A randomized controlled trial of the effects of multi-sensory stimulation (MSS) for people with dementia.
To investigate short-term effects of Multi-Sensory Stimulation (MSS) on behaviour, mood and cognition of older adults with dementia, the generalization of effects to day hospital and home environments and the endurance of any effects over time.
                A randomized controlled trial comparing MSS with a credible control of one-to-one activities.
                Fifty patients with diagnoses of moderate to severe dementia were randomized to either MSS or Activity groups. Patients participated in eight 30-minute sessions over a 4-week period. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre, mid, post-trial, and follow-up assessments were taken to investigate any generalization of effects on cognition, behaviour at the day hospital and behaviour and mood at home and endurance of effects once sessions had ceased.
                Immediately after MSS and Activity sessions patients talked more spontaneously, related better to others, did more from their own initiative, were less bored/inactive, and were more happy, active or alert. Both groups were more attentive to their environment than before, with a significantly greater improvement from the MSS group. At the day hospital, patients in the Activity group improved on their 'speech skills' (amount of speech; initiation of speech), whereas the MSS group remained unchanged during the trial. The MSS group showed a significant improvement in mood and behaviour at home compared to the Activity group whose behaviour deteriorated. No longer-term benefits were shown; indeed, behaviour declined sharply during the month follow-up period.
                Both MSS and Activity sessions appear to be effective and appropriate therapies for people with dementia.
A more vigorous review methodology was adopted in this update. The study of Kragt 1997, reported in the previous version, was excluded because the snoezelen programme only consisted of three sessions, which was considered too brief for a therapeutic intervention. Two new trials were reviewed. Meta-analyses could not be performed because of the limited number of trials and different study methods of the available trials. Overall, there is no evidence showing the efficacy of snoezelen for dementia. There is a need for more reliable and sound research-based evidence to inform and justify the use of snoezelen in dementia care.