of life, and others believing they are the defining features of quality of life. 14

In 1995, the WHO defined quality of life as ‘the individual’s perception of their position in life in the context of the culture and value system in which they live, and in relationship to their goals. 16 However, this definition does not consider the restricted ability of someone with declining cognitive ability to make judgements and communicate their subjective state. This gap was identified by Logsdon et al , 13 who designed the Quality of Life in Alzheimer’s Disease (QoL-AD) model to enable individuals with progressive cognitive impairment to rate their own quality of life, while providing a comparison to a caregiver’s opinion. This model was originally tested on a sample size of 177 patient/caregiver dyads and offers a series of 13 factors that fit under the four domains set out by Lawton. Patients and caregivers are able to rate each of the 13 factors to determine a quality of life rating. 13 This model has the benefit of being administered within 10 min and assessing the reliability against a caregiver’s score, yet lacks the ability for patients and caregivers to define their own weighting of the different factors, and thus what is most important to them.

One model that does take individual perception and weighting into consideration, influenced by Lawton’s model, is the DQoL. In contrast to QoL-AD, which is used by both people with dementia and their caregivers, DQoL is exclusively for people with dementia and allows an individual to rate factors under five domains: positive affect, negative affect, feelings of belonging, self-esteem and feelings of aesthetics. 17 The term ‘affect’ refers to an individual’s subjective opinion on how emotions impact their mood both positively (eg, pleasure, interest) and negatively (eg, sadness, anger). 18 The DQoL model was tested on a sample of 99 patients with mild to moderate dementia and was found to be more accessible than the QoL-AD scale, with only 4% unable to complete the screening stage, as opposed to 12.4% for the QoL-AD model. 14 The increased availability, domain simplicity and aggregated importance ratings are likely to better represent the subjective factors that contribute to quality of life.

The DQoL model ( table 4 ) has been selected for this review as a reference point for technologies discussed. Therefore, technological interventions will be compared against the five domains of DQoL deemed important to quality of life.

DQoL domains and mean ratings (adapted from Brod et al [ 24 ])

DQoL, Dementia Quality of Life Instrument.

The implementation and challenges of technological solutions for people with dementia

In 2017, the WHO recognised a neglect in public policy for the provision of dementia care solutions. 19 One specific strategic area of the WHO global action plan 5 is focused around improving care for people with dementia, with a focus on enhancing information systems for dementia and fostering innovation. 19 This action plan represents a positive movement to encourage the creation and support of solutions that improve the quality of life for both patients and caregivers. In response to the global action plan, the WHO developed iSupport, an online training programme for caregivers of people with dementia. 20 iSupport helps caregivers understand the impact of dementia and helps them recognise and improve the quality of care provided for both the person with dementia and themselves.

Beyond support for caregiver learning, such as iSupport, assistive technology appears to play a pivotal role in improving an individual’s quality of life. In the context of dementia, Marshall 21 defined assistive technology as ‘any item, piece of equipment, product or system… that is used to increase, maintain or improve functional capabilities’. However, this definition does not consider the potential impact on some of the qualitative measures that improve quality of life, such as those defined in DQoL. Consequently, this review suggests a more suitable definition, in the context of this literature review, would be ‘A technological solution that intends to improve the quality of life for people with dementia or their caregivers, either through maintaining or improving functional capabilities, facilitating improved self-esteem or sense of belonging, or increasing the ability to gain pleasure through activities or environments’.

Gibson et al 22 conducted a comprehensive study on the available assistive technology solutions for people with dementia in the UK and proposed a useful segregation of solutions. All solutions observed were able to be placed into one of three categories: ‘by’, ‘with’ or ‘on’. ‘By’ solutions are those that can be used independently by the person with dementia, and generally support the completion of everyday activities (eg, signage or alarms). ‘With’ solutions are collaborative and encourage the interaction between the caregiver and individual with dementia (eg, reminiscence aids). ‘On’ solutions are designed to intervene in a person’s life without active participation, and generally aim to lessen the risks to the person with dementia (eg, fall detectors or smoke alarms). It is, however, noted that some solutions may apply to more than one category, such as a game which can be used ‘by’ someone, but also as a tool to encourage communication ‘with’ a caregiver. Figure 2 illustrates the categories and some example subcategories that fit under assistive technology.

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Object name is bmjhci-2019-100064f02.jpg

Categories and subcategories of assistive technology (AT) (adapted from Gibson et al [ 36 ]). GPS, Global Positioning System.

Solutions used ‘By’ people with dementia

As one of the most prevalent symptoms of dementia is forgetfulness, 5 it inherently becomes more challenging for people with dementia to learn something new and unfamiliar. Therefore, it could be argued that creating solutions that are designed to be used ‘by’ someone with dementia independently, is one of the more complex problems faced in dementia-related care. Despite the challenging nature, enabling people to perform simple everyday activities is significant, as it lessens the burden on caregivers, and can help improve an individual’s self-esteem, 23 noted as one of the key domains in DQoL. 24 This is supported in a study 25 which concluded that technology can support increased confidence and retention of independence for people with progressive neurodegenerative diseases such as dementia.

Due to the challenges of designing solutions to be used by someone with dementia, many examples are simple in design and function, with an aim of improving intuitiveness and ease of use. Solutions such as large clock faces are examples where no user interaction is required, however Gibson et al 22 found the date format on many (dd/mm/yyyy) to be unsuitable for people with dementia. Other available examples have further simplified this by only displaying the day of the week, and a general time of day (ie, morning, afternoon, evening, night), such as that provided by Day Clock. 26 Similarly, Gilliard and Hagen, as cited by Fleming & Sum, 17 created a simple ‘Day and Night Calendar’ that was successfully adopted by 84% of participants, with caregivers stating simple and familiar formats were impactful. Other technologies for time and place orientation, such as motion sensor lighting, are also available to mitigate some of the risks associated with dementia.

One issue experienced by many people living with dementia and their caregivers is poor medicine adherence. Pill dispensers can help alleviate this problem, acting as alerts or reminders, in addition to preventing overdoses through the separation and locking of doses. Such devices are becoming increasingly sophisticated, with examples such as ‘Pivotell’ 27 able to alert a caregiver if a dose is missed. Fleming and Sum 17 emphasised the high acceptance rate for pill dispensers in the Gilliard and Hagen study, with over 80% of participants finding them useful. Despite this, Hopkins 28 found that complex designs and difficulties learning to use such devices often proved restricting. Other alert-based solutions, such as ‘Boil Alert’ to prevent cooking accidents, and ‘MagiPlug’ 29 to prevent overfilling baths or sinks, are available to enable people with dementia to safely live more independently.

Generally, ‘by’ solutions that require minimal interaction from users seem to promote greater acceptance. This is supported by Cook et al 9 who also highlight more successful outcomes through lower interaction requirements. Familiarity is also likely to play an important part, recognisable objects and familiar voices are more likely to be accepted and are easier to use intuitively.

Solutions used ‘With’ people with dementia

In a study conducted by Gibson et al , 22 it was found that the fewest available solutions fit into the ‘with’ category (enabling social interactions and communication with others). This could be attributed to healthy people often having trouble interacting with people with dementia, partly down to a lack of understanding. 24 In addition, other potential symptoms of dementia, including difficulties with speech, reasoning and decision-making, could make it difficult for people with dementia to engage in meaningful interactions, often detrimental to their self-confidence and quality of life. 30 Despite this, positive social interaction can have a substantial impact, with Kim et al 31 stating that positive social experiences are proven to slow down symptoms of the disease. Enabling these dialogues and experiences also has the potential to positively influence feelings of worth and belonging and can help individuals with dementia to experience activities or environments that they can appreciate and enjoy with others—all of which being vital factors in the DQoL model.

One example of a ‘with’ solution is Talking Mats, a communication tool seeking to help people with communication difficulties interact by using symbols to represent feelings and emotions. This was found to improve communication with people with dementia at all stages of the disease. 32 However, this study was conducted using the physical product, and although a mobile application is available, there is no literature on its effectiveness in the context of dementia.

Games and applications for the enjoyment of people with dementia are becoming more common with increased accessibility and affordability of touchscreen devices. 33 Although not primarily communication-based activities, they can be used with a caregiver to promote discussions and enjoyment. Touchscreen games appear to be well received, with over 90% of participants in the Astell et al ’s 33 study stating they experienced enjoyment when playing a familiar card game that had been digitised. This result was slightly higher than the 85% who enjoyed playing a generic, non-familiar game on a touchscreen device. This finding was echoed by Zheng et al , 34 who also identified positive impacts on an individual’s cognition and balance as a result of game-based interventions, however highlighted a current lack of evidence supporting their use.

With negative social experiences or social isolation impacting self-confidence, 30 it is imperative that positive experiences are encouraged and facilitated to improve quality of life. One method of achieving this is through reminiscence, proven to improve mood, cognition and behaviour, 6 while also increasing interpersonal communication. 35 Reminiscence therapy is the use of familiarity to promote discussion, with objects, activities or events of individual significance being used to facilitate this. Huldtgren et al 30 point to many examples of technological solutions for reminiscence, including:

  • The use of photo, video and music to support one-to-one reminiscence sessions, with positive reported outcomes.
  • 3D modelling of environments (eg, Gardens) for people with dementia to enjoy environments they can no longer access, well received among those in mild to moderate stages of dementia.
  • An old-fashioned radio, and television that played music and news from 1930 to 1980, proving popular although some participants had difficulties with a standard remote control.

Solutions used ‘On’ people with dementia

Accounting for most of available care solutions in the UK, and responsible for monitoring activity and location of individuals and giving caregivers access to people with dementia in emergencies, are ‘on’ solutions. 22 These solutions typically require no interaction or knowledge from the person with dementia and are often put in place for safety reasons and to reduce the physical and emotional burdens of care. 36 Solutions in this category fall into either telecare, location monitoring, or safety and security.

Telecare refers to the remote monitoring of people often in their own homes and aims to promote greater independence. 22 According to Gibson and colleagues, most telecare services included alarms and sensors connected to a telephone line or internet connection to a caregiver. Other advancements, such as those in accelerometers, also allowed for devices such as fall detectors, which can be easily included due to the modularity of telecare services. The use of such services, although endorsed by the Department of Health and having shown to prolong independent living, lacks evidence to support its cost-effectiveness in the context of dementia. 37

Location monitoring is perhaps one of the most controversial areas of dementia care and is often used to counteract some symptoms of dementia, such as wandering. These solutions generally use Global Positioning System (GPS) technology so that caregivers can monitor the geographic location of the person with dementia. 38 Liu and colleagues discovered a high acceptance rate of GPS-based devices among caregivers, with peace of mind and greater independence being the significant benefits. However, in a study conducted by Robinson et al , 11 it was found that people with dementia occasionally resent the idea due to a perceived loss of confidence in their abilities.

Devices for safety and security generally aim to monitor or restrict a specific activity that could potentially become a risk. Examples include key safes for easy access to a house in an emergency, technology to automatically disable water flows or gas supply, geofencing to mitigate the risk of wandering and telephone blockers that can divert or cancel calls not on a predefined list. 22

Measuring the quality of life for a person living with dementia presents a unique and complex challenge, this is due to the subjectivity of determining quality of life and the cognitive impairment experienced by someone with dementia. To handle this complexity, models have been suggested that aim to be more accessible and often objective in order to determine the quality of life. One example is DQoL, an instrument that allows an individual to rate factors under five domains: positive affect, negative affect, feelings of belonging, self-esteem and feelings of aesthetics. 24

The use of technology in dementia care has become increasingly popular, coinciding with the exponential growth in technological innovation. Care solutions can be broadly placed into three categories: solutions used ‘by’, ‘on’ or ‘with’ a person with dementia. 22 Solutions used ‘by’ or ‘on’ a person with dementia were determined to have a greater impact on an individual’s self-esteem, one domain of the DQoL model. This is due to their ability to enable someone to maintain independence despite their condition. Solutions used ‘with’ a person with dementia are more likely to have a profound impact on quality of life, due to their ability to increase a person’s self of belonging and their ability to engage meaningful conversation. The growing provision of dementia care solutions is likely to increase individuals’ trust and familiarity with them, in addition to reducing the dependence on institutional care. Such growth could continue to empower users of solutions; however, care should be taken to avoid the appearance and feelings of dependence for people with dementia. In addition, with the increased uptake of internet of things, devices such as fall detectors and carer alarms, the design and implementation of technological solutions should consider issues pertaining to system security and data privacy, in addition to the challenges of adoption.

Although research is extensive, it often does not directly involve people with dementia, especially those in the severe stages of the condition. This is evident in the quality of life studies and those testing the effectiveness of assistive technologies, with many instead consulting the caregivers of people with dementia. This could be seen to undermine the credibility of such research and explain the high level of disparity in the understanding of key factors, such as measuring quality of life or determining the acceptance of technology. These limitations would warrant further research and consolidation of the available techniques and, despite the ethical barriers, would benefit greatly from the involvement of people with dementia. Such research would benefit from longitudinal data analysis due to the progressive nature of the condition. In addition, this analysis should consider changing quality of life priorities and therefore determine the applicability, relevancy and ability for an individual to use a solution over a period of time.

Dementia care requires highly targeted and individual approaches due to the subjectivity of determining quality of life, and expansiveness of the condition combined with other health problems that a person might face. This challenge appears to negatively impact caregiver trust in available solutions, which may be seen to take a ‘one size fits all’ approach. However, multiple objective factors have appeared useful in determining subjective concepts such as quality of life and technology acceptance. The home environment of an individual and the care support they have available to them can act as useful indicators of general quality of life and technology acceptance.

To further tackle the complex challenges that face people with dementia, their caregivers and those creating solutions to support them, the following further research has been identified:

  • Research to further understand the progression of dementia and its effects on care needs and factors deemed important to quality of life.
  • Greater emphasis on the inclusion of people with dementia in studies on technology acceptance.
  • Research to understand the benefits of customisable solutions (ie, those with the ability to alter the level of functionality available to an individual based on their cognitive abilities).

Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests: None declared.

Patient consent for publication: Not required.

Provenance and peer review: Not commissioned; externally peer reviewed.

Data availability statement: No data are available.

The dementia diagnosis: a literature review of information, understanding, and attributions


  • 1 Department of Psychology, Keele University, Keele, UK.
  • 2 SUSTAIN, North Staffordshire Combined Healthcare Trust, Newcastle-under-Lyme, UK.
  • 3 Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, UK.
  • 4 BUPA UK, Leeds, UK.
  • PMID: 25515569
  • DOI: 10.1111/psyg.12095

This review examines how people understand and make sense of a dementia diagnosis. The review explores how lay frameworks and information presented at diagnosis may inform a caregiver's understanding of dementia in a family member. Existing qualitative research exploring how caregivers understand and make sense of dementia is reviewed. A literature search was conducted, and the results indicated that family carers often receive little or unclear information about dementia, with diagnostic information often delivered in euphemistic terms. Lack of clarity regarding diagnosis and prognosis creates uncertainty for caregivers and impacts future care planning. Caregiver's understandings of the condition vary, with some symptoms often not attributed to the condition. The literature highlights significant gaps and misconceptions in public knowledge regarding dementia, which raises questions about how family caregivers understand the condition. Further research is required to explore how information is presented to family carers at the time of diagnosis and how this is used to understand the condition.

Keywords: attributions; dementia; diagnosis; information; perceptions.

© 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Publication types

  • Aged, 80 and over
  • Caregivers / psychology*
  • Comprehension*
  • Dementia / diagnosis*
  • Family / psychology*
  • Health Knowledge, Attitudes, Practice*
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55 Dementia Dissertation Topics

Published by Owen Ingram at January 2nd, 2023 , Revised On August 16, 2023

The term dementia refers to a collection of symptoms and disorders, rather than a single disease. As a result, dementia has a wide range of dissertation topics. Finding a dissertation subject related to dementia sufferers might be advantageous. You may be attempting to make a difference in the lives of dementia sufferers. You must investigate some previously unknown features to assist them! For those hoping to use their dissertation to help people with dementia, this is the right place. Our team has compiled a list of dissertation topics for your consideration. Picking dementia research subjects that haven’t received as much attention as others can add something new to the table.

Useful Links:

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List Of Dementia Dissertation Topics For All Academic Levels

  • An in-depth investigation of dementia in men and women – a case study
  • An examination of the ways advocated by experts for dealing with dementia sufferers
  • Highlighting the genetic and environmental risk factors for dementia development in the elderly in the United Kingdom
  • The study of senior dementia patients and how they react to definite and uncertain conditions
  • A comprehensive analysis of the connection between risks and smog and an increase in dementia in European industrial towns
  • Experts studied a cognitive test for diagnosing mild dementia diseases in male patients.
  • Use educational expert dementia strategies and how they might help treat and care for dementia sufferers.
  • How much nursing assistance is required to care for dementia patients?
  • Investigating the significance of the care policy for senior dementia patients in the United States of America
  • The nursing qualification and certifications necessary for the care of senior dementia patients in the United Kingdom are highlighted.
  • Recognizing the patient’s quality of life. A patient with dementia is the subject of this case study
  • What are the most effective ways for early dementia identification in the United Kingdom? A thorough investigation
  • A study of dementia patients receiving home care and how it has aided in reducing the symptoms
  • Do dementia caregivers experience stress? – an examination of survey results.
  • Non-pharmacological therapies for aggressiveness and stress in dementia patients
  • What is the pain treatment procedure for dementia patients?
  • The dementia nurses training program in the United Kingdom and how it has improved dementia patient care
  • A comparison study evaluated the relationship between dementia patients’ longevity and the point at which their therapy began
  • Investigating the link between memory loss and the early stages of dementia
  • Investigating the cognitive tests nurses use to detect minor cognitive impairments that can progress to dementia in male patients
  • Problem behaviour in dementia and the production of informal caregiving services
  • Investigating the use of educational strategies by nursing staff in overcoming communication challenges in dementia patients
  • Patient-centred pain control in elderly people with dementia equality, diversity, and inclusion in dementia care practice
  • Can cognitive training slow the progression of dementia?
  • What function does physical activity increase mobility and stamina in vascular dementia patients? An in-depth examination
  • The importance of contemporary technology in the care of patients suffering from dementia. A thorough examination of dementia sufferers in the United Kingdom
  • Examine the factors that increase the likelihood of developing dementia at a young age in the United Kingdom
  • The ability of nursing staff to determine the requirements of dementia patients by interpreting behavioural displays and emotional responses of patients
  • Making end-of-life decisions for nursing home residents with dementia
  • Autism and dementia are both diagnosed and treated in the same way
  • Identifying modifiable dementia risk factors pathways connecting late-life depression and dementia
  • Is there communication between dementia doctors and patients?
  • What are the global trends in dementia? – case studies from various nations
  • Dementia research by UK ethnic minorities and how it has affected individuals
  • Mild cognitive impairment and dementia in Parkinson’s disease imaging
  • Improving cognitive function before clinical dementia symptoms
  • Longitudinal relationships between serum cytokine levels and dementia
  • Dementia and the affected parts of the brain
  • Examine doll therapy treatment and how it has progressed and improved the medical sector
  • Observational pain assessment scales for dementia patients
  • The treatment of dementia patients and its beneficial impact on their lives.
  • Deficits in exploration under ecological conditions as a marker of apathy in frontotemporal dementia
  • What are the three behavioural issues related to dementia?
  • What are some common behaviours observed in dementia patients?
  • When do dementia patients forget about family members?
  • What is the life expectancy of someone suffering from Parkinson’s disease and dementia?
  • How can you tell if someone has dementia is near death?
  • An overview of the literature on medical ideas and notions about dementia.
  • A study on a cognitive test for diagnosing mild dementia diseases in male patients.
  • What effect does dementia have on a person’s care needs?
  • Why is early retirement associated with an increased risk of dementia?
  • Do retirees with dementia require financial assistance?
  • What are dementia pharmacological interventions?

If you have chosen one of the above dementia dissertation topics, you can start working on your dissertation . You might also want to review our list of nursing dissertation topics for extensive research because they are correlated with the field of medical science.

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There is no doubt that your dissertation is the most important document of your academic career. A dissertation on dementia is another matter altogether. Your dissertation topic should entice your readers to read it by piquing their interest.

Above, we have provided the most comprehensive dementia research topics. The topic of your dissertation can be anything you wish. Ensure that your final dissertation topic meets the criteria for your dissertation. Dissertations that fail to meet the approval standards will almost certainly be rejected. We offer customised dementia dissertation topic s with research aims and objectives if you are still looking for suggestions.

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Home » Blog » Dissertation » Topics » Nursing » Dementia » 99 Dementia Dissertation Topics & Research Titles

dementia literature review dissertation

99 Dementia Dissertation Topics & Research Titles

By Amanda Jul 3, 2023 in Dementia , Nursing | No Comments

Previously, we had a combined post of dissertation topics on dementia and mental health nursing research topics. Due to a number of queries we receive daily from the nursing students seeking research topics in dementia for dissertation writing, we have decided to come up with a separate post contains an exclusive list of dissertation topics […]

nursing dissertation topics in dementia

Previously, we had a combined post of dissertation topics on dementia and mental health nursing research topics . Due to a number of queries we receive daily from the nursing students seeking research topics in dementia for dissertation writing, we have decided to come up with a separate post contains an exclusive list of dissertation topics in dementia. Before jumping to the list, Let’s understand what exactly it is.

Dementia is known as a slump in mental strength which impairs human memory, thinking, problem-solving, attention and insights. The normal causes of dementia occurring due to damage or death of the brain cells that are related to our thinking process. We have many forms of dementia but most common among them are Alzheimer’s disease which is degenerative and get severer over time. Another form is vascular dementia and is considered non-degenerative and hence remains mild with the passage of time.

Dementia is steadily overtaking the burden of costs in the UK health sector. Since dementia is associated with increasing age, and the UK is composed of an ageing population it is of critical importance to study the condition with utmost clarity to find viable solutions to ongoing issues. The nursing role of managing people with dementia is challenging and considered one of the most studying fields of nursing. Working with people with dementia requires patience, empathy, sensitivity, and dedication. We have written this blog contains examples of dementia research topics. By going through them, I am sure they can help you to come up with topics in dementia for your dissertation.

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List of Dementia Care Nursing Dissertation Topics:

Comparative study of the role of technology in dementia care: assessing the impact of assistive devices and telehealth services.

The impact of caring for a parent with dementia on young children- a qualitative study from the UK.

Applying the biopsychosocial model to understand the complexities of dementia care: a theoretical framework.

Exploring the effectiveness of multisensory stimulation therapy in enhancing cognitive function in individuals with dementia: a case study approach.

Reviewing the role of exercise and physical activity in maintaining cognitive functioning and delaying cognitive decline in dementia.

Is there a difference in the quality of care for dementia between care homes and personal homes of patients? A survey of close family caregivers.

Understanding dementia care through the lens of the social support theory: implications for caregiver interventions.

Exploring the role of artificial intelligence in early detection and monitoring of dementia in a post-covid-19 world.

The impact of leadership gender and style on how nurses manage pain in elderly patients with dementia in UK nursing homes- a primary investigation.

How can nurses educate family members at home in meal planning for dementia patients?

Comparative study of family involvement in dementia care: exploring cultural and societal factors.

A primary research assessment of the competency requirements of nurses working with people with dementia in acute care settings in the UK.

The role of social support networks in enhancing resilience and quality of life in individuals with dementia: an empirical analysis.

An exploration of the prevalence and trends of dementia in a global context.

Applying the stress and coping theory to examine the impact of caregiving stress on the well-being of family caregivers of individuals with dementia.

Exploring the efficacy of assistive technologies in enhancing independence and quality of life in individuals with dementia: an empirical study.

Using the person-centered care approach as a theoretical framework for enhancing the quality of life of individuals with dementia.

The impact of music therapy on agitation and anxiety in patients with dementia: a case study analysis.

Examining the efficacy of pharmacological interventions for managing cognitive decline in individuals with dementia: a literature review.

The role of exercise programs in delaying cognitive decline and improving functional abilities in individuals with dementia: an empirical analysis.

Applying the cognitive-behavioral theory to address behavioral and psychological symptoms of dementia in care settings.

The role of caregiver education and training programs in supporting families of individuals with dementia: a review of the literature.

A systematic review of the ethical considerations that nurses should be aware of in working with people with dementia in the UK.

Comparative analysis of the implementation of person-centered care approaches in dementia care settings: exploring challenges and success factors.

The influence of covid-19 on the experience of living with dementia: a qualitative study of individuals’ perspectives and coping strategies.

Exploring the efficacy of cognitive stimulation therapy in enhancing cognitive function and well-being in individuals with dementia: an empirical study.

The role of the ecological systems theory in exploring the influence of social context on dementia care practices.

A critical review of care models and caregiver support programs in dementia care: lessons learned and future directions.

Why does caring for patients with dementia physically and psychologically impact formal and informal caregivers? An extended literature review.

The impact of art and music therapy on emotional well-being and quality of life for individuals with dementia: a systematic review.

Evaluating the effectiveness of non-pharmacological interventions for managing behavioral and psychological symptoms of dementia: a comparative analysis.

How often do nurses resort to lying to people with dementia as a part of their service care delivery? A qualitative investigation.

Reviewing the effectiveness of assistive technologies in enhancing independence and quality of life for individuals with dementia.

Doll therapy and its growing incidence in treating people with dementia- a systematic review.

A comparative analysis of different models of dementia care: examining their effectiveness in improving quality of life for individuals with dementia.

Understanding dementia care through the lens of the health belief model: implications for health promotion and disease prevention.

Examining the effectiveness of multisensory stimulation interventions in reducing agitation and improving communication in individuals with dementia: an empirical study.

A review of the care policy for elderly patients with dementia in American public hospitals.

The influence of caregiver education and training programs on caregiver knowledge, skills, and coping in dementia care: an empirical analysis.

The impact of leadership gender on advanced care planning practices on nurses caring for dementia patients in the UK- a qualitative investigation.

A critical review of the impact of social support on caregiver burden and mental health in dementia care.

A systematic literature review on the relationship between smoking cessation and dementia.

A phenomenological research on informal caregivers perceptions of people with dementia and their psychological needs in the UK.

The impact of covid-19 on dementia caregivers: a comparative study of stress, coping strategies, and support systems.

The impact of covid-19 on access to dementia diagnosis and treatment: an analysis of healthcare disparities.

How does modern technology assist carers in looking after people with dementia? Evidence from literature.

The use of green areas for nursing home units for people with dementia- how can it help?

Exploring the application of the social identity theory in understanding the identity transition in individuals with dementia.

An assessment of the current measurement tools for nurse competencies for caring for people with dementia.

Implementing technology-based interventions in dementia care: a case study examination of the use of virtual reality.

An exploration of the key strategies used by nurses to assess pain in people with dementia- a phenomenological study of challenges.

The effectiveness of non-pharmacological interventions in managing behavioral and psychological symptoms of dementia: an empirical analysis.

Evaluating the effectiveness of residential care settings for individuals with dementia: a comparative analysis of nursing homes, assisted living facilities, and memory care units.

Exploring the role of telemedicine in dementia care during the covid-19 pandemic: a mixed-methods study.

A grounded theory research of attitudes of nurses towards informal caregivers of people with dementia and attitude of informal caregivers of people with dementia towards nurses in the UK.

Do nurses working with people with dementia want to work in solo, with teams composed of their chosen teammates or a comprehensive medical unit? Qualitative perspectives from the UK.

Comparative analysis of communication strategies in dementia care: investigating the effectiveness of validation therapy, reminiscence therapy, and montessori-based interventions.

Reviewing the effectiveness of respite care services in supporting caregivers of individuals with dementia.

The effect of social isolation on cognitive decline in individuals with dementia during the covid-19 lockdown: a longitudinal analysis.

Are people with dementia concerned with issues of Spirituality? Nurse caregivers’ perspectives.

A systematic review of non-pharmacological interventions for managing behavioral and psychological symptoms of dementia.

An exploratory evaluation of using technology as a medium for nurse and patient communication for people with dementia in the UK.

A study of people with dementia from ethnic minorities living in the UK.

What are the different non-medical strategies used by mental health nurses to manage patients with dementia in the UK- a qualitative survey.

A case study evaluation of a dementia care pathway: assessing the impact on caregiver burden and patient outcomes.

Examining the effectiveness of animal-assisted therapy in reducing behavioral symptoms in individuals with dementia: a case study.

What is the literature-based evidence for music therapy for people with dementia?

The influence of covid-19 vaccination on the health outcomes and quality of life of individuals with dementia.

Exploring the application of the attachment theory in understanding the caregiver-individual with dementia relationship.

An analysis of nurse qualification and certification for the care of elderly patients with dementia- the case of Britain.

The role of telehealth in providing dementia care services during and beyond the covid-19 pandemic: perspectives of healthcare providers and caregivers.

Implementing a person-centered care approach in a residential care facility for individuals with dementia: a case study evaluation.

An ethnographic study on the positive and negative experiences of nurses caring for people with dementia in the UK.

Living with dementia- an understanding of the patient’s quality of life.

Comparative analysis of the impact of caregiver support programs on the well-being and coping strategies of family caregivers of individuals with dementia.

Evaluating the effectiveness of palliative care approaches in dementia care: a comparative analysis of hospice and traditional care models.

Can nurses work with people with dementia in nursing homes be trained to look for signs of burnout in themselves and proactively manage these signs? A qualitative study.

Investigating the impact of a multidisciplinary team approach in managing challenging behaviors in individuals with dementia: a case study analysis.

Comparative study of dementia care practices in different healthcare systems: examining the role of policy and resources.

The effect of concurrent physical ailment drugs on dementia patient management- a literature review.

How important is communication in the dementia care process? A systematic literature review.

Using the person-environment fit theory to enhance the design of dementia-friendly environments.

The impact of reminiscence therapy on emotional well-being and quality of life in individuals with dementia: an empirical analysis.

The effectiveness of person-centered care approaches in improving quality of life and well-being in individuals with dementia: an empirical analysis.

The role of the transactional model of stress and coping in exploring the dynamic process of caregiving for individuals with dementia.

The effectiveness of mindfulness-based interventions in reducing caregiver stress and improving the well-being of individuals with dementia: a case study evaluation.

What role does patient culture play on the ethical considerations of nurses working with people with dementia in the UK? A grounded theory research.

Examining the impact of environmental modifications on safety and functioning in individuals with dementia: an empirical study.

Exploring the effectiveness of cognitive stimulation therapy in enhancing cognitive abilities in individuals with early-stage dementia: a case study approach.

Examining the role of environmental design and modifications in promoting safety and enhancing quality of life for individuals with dementia: a literature review.

Investigating the role of reminiscence therapy in improving quality of life for individuals with dementia: a case study analysis.

The use of virtual reality in managing behavioral and psychological symptoms of dementia in a post-covid-19 era: a randomized controlled trial.

Comparative study of caregiver burden and burnout in home-based and institutional dementia care settings.

The role of exercise programs in improving physical functioning and mental well-being in individuals with dementia: a case study analysis.

To what extent can nurses manage advanced care planning for dementia patients? A grounded theory research.

Examining the impact of covid-19-related disruptions on the progression of dementia and the effectiveness of remote support interventions.

Examining the impact of music therapy on cognitive functioning and quality of life in individuals with dementia: an empirical study.

Exploring the benefits and challenges of telehealth services in dementia care: a review of the literature.

Enhancing dementia caregivers’ resilience and mental health during the covid-19 crisis: a comparative study of support programs.

The comprehensive list of dementia dissertation topics provided above serves as a starting point for students interested in making a significant contribution to this field. With these compelling dissertation topics for dementia, students can embark on a fulfilling journey of research and make valuable contributions to the field of dementia care.

There you go. Use the list well and let us know if you have any comments or suggestions for our topics related blog posts for the future or looking to get help with dissertation writing , send us an email at [email protected] .

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Pain assessment in older people with dementia: literature review

Profile image of Megan O’Donnell

2009, Journal of Advanced Nursing

Title. Pain assessment in older people with dementia: literature review. Aim. This paper is a report of a literature review conducted to identify barriers to successful pain assessment in older adults with dementia and possible strategies to overcome such barriers. Background. Pain is frequently undetected, misinterpreted, or inaccurately assessed in older adults with cognitive impairment. These people are often unable to articulate or convey how they feel and are often perceived as incapable of experiencing or recalling pain. Data sources. Searches were conducted of CINAHL, Medline and other databases for the period 1993-2007 using the search terms pain, dementia, assess*, barrier* and obstacle*. Methods. Studies were critically appraised by two independent reviewers. Data were extracted using instruments specifically developed for the review. Studies were categorized according to levels of evidence defined by the Australian National Health and Medical Research Council and Joanna...

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Catalina Tudose

Pain is likely to be equally prevalent in people with dementia, however, only a small minority are prescribed regular analgesics. This is a key issue since untreated pain leads to reduced quality of life and increases the likelihood of emergence of behavioural and psychological symptoms such as agitation. Better assessment and treatment of pain in this fragile patient group are therefore mandatory. In this context, we reviewed the literature on pain and dementia and summarised the best available evidence regarding the frequency of pain and pain diagnosis. Unfortunately, hardly any randomized, controlled studies of pain treatment efficacy in patients with dementia are available, with the consequence that most pain treatment recommendations are not based on the highest level of evidence.

dementia literature review dissertation

Wilco P Achterberg , Judith Kappesser

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Chronic pain is highly prevalent in the ageing population. Individuals with neurological disorders such as dementia are susceptible patient groups in which pain is frequently under-recognised, underestimated, and undertreated. Results from neurophysiological and neuroimaging studies showing that elderly adults are particularly susceptible to the negative effects of pain are of additional concern. The inability to successfully communicate pain in severe dementia is a major barrier to effective treatment. The systematic study of facial expressions through a computerised system has identified core features that are highly specific to the experience of pain, with potential future effects on assessment practices in people with dementia. Various observational-behavioural pain assessment instruments have been reported to be both reliable and valid in individuals with dementia. These techniques need to be interpreted in the context of observer bias, contextual variables, and the overall sta...

wilson Astudillo

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Pain is common in people with dementia, representing a critical aspect of treatment and care. However, there remain considerable gaps in evidence to support pain assessment and treatment. An updated literature search focussing on systematic reviews and randomized controlled trials. There are key areas of consistency around the prevalence, causes and current treatment trends for pain in dementia, the impact of untreated pain and the need for an accurate, fully validated assessment tool. Accurate assessment due to inherent issues in dementia is a critical challenge. There is also a lack of evidence around alternative treatment options. New pain predictors are being identified, including physical function, depression and specific pain types, which should inform assessment methodology. Future research should focus on developing integrated pain management approaches with optimized assessment and evidence-based treatment guidance.

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Home » Blog » Dissertation » Topics » Nursing » Mental Health » Dementia Nursing Dissertation Topics (26 Examples) For Your Research

dementia literature review dissertation

Dementia Nursing Dissertation Topics (26 Examples) For Your Research

Mark Jun 13, 2020 Jun 13, 2020 Mental Health , Nursing No Comments

After delving into mental health nursing studies for hours, we have created a list of different dementia nursing dissertation topics for the students pursuing their career in the field of mental health and nursing. You can go through the list and choose any dementia nursing dissertation topics for your nursing project. These are some working […]

dementia nursing dissertation topics

After delving into mental health nursing studies for hours, we have created a list of different dementia nursing dissertation topics for the students pursuing their career in the field of mental health and nursing.

You can go through the list and choose any dementia research topics for your nursing project. These are some working titles that will suit the master level courses. Our group of experienced writers can facilitate in completing a dissertation on your selected research topics on dementia nursing.

Check more nursing research topics here.

List of Dementia nursing dissertation topics

A literature review on the methods that can be applied for detecting dementia in the early stages.

Studying the importance of tracking behavioural and psychological changes for diagnosing dementia in the early stages.

Comparing the cognitive tests for detecting mild cognitive disorders – evaluation and validation of dementia.

Identifying the educational methods for overcoming problems in interaction in people with dementia.

Analysing and comparing the causes of dementia in both men and women.

Studying the consequences and prognosis of dementia.

Investigating the communicative strategies used by nurses for managing dementia.

Exploring dementia across cultural borders through reflections and patterns of older adults with dementia.

A literature review on Lewy body dementia – the quality of life, survival, and consequence.

Studying the neuropathological findings and staging in dementia.

Comparing dementia with other mental disorders.

How can nurses meet the needs of older adults with dementia?

A literature review of the adverse effects of dementia on the nutritional status of elderly patients in hospitals.

Exploring and comparing the experiences of patients with dementia using a case study approach.

How can nurses improve the quality of life of people with dementia?

Studying the practical development approaches that support nurses in taking care of patients with dementia.

A 10-year follow-up review of the literature to examine the non-pharmacological interventions for stress and aggression in people with dementia.

The role of nurses in the decision-making process of pain management for dementia patients.

Screening tools for primary care used for development and validation of dementia.

Benefits of dementia supporting training programs for nurses.

Factors linked with the quality of life of dementia caregivers.

How to improve the quality of life of care home residents with dementia.

Studying the importance of cost-effectiveness of an optimised intervention for a resident with dementia.

To analyse the effects of nursing care programmes on the quality of life of patients with advanced dementia.

The role of progressive support for routine activities for people with dementia.

How can nurses help in improving the psychosocial outcomes for people with dementia.

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  • How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

  • Search for relevant literature
  • Evaluate sources
  • Identify themes, debates, and gaps
  • Outline the structure
  • Write your literature review

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

  • Quick Run-through
  • Step 1 & 2

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

  • Demonstrate your familiarity with the topic and its scholarly context
  • Develop a theoretical framework and methodology for your research
  • Position your work in relation to other researchers and theorists
  • Show how your research addresses a gap or contributes to a debate
  • Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

Literature review guide

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Professional editors proofread and edit your paper by focusing on:

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See an example

dementia literature review dissertation

Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

  • Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
  • Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
  • Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
  • Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

  • Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
  • Body image, self-perception, self-esteem, mental health
  • Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

  • Your university’s library catalogue
  • Google Scholar
  • Project Muse (humanities and social sciences)
  • Medline (life sciences and biomedicine)
  • EconLit (economics)
  • Inspec (physics, engineering and computer science)

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

  • What question or problem is the author addressing?
  • What are the key concepts and how are they defined?
  • What are the key theories, models, and methods?
  • Does the research use established frameworks or take an innovative approach?
  • What are the results and conclusions of the study?
  • How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
  • What are the strengths and weaknesses of the research?

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

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To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

  • Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
  • Themes: what questions or concepts recur across the literature?
  • Debates, conflicts and contradictions: where do sources disagree?
  • Pivotal publications: are there any influential theories or studies that changed the direction of the field?
  • Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

  • Most research has focused on young women.
  • There is an increasing interest in the visual aspects of social media.
  • But there is still a lack of robust research on highly visual platforms like Instagram and Snapchat—this is a gap that you could address in your own research.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).


The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.


If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

  • Look at what results have emerged in qualitative versus quantitative research
  • Discuss how the topic has been approached by empirical versus theoretical scholarship
  • Divide the literature into sociological, historical, and cultural sources


A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

  • Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
  • Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
  • Critically evaluate: mention the strengths and weaknesses of your sources
  • Write in well-structured paragraphs: use transition words and topic sentences to draw connections, comparisons and contrasts

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

  • Sampling methods
  • Simple random sampling
  • Stratified sampling
  • Cluster sampling
  • Likert scales
  • Reproducibility


  • Null hypothesis
  • Statistical power
  • Probability distribution
  • Effect size
  • Poisson distribution

Research bias

  • Optimism bias
  • Cognitive bias
  • Implicit bias
  • Hawthorne effect
  • Anchoring bias
  • Explicit bias

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

  • To familiarize yourself with the current state of knowledge on your topic
  • To ensure that you’re not just repeating what others have already done
  • To identify gaps in knowledge and unresolved problems that your research can address
  • To develop your theoretical framework and methodology
  • To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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