Measures used to evaluate psychosocial interventions in dementia care: a narrative review and synthesis

Psychosocial interventions are widely used in dementia care, yet standardized outcome measurement remains highly variable, and recent frameworks emphasize outcomes prioritized by people living with dementia and their care partners. This narrative, measurement-focused review does not appraise or synthesize treatment effects. Instead, it aims to map outcome measures to the International Consortium for Health Outcomes Measurement (ICHOM) dementia set plus an additional carer-wellbeing domain, to organize them into a taxonomy of wellbeing domains that highlights patterns and gaps in measurement practice. Eligible studies included participants with Alzheimer's disease and related dementias, evaluated a psychosocial intervention, and reported standardized pre- and post-intervention outcome measures at short and/or long-term follow-up. A total of 136 studies met inclusion criteria. Interventions encompassed arts and creative therapies, cognitive and reminiscence approaches, education and psychosocial support, physical and movement-based therapies, sensory and relaxation therapies, environmental and daily living support, and animal/robot-assisted programs. Outcome measures clustered on neuropsychiatric symptoms (205 instances) and cognitive functioning (146 instances), with fewer measures of social functioning (22 instances) and health-related quality of life (13 instances). Measurement approaches were highly variable (43 distinct neuropsychiatric measures, 47 cognitive measures, 14 social functioning measures). Outcomes were predominantly assessed using short-term measures, with some long-term follow-up, and few observational in-the-moment measures capturing engagement, enjoyment, reciprocity or mastery. This review presents a taxonomy of outcome measures that highlights the mismatch between current evaluation practices and person-centered psychosocial priorities in dementia care, and guides more purposeful measure selection.