Global Research Trends on Non-Pharmacologic Interventions for Dementia in Long-Term Care Settings: A Bibliometric Analysis

Global Research Trends on Non-Pharmacologic Interventions for Dementia in Long-Term Care Settings: A Bibliometric Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Global Research Trends on Non-Pharmacologic Interventions for Dementia in Long-Term Care Settings: A Bibliometric Analysis Cressy Alana Actie, Hung-En Liao, Fu-Gong Lin, Bing-Long Wang, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7967273/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: To analyze global research on non-pharmacologic interventions for dementia in long-term care settings using bibliometric methods and to identify research hotspots, intellectual structures, and emerging thematic trends. Methods: Data were retrieved from the Scopus database on May 29, 2025. A total of 424 eligible publications from 1990 to 2024 were included. VOSviewer (v1.6.20) was used to construct co-authorship networks, keyword co-occurrence maps, and institutional collaboration visualizations. Microsoft Excel 2019 was employed to visualize annual publication trends and citation metrics. Results: The number of publications related to NPIs for dementia in LTC has steadily increased over the past three decades. The most frequently occurring keywords included “music therapy,” “cognitive behavioral therapy,” and “long-term care.” Four thematic clusters emerged: psychological interventions, residential care environments, methodological design, and long-term care. The United States led in publication output, while the United Kingdom had the highest citation impact and H-index. Taiwan and the Netherlands also demonstrated high citation averages, indicating influential research. Leading journals included Aging and Mental Health and the Journal of Music Therapy , while top contributing institutions were the National Institute on Aging and the National Institutes of Health. Conclusion: Research on non-pharmacologic dementia interventions in LTC settings is gaining global momentum. Key areas of focus include behavioral therapies, sensory stimulation, and institutional care practices. However, gaps remain in culturally sensitive interventions and contributions from underrepresented regions. Future studies should prioritize equitable representation, interdisciplinary collaboration, and scalable models of care to enhance the real-world applicability of non-pharmacologic dementia strategies. Bibliometric Analysis Dementia Global Research Trends Long-Term Care Non-Pharmacologic Interventions VOS viewer Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction The global burden of dementia now exceeds 55 million cases(Organization, 2021 ) and is expected to rise to 139 million by 2050 (Nichols et al., 2022 ), placing unprecedented pressure on long-term care (LTC) systems. While pharmacologic regimens remain standard, their modest benefits and frequent adverse effects have accelerated interest in non-pharmacologic interventions (NPIs) such as music therapy, reminiscence therapy, cognitive training, multisensory stimulation, and environmental modifications (Abraha et al., 2017 ; Livingston et al., 2017a ). Despite this momentum, the literature remains fragmented, impeding the development of coherent clinical guidelines and obscuring where research efforts should be concentrated (Kochovska et al., 2020 ; Steen et al., 2020 ). Methodological heterogeneity further complicates interpretation; outcomes are often non-comparable, study designs vary widely, and person-centered philosophies are inconsistently integrated with institutional care cultures (Chenoweth et al., 2009 ; Gitlin et al., 2012 ; Van Der Ploeg et al., 2013 ). Without a systematic mapping of the field, it is unclear which NPIs command sustained scholarly attention, which regions and institutions drive innovation, and where critical knowledge gaps persist. Bibliometric analysis offers a robust means of addressing these uncertainties by quantifying productivity, visualizing intellectual structures, and tracing interdisciplinary linkages (Aria & Cuccurullo, 2017 ; Chen, 2006 ). Yet comprehensive bibliometric assessments focused specifically on NPIs for dementia within LTC settings are virtually absent. This omission risks duplication, underinvestment in underexplored domains, and stalled translation of evidence into scalable care models. Recognizing the need for a nuanced understanding of NPIs for dementia in LTC, particularly concerning their ethical implications, institutional integration, and alignment with person-centered care, this study conducts a global bibliometric analysis. Our primary objectives are to: (1) map global research trends; (2) identify leading authors, institutions, and journals; and (3) explore thematic and geographic concentrations of NPIs for dementia in LTC settings. Through this comprehensive analysis, we aim to not only quantify research output but also to critically inform the discourse by situating NPIs within the context of ethical considerations, practical implementation challenges in various institutional settings, and the fundamental concept of personhood in dementia care. Materials and Methods To systematically map the global research landscape on non-pharmacologic interventions (NPIs) for dementia within long-term care (LTC) settings, a bibliometric approach was adopted. This methodology allows for the quantitative evaluation of scientific literature and the visualization of scholarly structures, helping to identify thematic concentrations, intellectual linkages, and geographic patterns in knowledge production (Chen, 2018; van Eck & Waltman, 2017). While bibliometric studies do not replace in-depth systematic reviews, they are increasingly recognized for their capacity to synthesize large datasets and guide future research priorities (Cobo et al., 2011). Data Source and Search Strategy The bibliographic data were retrieved exclusively from the Scopus database, which is widely acknowledged for its expansive and multidisciplinary coverage of peer-reviewed literature (Falagas et al., 2008). Scopus was selected over other indexing services due to its inclusion of high-impact journals and its compatibility with bibliometric analysis software. Its comprehensiveness and broader inclusion of social science literature make it particularly suitable for interdisciplinary dementia research (Mongeon & Paul-Hus, 2016). The database query was executed on May 29, 2025, to capture a comprehensive dataset reflecting contemporary research output. To ensure conceptual precision and thematic relevance, a multi-component search string was constructed using Boolean operators. The query combined terms related to dementia ((“dementia” OR “Alzheimer’s disease”) AND (“nursing homes” OR “residential care”) AND (“music therapy” OR “non-pharmacologic intervention*”)). The search was conducted in the full-text, article title, abstract, and keywords fields to enhance specificity. Only original research articles and reviews published in English were included; conference proceedings, book chapters, editorials, and grey literature were excluded to maintain methodological consistency and quality. Inclusion and Exclusion Criteria Articles were retained if they met the following criteria: (1) the primary focus involved one or more NPIs targeting individuals diagnosed with dementia; (2) the intervention was implemented within a formal long-term care setting; and (3) the study presented empirical data or conducted a scholarly review of relevant interventions. Exclusion criteria encompassed studies (1) focused exclusively on pharmacologic or surgical treatments; (2) examined dementia prevention or early-stage, community-based interventions outside LTC contexts; (3) were not written in English; (4) were non-peer-reviewed (e.g., conference abstracts, editorials, or dissertations); or (5) lacked full-text accessibility. Study Selection Process A total of 518 publications on non-pharmacologic interventions (NPIs) for dementia in long-term care (LTC) settings were identified through the Scopus database (Fig. 1). Publications dated before 1990 were excluded, as they were minimal in number and fell outside the defined scope of contemporary research trends. In total, 424 publications met the eligibility criteria and were included in the final bibliometric dataset. Detailed information regarding the selection process, including screening and exclusion steps, is presented in Figure 1 . Articles and review articles were considered eligible for inclusion. To minimize language bias, non-English publications were excluded. Each Scopus record provided comprehensive metadata, including title, abstract, author information, institutional affiliations, publication year, journal source, and citation data. These records formed the foundation for the bibliometric mapping using VOSviewer. Data Processing and Analysis Following retrieval, bibliographic records were exported in CSV and RIS formats to enable compatibility with VOSviewer (version 1.6.20), a widely utilized tool for bibliometric visualization. Microsoft Excel 2019 was employed to visualize annual publication trends and citation metrics. These platforms allow for distinct but complementary forms of analysis. In parallel, VOSviewer facilitated the construction of co-authorship, keyword co-occurrence, and institutional collaboration networks, employing fractional counting and relevance-based clustering to enhance interpretability (van Eck & Waltman, 2009). To minimize redundancy and correct author name variations, the dataset was manually cleaned. Author affiliations were standardized where possible, and duplicates were removed. Data cleaning is a critical step in bibliometric analysis to avoid fragmentation of authorship networks and inaccurate cluster generation (Martín-Martín et al., 2018). Given the field’s interdisciplinary nature, subject areas were also examined using Scopus’ classification scheme to explore research orientation across disciplines such as nursing, gerontology, psychology, and public health. Results Global publication trends Number of global publications A total of 424 publications on non-pharmacologic interventions for dementia in long-term care (LTC) settings were identified. As depicted in Figure 2a, there has been a progressive increase in scholarly interest over the years, with a particularly steep rise observed in the past decade. To better understand this growth trajectory, a linear regression model was applied, as shown in Figure 2b. The model exhibits a strong fit with an R-squared value of 0.8201, where R-squared (or the coefficient of determination) indicates the proportion of the variance in the dependent variable (research output) that can be predicted from the independent variable (time). This high value suggests that approximately 82.01% of the variation in research output can be explained by the trend over time, thereby indicating a robust and predictable growth in the field. If this trajectory continues, the volume of publications could approach 60 by 2030. Country and regional contributions Figure 2c and Figure 2d illustrate the geographical distribution and ranking of countries by publication output. The United States (U.S.) contributed the highest number of publications (n = 138), accounting for 32.5% of the total. This leadership is reflective of long-standing investments in aging and Alzheimer’s research infrastructure in the U.S. (Oh et al., 2023). This was followed by the United Kingdom (n = 60), Australia (n = 48), and Germany (n = 33). These four countries collectively accounted for over 66% of all identified research outputs in the domain. Total number of citations In terms of total citations, the United Kingdom led significantly with 21,278 citations, despite having fewer publications than the United States. Canada and the Netherlands also exhibited notable citation counts, with 4,809 and 4,849 citations, respectively. This suggests that although some countries contributed fewer papers, their work had a considerable academic impact (Table 1). Table 1. Contributions in publication of countries Country Publications Sum of the Times Cited Average Citations per Item H-index United States 138 11,109 80.50 50 United Kingdom 60 21,278 354.63 54 Australia 48 4,257 88.69 32 Germany 33 4,277 129.61 20 Canada 30 4,809 160.30 30 Taiwan 22 3,775 171.59 41 Netherlands 20 4,849 242.45 33 Norway 17 3,819 224.65 16 Spain 17 4,018 236.35 28 Italy 14 3,494 249.57 24 Average citation frequency Figure 3a highlights the average citation frequency across the top contributing countries. United Kingdom (354.63), Italy (249.57), the Netherlands (242.45), and Norway (224.65) were among the highest in terms of citations per publication. Taiwan, with an average of 171.59 citations per article, also demonstrated substantial research influence relative to output. High citation rates may also reflect stronger academic networking, English-language publication bias, and international collaboration trends (Thelwall & Maflahi, 2020). H-index The H-index, as illustrated in Figure 3b, reveals the United Kingdom's leading position (h = 54), followed by the United States (h = 50) and Taiwan (h = 41). These indices reflect not only volume but also consistency and citation quality of contributions in the field. Analysis of publications Journals Table 2 displays the top ten journals publishing research on non-pharmacologic interventions for dementia in LTC settings. "Aging and Mental Health" ranked highest with 16 publications (3.77%), followed by the "Journal of Music Therapy" (2.83%) and the "International Journal of Geriatric Psychiatry" (2.59%). The presence of journals like "Cochrane Database of Systematic Reviews" and "Journal of the American Medical Directors Association" underscores a balance of clinical and methodological rigor. Table 2. Top 10 Journals on Non-pharmacologic Interventions for Dementia in LTC Journal Publications Percentage (n = 424) Aging and Mental Health 16 3.774% Journal of Music Therapy 12 2.830% International Journal of Geriatric Psychiatry 11 2.594% Cochrane Database of Systematic Reviews 10 2.358% Journal of the American Medical Directors Association 10 2.358% International Psychogeriatrics 9 2.123% Geriatric Nursing 8 1.887% BMC Geriatrics 8 1.887% Dementia 8 1.887% Frontiers in Medicine 7 1.651% Authors As detailed in Table 3, the top contributing authors included Wilz G., Rudolph J.L., and Vink A.C., each with six publications. Notably, van der Steen J.T., despite contributing only three articles, had a high average citation per item (88.00), indicating a strong impact. Authors such as Orrell M. and Cohen-Mansfield J. also showed high citation averages, reflecting the influence of their work in shaping the discourse. Table 3. Top 20 authors of publications Author Publications Sum of Times Cited Average Citations per Item H-index Wilz G. 6 69 11.50 4 Rudolph J.L. 6 73 12.17 4 Vink A.C. 6 275 45.83 4 Orrell M. 5 262 52.40 5 McDermott O. 5 53 10.60 4 Bhar S. 5 32 6.40 2 Mor V. 5 121 24.20 4 McCreedy E.M. 5 53 10.60 4 Dassa A. 5 55 11.00 3 Baker F.A. 5 153 30.60 4 O’Connor D.W. 4 393 98.25 4 Koder D. 4 31 7.75 2 Inoue M. 4 20 5.00 2 Cohen-Mansfield J. 4 191 47.75 4 Thomas K.S. 4 117 29.25 4 Davison T.E. 4 31 7.75 2 Odell-Miller H. 4 64 16.00 3 Wosch T. 4 97 24.25 2 Gold C. 4 238 59.50 4 van der Steen J.T. 3 264 88.00 2 Research orientations Figure 4a illustrates the top research orientations associated with this field. The predominant categories included geriatrics, psychiatry, nursing, and palliative care, reflecting the interdisciplinary nature of non-pharmacologic dementia interventions. These alignments suggest a holistic approach integrating behavioral science, caregiving practices, and mental health. Institutions Figure 4b shows the top 20 institutions with the most published papers. The National Institute on Aging recorded the highest number of publications with 21, followed by the National Institutes of Health and the National Health and Medical Research Council, each with 8. The National Institute of Mental Health contributed 6 publications, while ZonMw and National Institute for Health and Care Research each had 5. Co-occurrence analysis The keyword co-occurrence network, illustrated in Figure 5, reveals four distinct clusters emerging from the thematic proximity and interrelations among frequently used terms in the field. A total of 3,387 keywords were analyzed, of which 43 met the inclusion criteria. These were subsequently grouped into four clusters: Clinical and psychological dimensions (red), Demographic context (green), Methodological structure (blue), and Long-term Care (yellow). Cluster 1: Clinical and psychological dimensions (red cluster) The Clinical and psychological dimensions cluster (red) primarily focuses on the direct impact of dementia and NPIs on individuals. Key keywords within this cluster include "human," "depression," "anxiety," "cognition," "quality of life," and "psychotherapy." These terms collectively highlight the core clinical manifestations and psychological responses associated with dementia, as well as the interventions designed to address these aspects, emphasizing the patient's subjective experience and well-being. Cluster 2: Demographic context (green cluster) The Demographic context cluster (green) centers on the characteristics of the patient population and the broader social factors influencing care. Representative keywords are "humans," "aged," "very elderly," "nursing home," and "homes for the aged." This cluster underscores the importance of understanding the diverse demographic profiles of individuals with dementia and their caregivers, suggesting a focus on tailored interventions that consider age, cultural background, and the role of family support within the LTC environment. Cluster 3: Methodological structure (blue cluster) The Methodological structure cluster (blue) is concerned with the research designs and evaluation approaches employed in NPI studies. Prominent keywords include "article," "clinical trial," "controlled study," and "randomized controlled trial." This cluster reflects the scientific rigor and diverse methodologies used to assess the effectiveness and implementation of NPIs, indicating a growing emphasis on robust research designs and the translation of findings into practice. Cluster 4: Long-term care (yellow cluster) The Long-term Care cluster (yellow), though the smallest, centers on the theme of long-term care. This keyword emphasizes the practical aspects of NPI implementation within long-term care facilities, highlighting the crucial roles of the physical environment, trained staff, and a person-centered approach in optimizing care for residents with dementia. In essence, these clusters illustrate a methodologically diverse and thematically integrated landscape of research. The interplay of clinical, contextual, empirical, and systemic elements reflects a comprehensive scholarly engagement with the complexities of non-pharmacologic dementia care in long-term settings. Discussion Global Trends in Non-Pharmacologic Dementia Research This bibliometric analysis reveals a consistent increase in global research output on non-pharmacologic interventions (NPIs) for dementia in long-term care (LTC) settings. The field has grown rapidly in the past decade, reflecting a shift towards person-centered and holistic care and a recognition of the limitations of pharmacological treatments (Livingston et al., 2017b ). High-income countries, particularly the United States, the United Kingdom, Australia, and Germany, remain the most prolific contributors, underscoring the structural advantages of well-resourced research systems. However, the analysis also exposes pronounced regional disparities in both publication volume and citation impact. Research from low and middle-income countries (LMICs) remains underrepresented, with many studies limited by constrained funding, fewer specialized training programs, and lower access to international collaborations (Prince et al., 2008 ). Despite these barriers, emerging contributions from Asia, Africa, and Latin America demonstrate innovative use of locally grounded care models, such as family-mediated reminiscence therapy and community-based engagement programs. These efforts highlight a growing awareness of how cultural values and caregiving traditions shape dementia care practices. Expanding equitable research partnerships and targeted funding initiatives will be vital to reducing this geographic imbalance and strengthening global inclusivity. Quality and Status of Publications Worldwide Dementia related non-pharmacological intervention (NPI) research is notably robust in high-income settings due to well-established institutional infrastructure and consistent funding, fostering a conducive environment for innovation. The United Kingdom’s high h-index and citation rates reflect both productivity and intellectual influence, while Taiwan and the Netherlands, despite their smaller publication volumes, achieve notably high citation averages. This pattern suggests that concentrated, methodologically rigorous studies may yield greater visibility and scholarly impact than high output alone (Bornmann & Leydesdorff, 2013 ). Differences in citation performance between regions may be attributed to several structural and contextual factors. Articles published in English-language, high-impact journals tend to attract more citations due to broader accessibility and indexing coverage (Mongeon & Paul-Hus, 2016 ). In contrast, research from LMICs is often published in regional or non-English outlets that receive limited international exposure. Collaboration networks tend to favor Western institutions, which boosts the visibility of authors from these academic environments (Ynalvez & Shrum, 2011 ). Future bibliometric studies should investigate the correlation between authorship networks, funding sources, and citation practices to understand how epistemic inequities influence global recognition in dementia research. Research Focus on Non-Pharmacologic Interventions The keyword analysis revealed four primary thematic clusters: clinical and psychological interventions, demographic and residential contexts, methodological frameworks, and long-term care (LTC), illustrating how research on NPIs has become more multidimensional. Within the clinical and psychological domains, studies continue to emphasize cognitive engagement, emotional regulation, and behavioral management. Interventions such as reminiscence therapy, multisensory stimulation, and music-based programs are widely recognized for their role in improving mood, reducing agitation, and fostering social interaction (Brodaty & Arasaratnam, 2012 ). Nevertheless, transferring these practices across diverse cultural and care contexts remains a challenge, particularly where resources, staff expertise, and institutional support vary. The demographic and residential context cluster points to growing awareness that social and environmental conditions shape both the experience of dementia and the success of NPIs. Residents in smaller, homelike facilities often demonstrate higher satisfaction, lower agitation, and more positive social engagement compared to those in institutionalized settings (Chaudhury et al., 2018 ). These findings highlight the significance of environmental design, social connections, and family engagement in influencing care outcomes. They also underscore disparities in the quality of long-term care, especially in low and middle-income countries with limited formal infrastructure. The field is rooted in evidence-based designs, but traditional randomized controlled trials often fail to consider the contextual complexities of long-term care (LTC) environments. Realist evaluation and implementation frameworks(Pawson et al., 2005 ) offer alternative approaches capable of capturing the nuanced interplay between intervention fidelity, organizational capacity, and care culture. Incorporating mixed-methods and participatory approaches may therefore yield findings that are both generalizable and adaptable to the realities of LTC settings. The long-term care cluster highlights the importance of organizational culture and workforce engagement in determining the success of interventions. NPIs implemented within supportive LTC environments where autonomy, continuity of care, and relational caregiving are valued tend to produce more sustainable and person-centered outcomes (Backhouse et al., 2022 ). High staff turnover, limited training, and resource shortages can reduce the effectiveness of interventions and lead to increased reliance on pharmacological management. Growing international interest in staff education, supervision, and co-designed care programs highlights a shift from intervention delivery to system-level implementation. In high-income settings, structured programs emphasizing staff well-being and communication have shown measurable improvements in resident quality of life (Howden-Chapman et al., 2023 ). Research on non-pharmacological interventions (NPIs) is influencing dementia care policy and practice at a systemic level. This aligns with global guidelines advocating for person-centered, ethical, and psychosocial approaches to long-term care (Health Organization, 2021 ). However, the translation of evidence into policy remains uneven. Many LMICs still lack comprehensive LTC frameworks capable of integrating NPIs into everyday practice. Strengthening cross-country collaboration and supporting the professionalization of LTC workforces could bridge this gap, ensuring that person-centered approaches extend beyond isolated pilot programs into routine care delivery. Thematic Clustering and Emerging Research Directions The evolution of NPI research signals a move toward more integrated, system-oriented care models that link individual interventions with broader institutional and policy dimensions. This shift aligns with the growing influence of implementation science and participatory research, both of which emphasize real-world applicability and sustainability. Conceptually, NPIs are being reframed as more than therapeutic tools; they are increasingly understood as forms of social participation and ethical caregiving that preserve identity, autonomy, and dignity in dementia care. Nevertheless, global participation remains uneven. Western frameworks continue to dominate scholarly discourse, often sidelining cultural and indigenous knowledge systems that could enrich care models (Durie, 2004 ). Bridging these epistemic divides will require inclusive collaboration, open-access dissemination, and equitable authorship practices. Integrating underrepresented perspectives may also improve ecological validity by ensuring interventions are contextually relevant and culturally grounded (Health Organization, 2021 ). All in all, these findings reflect a field in transition, one that is expanding in both scope and inclusivity but still marked by structural disparities. Future research should prioritize the development of inclusive networks that bridge high, middle, and low-income areas, as well as enhance the theoretical and methodological frameworks for assessing non-pharmaceutical interventions (NPIs). Through sustained collaboration and shared global engagement, dementia care research can evolve toward a more balanced, contextually sensitive, and culturally responsive foundation. Limitations This study has several important limitations that need to be acknowledged. First, it used quantitative bibliometric methods to review publications on non-pharmacologic interventions for dementia. The analysis concentrated on publication data, including author details, citations, and keywords, rather than assessing the research findings or intervention outcomes. As a result, while the study provides insight into overall research trends, it does not assess the effectiveness or quality of the interventions discussed. Another important consideration is that this study relied exclusively on documents indexed in the Scopus database. While Scopus is a widely used and robust source of academic literature, depending on a single database may introduce bias. Relevant articles from other databases or region-specific journals could have been excluded from the analysis. Future bibliometric studies should consider triangulating multiple databases such as Web of Science and PubMed, to ensure broader coverage and reduce potential bias in mapping research trends. In addition, the review focused mainly on English-language publications. This language constraint may have excluded research conducted in other languages, particularly studies from non-English-speaking countries that could offer diverse perspectives or locally grounded insights into dementia care. Despite our careful efforts to define screening criteria, some relevant literature may have been missed. The broad nature of dementia care and non-pharmacologic research means that certain interdisciplinary or context-specific studies may have been overlooked, especially if their keywords did not align with the search parameters. Conclusion This study not only highlights the growing global attention and expanding research on non-pharmacologic interventions, but also successfully achieves its aims of mapping global research trends, identifying leading contributors, and exploring thematic and geographic concentrations of non-pharmacologic interventions (NPIs) for dementia in long-term care (LTC) settings. The findings reveal a rapidly expanding body of literature, particularly over the past decade, reflecting the increasing global recognition of NPIs as vital components of dementia care. The United States and the United Kingdom remain dominant in publication volume and impact, with emerging contributions from Asia and other regions indicating a growing international engagement. Thematic analysis highlighted four major domains clinical and psychological dimensions, demographic contexts, methodological rigor, and systemic challenges within LTC environments providing an integrated understanding of the evolving landscape of NPI research. Moving forward, strengthening interdisciplinary collaboration and ensuring greater participation of low and middle-income countries will be essential to advancing equitable, culturally sensitive, and person-centered dementia care worldwide. Such inclusive approaches can bridge existing research disparities and align global NPI research efforts with the principles of sustainability and social justice. Declarations Ethical Approval : This manuscript does not contain any studies with human participants or animals performed by any of the authors. Informed Consent: This manuscript does not contain any individual person’s data. Funding : No funding was received for conducting this study. Competing Interests: The authors have no relevant financial or non-financial interests to disclose. Authors’ Contributions: Cressy Alana Actie is the lead author of this manuscript and was responsible for the conceptualization, design, analysis, and overall development of the study. Hung-En Liao made a major contribution by leading the editing and final revision of the manuscript. Fu-Gong Lin provided academic guidance and reviewed the manuscript. Bing-Long Wang contributed to the study design and discussion. Yu-Ni Huang contributed to the study design and data analysis. Francis Sarial Ganancial, Nidhi, and Aruna A. C. supported the research during its initial organization and planning. All authors read and approved the final version of the manuscript. Data Availability Data is provided within the manuscript. Acknowledgments The authors wish to thank Asia University, Taiwan, and its library services for providing access to the Scopus database, which made this research possible. The authors are grateful to Professor Dr. Kuan-Han Lin, Ph.D., of Asia University, Taiwan, for her constructive feedback and guidance, which enhanced the rigor of this study. Funding Statement No external funding was received for this study. Conflicts of Interest The authors declare no conflicts of interest. Ethical Approval This study was based on publicly available published research. Ethical approval was therefore not required. References Abraha, I., Rimland, J. M., Trotta, F. M., Dell’Aquila, G., Cruz-Jentoft, A., Petrovic, M., Gudmundsson, A., Soiza, R., O’Mahony, D., Guaita, A., & Cherubini, A. (2017). Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ Open , 7 (3), e012759. https://doi.org/10.1136/BMJOPEN-2016-012759 Aria, M., & Cuccurullo, C. (2017). bibliometrix: An R-tool for comprehensive science mapping analysis. Journal of Informetrics , 11 (4), 959–975. https://doi.org/10.1016/J.JOI.2017.08.007 Backhouse, T., Jeon, Y. H., Killett, A., & Mioshi, E. (2022). How do family carers and care-home staff manage refusals when assisting a person with advanced dementia with their personal care? Dementia , 21 (8), 2458–2475. https://doi.org/10.1177/14713012221123578 Bornmann, L., & Leydesdorff, L. (2013). The validation of (advanced) bibliometric indicators through peer assessments: A comparative study using data from InCites and F1000. Journal of Informetrics , 7 (2), 286–291. Brodaty, H., & Arasaratnam, C. (2012). Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. American Journal of Psychiatry , 169 (9), 946–953. Chaudhury, H., Cooke, H. A., Cowie, H., & Razaghi, L. (2018). The Influence of the Physical Environment on Residents With Dementia in Long-Term Care Settings: A Review of the Empirical Literature. The Gerontologist , 58 (5), e325–e337. https://doi.org/10.1093/GERONT/GNW259 Chen, C. (2006). CiteSpace II: Detecting and visualizing emerging trends and transient patterns in scientific literature. Journal of the American Society for Information Science and Technology , 57 (3), 359–377. https://doi.org/10.1002/ASI.20317;PAGEGROUP:STRING:PUBLICATION Chen, C. (2018). Visualizing and exploring scientific literature with citespace an introduction to a half-day tutorial. CHIIR 2018 - Proceedings of the 2018 Conference on Human Information Interaction and Retrieval , 2018-March , 369–370. https://doi.org/10.1145/3176349.3176897;PAGE:STRING:ARTICLE/CHAPTER Chenoweth, L., King, M. T., Jeon, Y. H., Brodaty, H., Stein-Parbury, J., Norman, R., Haas, M., & Luscombe, G. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. The Lancet Neurology , 8 (4), 317–325. https://doi.org/10.1016/S1474-4422(09)70045-6 Cobo, M. J., López-Herrera, A. G., Herrera-Viedma, E., & Herrera, F. (2011). Science mapping software tools: Review, analysis, and cooperative study among tools. Wiley Online LibraryMJ Cobo, AG López‐Herrera, E Herrera‐Viedma, F HerreraJournal of the American Society for Information Science and Technology, 2011•Wiley Online Library , 62 (7), 1382–1402. https://doi.org/10.1002/ASI.21525 Durie, M. (2004). Understanding health and illness: research at the interface between science and indigenous knowledge. International Journal of Epidemiology , 33 (5), 1138–1143. https://doi.org/10.1093/IJE/DYH250 Falagas, M. E., Pitsouni, E. I., Malietzis, G. A., & Pappas, G. (2008). Comparison of PubMed, Scopus, web of science, and Google scholar: strengths and weaknesses. Wiley Online LibraryME Falagas, EI Pitsouni, GA Malietzis, G PappasThe FASEB Journal, 2008•Wiley Online Library , 22 (2), 338–342. https://doi.org/10.1096/FJ.07-9492LSF Gitlin, L. N., Kales, H. C., & Lyketsos, C. G. (2012). Nonpharmacologic Management of Behavioral Symptoms in Dementia. JAMA , 308 (19), 2020–2029. https://doi.org/10.1001/JAMA.2012.36918 Health Organization, W. (2021). Global status report on the public health response to dementia . http://apps.who.int/ Howden-Chapman, P., Bennett, J., Edwards, R., Jacobs, D., Nathan, K., & Ormandy, D. (2023). Review of the Impact of Housing Quality on Inequalities in Health and Well-Being. Annual Review of Public Health , 44 (Volume 44, 2023), 233–254. https://doi.org/10.1146/ANNUREV-PUBLHEALTH-071521-111836/CITE/REFWORKS Kochovska, S., Garcia, M. V., Bunn, F., Goodman, C., Luckett, T., Parker, D., Phillips, J. L., Sampson, E. L., van der Steen, J. T., & Agar, M. R. (2020). Components of palliative care interventions addressing the needs of people with dementia living in long-term care: A systematic review. Palliative Medicine , 34 (4), 454–492. https://doi.org/10.1177/0269216319900141/ASSET/16155FD5-0C42-413F-92BE-F91ADEA42829/ASSETS/IMAGES/LARGE/10.1177_0269216319900141-FIG1.JPG Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., Cooper, C., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Larson, E. B., Ritchie, K., Rockwood, K., Sampson, E. L., … Mukadam, N. (2017a). Dementia prevention, intervention, and care. The Lancet , 390 (10113), 2673–2734. https://doi.org/10.1016/S0140-6736(17)31363-6 Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., Cooper, C., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Larson, E. B., Ritchie, K., Rockwood, K., Sampson, E. L., … Mukadam, N. (2017b). Dementia prevention, intervention, and care. The Lancet , 390 (10113), 2673–2734. https://doi.org/10.1016/S0140-6736(17)31363-6 Martín-Martín, A., Orduna-Malea, E., Thelwall, M., & Delgado López-Cózar, E. (2018). Google Scholar, Web of Science, and Scopus: A systematic comparison of citations in 252 subject categories. Journal of Informetrics , 12 (4), 1160–1177. https://doi.org/10.1016/J.JOI.2018.09.002 Mongeon, P., & Paul-Hus, A. (2016). The journal coverage of Web of Science and Scopus: a comparative analysis. SpringerP Mongeon, A Paul-HusScientometrics, 2016•Springer , 106 (1), 213–228. https://doi.org/10.1007/S11192-015-1765-5 Nichols, E., Steinmetz, J. D., Vollset, S. E., Fukutaki, K., Chalek, J., Abd-Allah, F., Abdoli, A., Abualhasan, A., Abu-Gharbieh, E., Akram, T. T., Al Hamad, H., Alahdab, F., Alanezi, F. M., Alipour, V., Almustanyir, S., Amu, H., Ansari, I., Arabloo, J., Ashraf, T., … Vos, T. (2022). Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. The Lancet Public Health , 7 (2), e105–e125. https://doi.org/10.1016/S2468-2667(21)00249-8/ATTACHMENT/60E03FD1-38B2-4B40-A91D-9AFDDA22B45E/MMC1.PDF Oh, H., White, E. M., Muench, U., Santostefano, C., Thapa, B., Kosar, C., Gadbois, E. A., Osakwe, Z. T., Gozalo, P., & Rahman, M. (2023). Advanced practice clinician care and end-of-life outcomes for community- and nursing home-dwelling Medicare beneficiaries with dementia. Alzheimer’s & Dementia , 19 (9), 3946–3964. https://doi.org/10.1002/ALZ.13052 Organization, W. H. (2021). Global status report on the public health response to dementia. Security Research Hub Reports . https://digitalcommons.fiu.edu/srhreports/health/health/65 Pawson, R., Greenhalgh, T., Harvey, G., & Walshe, K. (2005). Realist review - A new method of systematic review designed for complex policy interventions. Journal of Health Services Research and Policy , 10 (SUPPL. 1), 21–34. https://doi.org/10.1258/1355819054308530;CTYPE:STRING:JOURNAL Prince, M., Acosta, D., Albanese, E., Arizaga, R., Ferri, C. P., Guerra, M., Huang, Y., Jacob, K. S., Jimenez-Velazquez, I. Z., Rodriguez, J. L., Salas, A., Sosa, A. L., Sousa, R., Uwakwe, R., Van Der Poel, R., Williams, J., & Wortmann, M. (2008). Ageing and dementia in low and middle income countries–Using research to engage with public and policy makers. International Review of Psychiatry , 20 (4), 332–343. https://doi.org/10.1080/09540260802094712 Steen, J. T. van der, Klapwijk, M. S., & Achterberg, W. P. (2020). Palliative care and impact of the COVID-19 pandemic on nursing home residents with dementia. Rivista Italiana Di Cure Palliative , 22 (3), 129–139. https://doi.org/10.1726/3439.34275 Thelwall, M., & Maflahi, N. (2020). Academic collaboration rates and citation associations vary substantially between countries and fields. Journal of the Association for Information Science and Technology , 71 (8), 968–978. https://doi.org/10.1002/ASI.24315;WEBSITE:WEBSITE:ASISTDL;REQUESTEDJOURNAL:JOURNAL:23301643;WGROUP:STRING:PUBLICATION Van Der Ploeg, E. S., Eppingstall, B., Camp, C. J., Runci, S. J., Taffe, J., & O’Connor, D. W. (2013). A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with Dementia. International Psychogeriatrics , 25 (4), 565–575. https://doi.org/10.1017/S1041610212002128 van Eck, N. J., & Waltman, L. (2009). Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics , 84 (2), 523–538. https://doi.org/10.1007/S11192-009-0146-3 van Eck, N. J., & Waltman, L. (2017). Citation-based clustering of publications using CitNetExplorer and VOSviewer. SpringerNJ Van Eck, L WaltmanScientometrics, 2017•Springer , 111 (2), 1053–1070. https://doi.org/10.1007/S11192-017-2300-7 Ynalvez, M. A., & Shrum, W. M. (2011). Professional networks, scientific collaboration, and publication productivity in resource-constrained research institutions in a developing country. Research Policy , 40 (2), 204–216. https://doi.org/10.1016/j.respol.2010.10.004 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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07:05:30","extension":"html","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":133733,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7967273/v1/6467541cea19ca2196c9b0b5.html"},{"id":94724128,"identity":"4a98ec8f-d42f-4c4f-b0b9-ae328dea62b1","added_by":"auto","created_at":"2025-10-30 06:09:53","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":171013,"visible":true,"origin":"","legend":"\u003cp\u003eWorkflow diagram illustrating the bibliometric analysis\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7967273/v1/c2cc69eb00db1528676f315b.png"},{"id":94730110,"identity":"3e011a00-287e-49b7-a043-5074da462ba2","added_by":"auto","created_at":"2025-10-30 07:05:40","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":587974,"visible":true,"origin":"","legend":"\u003cp\u003ea – Total number of publications related to Dementia. The bars indicate the number of publications\u003c/p\u003e\n\u003cp\u003eb. – Model fitting curve of curves global publications trends.\u003c/p\u003e\n\u003cp\u003ec. Top 10 countries of total publications\u003c/p\u003e\n\u003cp\u003ed. Distribution world map of dementia research\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7967273/v1/a8171b51bfa1492c406d0602.png"},{"id":94724173,"identity":"caa53cee-e8e2-45f0-aad8-eeec70de8f0e","added_by":"auto","created_at":"2025-10-30 06:09:56","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":232047,"visible":true,"origin":"","legend":"\u003cp\u003ea. Top 10 countries of average citations for each article\u003c/p\u003e\n\u003cp\u003eb. Top 10 countries of the H-Index\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7967273/v1/097fd0cf633026b50f9c0415.png"},{"id":94724130,"identity":"8c6bae0f-9d05-4c77-837b-63d4d9eedc64","added_by":"auto","created_at":"2025-10-30 06:09:53","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":332156,"visible":true,"origin":"","legend":"\u003cp\u003ea. Top 10 research orientations and the number of publications in each orientation\u003c/p\u003e\n\u003cp\u003eb. Top 20 institution with the most publications\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7967273/v1/5b6b77ad30a9428e5410ac4c.png"},{"id":94730341,"identity":"bc8279ab-88cc-4c73-9ade-64e3125bd2fc","added_by":"auto","created_at":"2025-10-30 07:05:52","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":997264,"visible":true,"origin":"","legend":"\u003cp\u003eCo-occurrence analysis of Non-drug interventions for dementia in long-term care\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7967273/v1/9e78f1f0fddf07c6b7f63bef.png"},{"id":96603835,"identity":"cc476b03-2b79-4874-a213-824826bd4a53","added_by":"auto","created_at":"2025-11-24 09:11:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3046958,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7967273/v1/5e017633-4879-4865-b2f1-91be851aa612.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Global Research Trends on Non-Pharmacologic Interventions for Dementia in Long-Term Care Settings: A Bibliometric Analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe global burden of dementia now exceeds 55\u0026nbsp;million cases(Organization, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) and is expected to rise to 139\u0026nbsp;million by 2050 (Nichols et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), placing unprecedented pressure on long-term care (LTC) systems. While pharmacologic regimens remain standard, their modest benefits and frequent adverse effects have accelerated interest in non-pharmacologic interventions (NPIs) such as music therapy, reminiscence therapy, cognitive training, multisensory stimulation, and environmental modifications (Abraha et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Livingston et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017a\u003c/span\u003e). Despite this momentum, the literature remains fragmented, impeding the development of coherent clinical guidelines and obscuring where research efforts should be concentrated (Kochovska et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Steen et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMethodological heterogeneity further complicates interpretation; outcomes are often non-comparable, study designs vary widely, and person-centered philosophies are inconsistently integrated with institutional care cultures (Chenoweth et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Gitlin et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Van Der Ploeg et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Without a systematic mapping of the field, it is unclear which NPIs command sustained scholarly attention, which regions and institutions drive innovation, and where critical knowledge gaps persist.\u003c/p\u003e\u003cp\u003eBibliometric analysis offers a robust means of addressing these uncertainties by quantifying productivity, visualizing intellectual structures, and tracing interdisciplinary linkages (Aria \u0026amp; Cuccurullo, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Chen, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). Yet comprehensive bibliometric assessments focused specifically on NPIs for dementia within LTC settings are virtually absent. This omission risks duplication, underinvestment in underexplored domains, and stalled translation of evidence into scalable care models.\u003c/p\u003e\u003cp\u003eRecognizing the need for a nuanced understanding of NPIs for dementia in LTC, particularly concerning their ethical implications, institutional integration, and alignment with person-centered care, this study conducts a global bibliometric analysis. Our primary objectives are to: (1) map global research trends; (2) identify leading authors, institutions, and journals; and (3) explore thematic and geographic concentrations of NPIs for dementia in LTC settings. Through this comprehensive analysis, we aim to not only quantify research output but also to critically inform the discourse by situating NPIs within the context of ethical considerations, practical implementation challenges in various institutional settings, and the fundamental concept of personhood in dementia care.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eTo systematically map the global research landscape on non-pharmacologic interventions (NPIs) for dementia within long-term care (LTC) settings, a bibliometric approach was adopted. This methodology allows for the quantitative evaluation of scientific literature and the visualization of scholarly structures, helping to identify thematic concentrations, intellectual linkages, and geographic patterns in knowledge production (Chen, 2018; van Eck \u0026amp; Waltman, 2017). While bibliometric studies do not replace in-depth systematic reviews, they are increasingly recognized for their capacity to synthesize large datasets and guide future research priorities (Cobo et al., 2011).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Source and Search Strategy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe bibliographic data were retrieved exclusively from the Scopus database, which is widely acknowledged for its expansive and multidisciplinary coverage of peer-reviewed literature (Falagas et al., 2008). Scopus was selected over other indexing services due to its inclusion of high-impact journals and its compatibility with bibliometric analysis software. Its comprehensiveness and broader inclusion of social science literature make it particularly suitable for interdisciplinary dementia research (Mongeon \u0026amp; Paul-Hus, 2016). The database query was executed on May 29, 2025, to capture a comprehensive dataset reflecting contemporary research output.\u003c/p\u003e\n\u003cp\u003eTo ensure conceptual precision and thematic relevance, a multi-component search string was constructed using Boolean operators. The query combined terms related to dementia ((\u0026ldquo;dementia\u0026rdquo; OR \u0026ldquo;Alzheimer\u0026rsquo;s disease\u0026rdquo;) AND (\u0026ldquo;nursing homes\u0026rdquo; OR \u0026ldquo;residential care\u0026rdquo;) AND (\u0026ldquo;music therapy\u0026rdquo; OR \u0026ldquo;non-pharmacologic intervention*\u0026rdquo;)). The search was conducted in the full-text, article title, abstract, and keywords fields to enhance specificity. Only original research articles and reviews published in English were included; conference proceedings, book chapters, editorials, and grey literature were excluded to maintain methodological consistency and quality.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and Exclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eArticles were retained if they met the following criteria: (1) the primary focus involved one or more NPIs targeting individuals diagnosed with dementia; (2) the intervention was implemented within a formal long-term care setting; and (3) the study presented empirical data or conducted a scholarly review of relevant interventions. Exclusion criteria encompassed studies (1) focused exclusively on pharmacologic or surgical treatments; (2) examined dementia prevention or early-stage, community-based interventions outside LTC contexts; (3) were not written in English; (4) were non-peer-reviewed (e.g., conference abstracts, editorials, or dissertations); or (5) lacked full-text accessibility.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Selection Process\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of \u003cstrong\u003e518 publications\u003c/strong\u003e on non-pharmacologic interventions (NPIs) for dementia in long-term care (LTC) settings were identified through the \u003cstrong\u003eScopus\u003c/strong\u003e database (Fig. 1). Publications dated before 1990 were excluded, as they were minimal in number and fell outside the defined scope of contemporary research trends. In total, \u003cstrong\u003e424 publications\u003c/strong\u003e met the eligibility criteria and were included in the final bibliometric dataset. Detailed information regarding the selection process, including screening and exclusion steps, is presented in \u003cstrong\u003eFigure 1\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eArticles and review articles were considered eligible for inclusion. To minimize language bias, non-English publications were excluded. Each Scopus record provided comprehensive metadata, including title, abstract, author information, institutional affiliations, publication year, journal source, and citation data. These records formed the foundation for the bibliometric mapping using VOSviewer.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Processing and Analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFollowing retrieval, bibliographic records were exported in CSV and RIS formats to enable compatibility with VOSviewer (version 1.6.20), a widely utilized tool for bibliometric visualization. \u0026nbsp;Microsoft Excel 2019 was employed to visualize annual publication trends and citation metrics. These platforms allow for distinct but complementary forms of analysis. In parallel, VOSviewer facilitated the construction of co-authorship, keyword co-occurrence, and institutional collaboration networks, employing fractional counting and relevance-based clustering to enhance interpretability (van Eck \u0026amp; Waltman, 2009).\u003c/p\u003e\n\u003cp\u003eTo minimize redundancy and correct author name variations, the dataset was manually cleaned. Author affiliations were standardized where possible, and duplicates were removed. \u0026nbsp;Data cleaning is a critical step in bibliometric analysis to avoid fragmentation of authorship networks and inaccurate cluster generation (Mart\u0026iacute;n-Mart\u0026iacute;n et al., 2018). Given the field\u0026rsquo;s interdisciplinary nature, subject areas were also examined using Scopus\u0026rsquo; classification scheme to explore research orientation across disciplines such as nursing, gerontology, psychology, and public health.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eGlobal publication trends\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNumber of global publications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 424 publications on non-pharmacologic interventions for dementia in long-term care (LTC) settings were identified. As depicted in Figure 2a, there has been a progressive increase in scholarly interest over the years, with a particularly steep rise observed in the past decade. To better understand this growth trajectory, a linear regression model was applied, as shown in Figure 2b. The model exhibits a strong fit with an R-squared value of 0.8201, where R-squared (or the coefficient of determination) indicates the proportion of the variance in the dependent variable (research output) that can be predicted from the independent variable (time). This high value suggests that approximately 82.01% of the variation in research output can be explained by the trend over time, thereby indicating a robust and predictable growth in the field. If this trajectory continues, the volume of publications could approach 60 by 2030.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCountry and regional contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 2c and Figure 2d illustrate the geographical distribution and ranking of countries by publication output. The United States (U.S.) contributed the highest number of publications (n = 138), accounting for 32.5% of the total. This leadership is reflective of long-standing investments in aging and Alzheimer\u0026rsquo;s research infrastructure in the U.S. (Oh et al., 2023). This was followed by the United Kingdom (n = 60), Australia (n = 48), and Germany (n = 33). These four countries collectively accounted for over 66% of all identified research outputs in the domain.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTotal number of citations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn terms of total citations, the United Kingdom led significantly with 21,278 citations, despite having fewer publications than the United States. Canada and the Netherlands also exhibited notable citation counts, with 4,809 and 4,849 citations, respectively. This suggests that although some countries contributed fewer papers, their work had a considerable academic impact (Table 1).\u003c/p\u003e\n\u003cp\u003eTable 1. Contributions in publication of countries\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCountry\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePublications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSum of the\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTimes Cited\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAverage Citations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eper Item\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eH-index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnited States\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11,109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnited Kingdom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21,278\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e354.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAustralia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4,257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGermany\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4,277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e129.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4,809\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e160.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTaiwan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3,775\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e171.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNetherlands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4,849\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e242.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNorway\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3,819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e224.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSpain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4,018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e236.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eItaly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3,494\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e249.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAverage citation frequency\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 3a highlights the average citation frequency across the top contributing countries. United Kingdom (354.63), Italy (249.57), the Netherlands (242.45), and Norway (224.65) were among the highest in terms of citations per publication. Taiwan, with an average of 171.59 citations per article, also demonstrated substantial research influence relative to output. High citation rates may also reflect stronger academic networking, English-language publication bias, and international collaboration trends (Thelwall \u0026amp; Maflahi, 2020).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eH-index\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe H-index, as illustrated in Figure 3b, reveals the United Kingdom\u0026apos;s leading position (h = 54), followed by the United States (h = 50) and Taiwan (h = 41). These indices reflect not only volume but also consistency and citation quality of contributions in the field.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnalysis of publications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJournals\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 displays the top ten journals publishing research on non-pharmacologic interventions for dementia in LTC settings. \u0026quot;Aging and Mental Health\u0026quot; ranked highest with 16 publications (3.77%), followed by the \u0026quot;Journal of Music Therapy\u0026quot; (2.83%) and the \u0026quot;International Journal of Geriatric Psychiatry\u0026quot; (2.59%). The presence of journals like \u0026quot;Cochrane Database of Systematic Reviews\u0026quot; and \u0026quot;Journal of the American Medical Directors Association\u0026quot; underscores a balance of clinical and methodological rigor.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2. Top 10 Journals on Non-pharmacologic Interventions for Dementia in LTC\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"6144\" cellpadding=\"0\" align=\"\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eJournal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePublications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (n = 424)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAging and Mental Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.774%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eJournal of Music Therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.830%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eInternational Journal of Geriatric Psychiatry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.594%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCochrane Database of Systematic Reviews\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.358%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eJournal of the American Medical Directors Association\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.358%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eInternational Psychogeriatrics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.123%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGeriatric Nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.887%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBMC Geriatrics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.887%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDementia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.887%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFrontiers in Medicine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.651%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs detailed in Table 3, the top contributing authors included Wilz G., Rudolph J.L., and Vink A.C., each with six publications. Notably, van der Steen J.T., despite contributing only three articles, had a high average citation per item (88.00), indicating a strong impact. Authors such as Orrell M. and Cohen-Mansfield J. also showed high citation averages, reflecting the influence of their work in shaping the discourse.\u003c/p\u003e\n\u003cp\u003eTable 3. Top 20 authors of publications\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"6144\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAuthor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePublications\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSum of Times Cited\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAverage Citations per Item\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eH-index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWilz G.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRudolph J.L.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eVink A.C.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e45.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOrrell M.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e52.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMcDermott O.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBhar S.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMor V.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMcCreedy E.M.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDassa A.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBaker F.A.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eO\u0026rsquo;Connor D.W.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e98.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eKoder D.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eInoue M.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCohen-Mansfield J.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e47.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eThomas K.S.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e29.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDavison T.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOdell-Miller H.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e16.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWosch T.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGold C.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e59.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003evan der Steen J.T.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e88.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eResearch orientations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 4a illustrates the top research orientations associated with this field. The predominant categories included geriatrics, psychiatry, nursing, and palliative care, reflecting the interdisciplinary nature of non-pharmacologic dementia interventions. These alignments suggest a holistic approach integrating behavioral science, caregiving practices, and mental health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 4b shows the top 20 institutions with the most published papers. The National Institute on Aging recorded the highest number of publications with 21, followed by the National Institutes of Health and the National Health and Medical Research Council, each with 8. The National Institute of Mental Health contributed 6 publications, while ZonMw and National Institute for Health and Care Research each had 5.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCo-occurrence analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe keyword co-occurrence network, illustrated in Figure 5, reveals four distinct clusters emerging from the thematic proximity and interrelations among frequently used terms in the field. A total of 3,387 keywords were analyzed, of which 43 met the inclusion criteria. These were subsequently grouped into four clusters: Clinical and psychological dimensions (red), Demographic context (green), Methodological structure (blue), and Long-term Care (yellow).\u003c/p\u003e\n\u003cp\u003eCluster 1: Clinical and psychological dimensions (red cluster)\u003c/p\u003e\n\u003cp\u003eThe Clinical and psychological dimensions cluster (red) primarily focuses on the direct impact of dementia and NPIs on individuals. Key keywords within this cluster include \u0026quot;human,\u0026quot; \u0026quot;depression,\u0026quot; \u0026quot;anxiety,\u0026quot; \u0026quot;cognition,\u0026quot; \u0026quot;quality of life,\u0026quot; and \u0026quot;psychotherapy.\u0026quot; These terms collectively highlight the core clinical manifestations and psychological responses associated with dementia, as well as the interventions designed to address these aspects, emphasizing the patient\u0026apos;s subjective experience and well-being.\u003c/p\u003e\n\u003cp\u003eCluster 2: Demographic context (green cluster)\u003c/p\u003e\n\u003cp\u003eThe Demographic context cluster (green) centers on the characteristics of the patient population and the broader social factors influencing care. Representative keywords are \u0026quot;humans,\u0026quot; \u0026quot;aged,\u0026quot; \u0026quot;very elderly,\u0026quot; \u0026quot;nursing home,\u0026quot; and \u0026quot;homes for the aged.\u0026quot; This cluster underscores the importance of understanding the diverse demographic profiles of individuals with dementia and their caregivers, suggesting a focus on tailored interventions that consider age, cultural background, and the role of family support within the LTC environment.\u003c/p\u003e\n\u003cp\u003eCluster 3: Methodological structure (blue cluster)\u003c/p\u003e\n\u003cp\u003eThe Methodological structure cluster (blue) is concerned with the research designs and evaluation approaches employed in NPI studies. Prominent keywords include \u0026quot;article,\u0026quot; \u0026quot;clinical trial,\u0026quot; \u0026quot;controlled study,\u0026quot; and \u0026quot;randomized controlled trial.\u0026quot; This cluster reflects the scientific rigor and diverse methodologies used to assess the effectiveness and implementation of NPIs, indicating a growing emphasis on robust research designs and the translation of findings into practice.\u003c/p\u003e\n\u003cp\u003eCluster 4: Long-term care (yellow cluster)\u003c/p\u003e\n\u003cp\u003eThe Long-term Care cluster (yellow), though the smallest, centers on the theme of long-term care. This keyword emphasizes the practical aspects of NPI implementation within long-term care facilities, highlighting the crucial roles of the physical environment, trained staff, and a person-centered approach in optimizing care for residents with dementia.\u003c/p\u003e\n\u003cp\u003eIn essence, these clusters illustrate a methodologically diverse and thematically integrated landscape of research. The interplay of clinical, contextual, empirical, and systemic elements reflects a comprehensive scholarly engagement with the complexities of non-pharmacologic dementia care in long-term settings.\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003eGlobal Trends in Non-Pharmacologic Dementia Research\u003c/h2\u003e\u003cp\u003eThis bibliometric analysis reveals a consistent increase in global research output on non-pharmacologic interventions (NPIs) for dementia in long-term care (LTC) settings. The field has grown rapidly in the past decade, reflecting a shift towards person-centered and holistic care and a recognition of the limitations of pharmacological treatments (Livingston et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2017b\u003c/span\u003e). High-income countries, particularly the United States, the United Kingdom, Australia, and Germany, remain the most prolific contributors, underscoring the structural advantages of well-resourced research systems.\u003c/p\u003e\u003cp\u003eHowever, the analysis also exposes pronounced regional disparities in both publication volume and citation impact. Research from low and middle-income countries (LMICs) remains underrepresented, with many studies limited by constrained funding, fewer specialized training programs, and lower access to international collaborations (Prince et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). Despite these barriers, emerging contributions from Asia, Africa, and Latin America demonstrate innovative use of locally grounded care models, such as family-mediated reminiscence therapy and community-based engagement programs. These efforts highlight a growing awareness of how cultural values and caregiving traditions shape dementia care practices. Expanding equitable research partnerships and targeted funding initiatives will be vital to reducing this geographic imbalance and strengthening global inclusivity.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003eQuality and Status of Publications Worldwide\u003c/h2\u003e\u003cp\u003eDementia related non-pharmacological intervention (NPI) research is notably robust in high-income settings due to well-established institutional infrastructure and consistent funding, fostering a conducive environment for innovation. The United Kingdom\u0026rsquo;s high h-index and citation rates reflect both productivity and intellectual influence, while Taiwan and the Netherlands, despite their smaller publication volumes, achieve notably high citation averages. This pattern suggests that concentrated, methodologically rigorous studies may yield greater visibility and scholarly impact than high output alone (Bornmann \u0026amp; Leydesdorff, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDifferences in citation performance between regions may be attributed to several structural and contextual factors. Articles published in English-language, high-impact journals tend to attract more citations due to broader accessibility and indexing coverage (Mongeon \u0026amp; Paul-Hus, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). In contrast, research from LMICs is often published in regional or non-English outlets that receive limited international exposure. Collaboration networks tend to favor Western institutions, which boosts the visibility of authors from these academic environments (Ynalvez \u0026amp; Shrum, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Future bibliometric studies should investigate the correlation between authorship networks, funding sources, and citation practices to understand how epistemic inequities influence global recognition in dementia research.\u003c/p\u003e\u003cdiv id=\"Sec23\" class=\"Section3\"\u003e\u003ch2\u003eResearch Focus on Non-Pharmacologic Interventions\u003c/h2\u003e\u003cp\u003eThe keyword analysis revealed four primary thematic clusters: clinical and psychological interventions, demographic and residential contexts, methodological frameworks, and long-term care (LTC), illustrating how research on NPIs has become more multidimensional. Within the clinical and psychological domains, studies continue to emphasize cognitive engagement, emotional regulation, and behavioral management. Interventions such as reminiscence therapy, multisensory stimulation, and music-based programs are widely recognized for their role in improving mood, reducing agitation, and fostering social interaction (Brodaty \u0026amp; Arasaratnam, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Nevertheless, transferring these practices across diverse cultural and care contexts remains a challenge, particularly where resources, staff expertise, and institutional support vary.\u003c/p\u003e\u003cp\u003eThe demographic and residential context cluster points to growing awareness that social and environmental conditions shape both the experience of dementia and the success of NPIs. Residents in smaller, homelike facilities often demonstrate higher satisfaction, lower agitation, and more positive social engagement compared to those in institutionalized settings (Chaudhury et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). These findings highlight the significance of environmental design, social connections, and family engagement in influencing care outcomes. They also underscore disparities in the quality of long-term care, especially in low and middle-income countries with limited formal infrastructure.\u003c/p\u003e\u003cp\u003eThe field is rooted in evidence-based designs, but traditional randomized controlled trials often fail to consider the contextual complexities of long-term care (LTC) environments. Realist evaluation and implementation frameworks(Pawson et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2005\u003c/span\u003e) offer alternative approaches capable of capturing the nuanced interplay between intervention fidelity, organizational capacity, and care culture. Incorporating mixed-methods and participatory approaches may therefore yield findings that are both generalizable and adaptable to the realities of LTC settings.\u003c/p\u003e\u003cp\u003eThe long-term care cluster highlights the importance of organizational culture and workforce engagement in determining the success of interventions. NPIs implemented within supportive LTC environments where autonomy, continuity of care, and relational caregiving are valued tend to produce more sustainable and person-centered outcomes (Backhouse et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). High staff turnover, limited training, and resource shortages can reduce the effectiveness of interventions and lead to increased reliance on pharmacological management. Growing international interest in staff education, supervision, and co-designed care programs highlights a shift from intervention delivery to system-level implementation. In high-income settings, structured programs emphasizing staff well-being and communication have shown measurable improvements in resident quality of life (Howden-Chapman et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eResearch on non-pharmacological interventions (NPIs) is influencing dementia care policy and practice at a systemic level. This aligns with global guidelines advocating for person-centered, ethical, and psychosocial approaches to long-term care (Health Organization, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, the translation of evidence into policy remains uneven. Many LMICs still lack comprehensive LTC frameworks capable of integrating NPIs into everyday practice. Strengthening cross-country collaboration and supporting the professionalization of LTC workforces could bridge this gap, ensuring that person-centered approaches extend beyond isolated pilot programs into routine care delivery.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\u003ch2\u003eThematic Clustering and Emerging Research Directions\u003c/h2\u003e\u003cp\u003eThe evolution of NPI research signals a move toward more integrated, system-oriented care models that link individual interventions with broader institutional and policy dimensions. This shift aligns with the growing influence of implementation science and participatory research, both of which emphasize real-world applicability and sustainability. Conceptually, NPIs are being reframed as more than therapeutic tools; they are increasingly understood as forms of social participation and ethical caregiving that preserve identity, autonomy, and dignity in dementia care.\u003c/p\u003e\u003cp\u003eNevertheless, global participation remains uneven. Western frameworks continue to dominate scholarly discourse, often sidelining cultural and indigenous knowledge systems that could enrich care models (Durie, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). Bridging these epistemic divides will require inclusive collaboration, open-access dissemination, and equitable authorship practices. Integrating underrepresented perspectives may also improve ecological validity by ensuring interventions are contextually relevant and culturally grounded (Health Organization, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAll in all, these findings reflect a field in transition, one that is expanding in both scope and inclusivity but still marked by structural disparities. Future research should prioritize the development of inclusive networks that bridge high, middle, and low-income areas, as well as enhance the theoretical and methodological frameworks for assessing non-pharmaceutical interventions (NPIs). Through sustained collaboration and shared global engagement, dementia care research can evolve toward a more balanced, contextually sensitive, and culturally responsive foundation.\u003c/p\u003e\u003cdiv id=\"Sec25\" class=\"Section3\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThis study has several important limitations that need to be acknowledged. First, it used quantitative bibliometric methods to review publications on non-pharmacologic interventions for dementia. The analysis concentrated on publication data, including author details, citations, and keywords, rather than assessing the research findings or intervention outcomes. As a result, while the study provides insight into overall research trends, it does not assess the effectiveness or quality of the interventions discussed.\u003c/p\u003e\u003cp\u003eAnother important consideration is that this study relied exclusively on documents indexed in the Scopus database. While Scopus is a widely used and robust source of academic literature, depending on a single database may introduce bias. Relevant articles from other databases or region-specific journals could have been excluded from the analysis. Future bibliometric studies should consider triangulating multiple databases such as Web of Science and PubMed, to ensure broader coverage and reduce potential bias in mapping research trends.\u003c/p\u003e\u003cp\u003eIn addition, the review focused mainly on English-language publications. This language constraint may have excluded research conducted in other languages, particularly studies from non-English-speaking countries that could offer diverse perspectives or locally grounded insights into dementia care.\u003c/p\u003e\u003cp\u003eDespite our careful efforts to define screening criteria, some relevant literature may have been missed. The broad nature of dementia care and non-pharmacologic research means that certain interdisciplinary or context-specific studies may have been overlooked, especially if their keywords did not align with the search parameters.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study not only highlights the growing global attention and expanding research on non-pharmacologic interventions, but also successfully achieves its aims of mapping global research trends, identifying leading contributors, and exploring thematic and geographic concentrations of non-pharmacologic interventions (NPIs) for dementia in long-term care (LTC) settings. The findings reveal a rapidly expanding body of literature, particularly over the past decade, reflecting the increasing global recognition of NPIs as vital components of dementia care. The United States and the United Kingdom remain dominant in publication volume and impact, with emerging contributions from Asia and other regions indicating a growing international engagement. Thematic analysis highlighted four major domains clinical and psychological dimensions, demographic contexts, methodological rigor, and systemic challenges within LTC environments providing an integrated understanding of the evolving landscape of NPI research.\u003c/p\u003e\u003cp\u003eMoving forward, strengthening interdisciplinary collaboration and ensuring greater participation of low and middle-income countries will be essential to advancing equitable, culturally sensitive, and person-centered dementia care worldwide. Such inclusive approaches can bridge existing research disparities and align global NPI research efforts with the principles of sustainability and social justice.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e: This manuscript does not contain any studies with human participants or animals performed by any of the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent:\u003c/strong\u003e This manuscript does not contain any individual person\u0026rsquo;s data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: No funding was received for conducting this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003e The authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions:\u003c/strong\u003e Cressy Alana Actie is the lead author of this manuscript and was responsible for the conceptualization, design, analysis, and overall development of the study. Hung-En Liao made a major contribution by leading the editing and final revision of the manuscript. Fu-Gong Lin provided academic guidance and reviewed the manuscript. Bing-Long Wang contributed to the study design and discussion. Yu-Ni Huang contributed to the study design and data analysis. Francis Sarial Ganancial, Nidhi, and Aruna A. C. supported the research during its initial organization and planning. All authors read and approved the final version of the manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData is provided within the manuscript.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors wish to thank Asia University, Taiwan, and its library services for providing access to the Scopus database, which made this research possible. The authors are grateful to Professor Dr. Kuan-Han Lin, Ph.D., of Asia University, Taiwan, for her constructive feedback and guidance, which enhanced the rigor of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;No external funding was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The authors declare no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;This study was based on publicly available published research. Ethical approval was therefore not required.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbraha, I., Rimland, J. M., Trotta, F. M., Dell\u0026rsquo;Aquila, G., Cruz-Jentoft, A., Petrovic, M., Gudmundsson, A., Soiza, R., O\u0026rsquo;Mahony, D., Guaita, A., \u0026amp; Cherubini, A. (2017). Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. \u003cem\u003eBMJ Open\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(3), e012759. https://doi.org/10.1136/BMJOPEN-2016-012759\u003c/li\u003e\n\u003cli\u003eAria, M., \u0026amp; Cuccurullo, C. (2017). bibliometrix: An R-tool for comprehensive science mapping analysis. \u003cem\u003eJournal of Informetrics\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(4), 959\u0026ndash;975. https://doi.org/10.1016/J.JOI.2017.08.007\u003c/li\u003e\n\u003cli\u003eBackhouse, T., Jeon, Y. H., Killett, A., \u0026amp; Mioshi, E. (2022). How do family carers and care-home staff manage refusals when assisting a person with advanced dementia with their personal care? \u003cem\u003eDementia\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(8), 2458\u0026ndash;2475. https://doi.org/10.1177/14713012221123578\u003c/li\u003e\n\u003cli\u003eBornmann, L., \u0026amp; Leydesdorff, L. (2013). The validation of (advanced) bibliometric indicators through peer assessments: A comparative study using data from InCites and F1000. \u003cem\u003eJournal of Informetrics\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(2), 286\u0026ndash;291.\u003c/li\u003e\n\u003cli\u003eBrodaty, H., \u0026amp; Arasaratnam, C. (2012). Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. \u003cem\u003eAmerican Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e169\u003c/em\u003e(9), 946\u0026ndash;953.\u003c/li\u003e\n\u003cli\u003eChaudhury, H., Cooke, H. A., Cowie, H., \u0026amp; Razaghi, L. (2018). The Influence of the Physical Environment on Residents With Dementia in Long-Term Care Settings: A Review of the Empirical Literature. \u003cem\u003eThe Gerontologist\u003c/em\u003e, \u003cem\u003e58\u003c/em\u003e(5), e325\u0026ndash;e337. https://doi.org/10.1093/GERONT/GNW259\u003c/li\u003e\n\u003cli\u003eChen, C. (2006). CiteSpace II: Detecting and visualizing emerging trends and transient patterns in scientific literature. \u003cem\u003eJournal of the American Society for Information Science and Technology\u003c/em\u003e, \u003cem\u003e57\u003c/em\u003e(3), 359\u0026ndash;377. https://doi.org/10.1002/ASI.20317;PAGEGROUP:STRING:PUBLICATION\u003c/li\u003e\n\u003cli\u003eChen, C. (2018). Visualizing and exploring scientific literature with citespace an introduction to a half-day tutorial. \u003cem\u003eCHIIR 2018 - Proceedings of the 2018 Conference on Human Information Interaction and Retrieval\u003c/em\u003e, \u003cem\u003e2018-March\u003c/em\u003e, 369\u0026ndash;370. https://doi.org/10.1145/3176349.3176897;PAGE:STRING:ARTICLE/CHAPTER\u003c/li\u003e\n\u003cli\u003eChenoweth, L., King, M. T., Jeon, Y. H., Brodaty, H., Stein-Parbury, J., Norman, R., Haas, M., \u0026amp; Luscombe, G. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. \u003cem\u003eThe Lancet Neurology\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(4), 317\u0026ndash;325. https://doi.org/10.1016/S1474-4422(09)70045-6\u003c/li\u003e\n\u003cli\u003eCobo, M. J., L\u0026oacute;pez-Herrera, A. G., Herrera-Viedma, E., \u0026amp; Herrera, F. (2011). Science mapping software tools: Review, analysis, and cooperative study among tools. \u003cem\u003eWiley Online LibraryMJ Cobo, AG L\u0026oacute;pez‐Herrera, E Herrera‐Viedma, F HerreraJournal of the American Society for Information Science and Technology, 2011\u0026bull;Wiley Online Library\u003c/em\u003e, \u003cem\u003e62\u003c/em\u003e(7), 1382\u0026ndash;1402. https://doi.org/10.1002/ASI.21525\u003c/li\u003e\n\u003cli\u003eDurie, M. (2004). Understanding health and illness: research at the interface between science and indigenous knowledge. \u003cem\u003eInternational Journal of Epidemiology\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(5), 1138\u0026ndash;1143. https://doi.org/10.1093/IJE/DYH250\u003c/li\u003e\n\u003cli\u003eFalagas, M. E., Pitsouni, E. I., Malietzis, G. A., \u0026amp; Pappas, G. (2008). Comparison of PubMed, Scopus, web of science, and Google scholar: strengths and weaknesses. \u003cem\u003eWiley Online LibraryME Falagas, EI Pitsouni, GA Malietzis, G PappasThe FASEB Journal, 2008\u0026bull;Wiley Online Library\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(2), 338\u0026ndash;342. https://doi.org/10.1096/FJ.07-9492LSF\u003c/li\u003e\n\u003cli\u003eGitlin, L. N., Kales, H. C., \u0026amp; Lyketsos, C. G. (2012). Nonpharmacologic Management of Behavioral Symptoms in Dementia. \u003cem\u003eJAMA\u003c/em\u003e, \u003cem\u003e308\u003c/em\u003e(19), 2020\u0026ndash;2029. https://doi.org/10.1001/JAMA.2012.36918\u003c/li\u003e\n\u003cli\u003eHealth Organization, W. (2021). \u003cem\u003eGlobal status report on the public health response to dementia\u003c/em\u003e. http://apps.who.int/\u003c/li\u003e\n\u003cli\u003eHowden-Chapman, P., Bennett, J., Edwards, R., Jacobs, D., Nathan, K., \u0026amp; Ormandy, D. (2023). Review of the Impact of Housing Quality on Inequalities in Health and Well-Being. \u003cem\u003eAnnual Review of Public Health\u003c/em\u003e, \u003cem\u003e44\u003c/em\u003e(Volume 44, 2023), 233\u0026ndash;254. https://doi.org/10.1146/ANNUREV-PUBLHEALTH-071521-111836/CITE/REFWORKS\u003c/li\u003e\n\u003cli\u003eKochovska, S., Garcia, M. V., Bunn, F., Goodman, C., Luckett, T., Parker, D., Phillips, J. L., Sampson, E. L., van der Steen, J. T., \u0026amp; Agar, M. R. (2020). Components of palliative care interventions addressing the needs of people with dementia living in long-term care: A systematic review. \u003cem\u003ePalliative Medicine\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e(4), 454\u0026ndash;492. https://doi.org/10.1177/0269216319900141/ASSET/16155FD5-0C42-413F-92BE-F91ADEA42829/ASSETS/IMAGES/LARGE/10.1177_0269216319900141-FIG1.JPG\u003c/li\u003e\n\u003cli\u003eLivingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., Cooper, C., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Larson, E. B., Ritchie, K., Rockwood, K., Sampson, E. L., \u0026hellip; Mukadam, N. (2017a). Dementia prevention, intervention, and care. \u003cem\u003eThe Lancet\u003c/em\u003e, \u003cem\u003e390\u003c/em\u003e(10113), 2673\u0026ndash;2734. https://doi.org/10.1016/S0140-6736(17)31363-6\u003c/li\u003e\n\u003cli\u003eLivingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., Cooper, C., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Larson, E. B., Ritchie, K., Rockwood, K., Sampson, E. L., \u0026hellip; Mukadam, N. (2017b). Dementia prevention, intervention, and care. \u003cem\u003eThe Lancet\u003c/em\u003e, \u003cem\u003e390\u003c/em\u003e(10113), 2673\u0026ndash;2734. https://doi.org/10.1016/S0140-6736(17)31363-6\u003c/li\u003e\n\u003cli\u003eMart\u0026iacute;n-Mart\u0026iacute;n, A., Orduna-Malea, E., Thelwall, M., \u0026amp; Delgado L\u0026oacute;pez-C\u0026oacute;zar, E. (2018). Google Scholar, Web of Science, and Scopus: A systematic comparison of citations in 252 subject categories. \u003cem\u003eJournal of Informetrics\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(4), 1160\u0026ndash;1177. https://doi.org/10.1016/J.JOI.2018.09.002\u003c/li\u003e\n\u003cli\u003eMongeon, P., \u0026amp; Paul-Hus, A. (2016). The journal coverage of Web of Science and Scopus: a comparative analysis. \u003cem\u003eSpringerP Mongeon, A Paul-HusScientometrics, 2016\u0026bull;Springer\u003c/em\u003e, \u003cem\u003e106\u003c/em\u003e(1), 213\u0026ndash;228. https://doi.org/10.1007/S11192-015-1765-5\u003c/li\u003e\n\u003cli\u003eNichols, E., Steinmetz, J. D., Vollset, S. E., Fukutaki, K., Chalek, J., Abd-Allah, F., Abdoli, A., Abualhasan, A., Abu-Gharbieh, E., Akram, T. T., Al Hamad, H., Alahdab, F., Alanezi, F. M., Alipour, V., Almustanyir, S., Amu, H., Ansari, I., Arabloo, J., Ashraf, T., \u0026hellip; Vos, T. (2022). Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. \u003cem\u003eThe Lancet Public Health\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(2), e105\u0026ndash;e125. https://doi.org/10.1016/S2468-2667(21)00249-8/ATTACHMENT/60E03FD1-38B2-4B40-A91D-9AFDDA22B45E/MMC1.PDF\u003c/li\u003e\n\u003cli\u003eOh, H., White, E. M., Muench, U., Santostefano, C., Thapa, B., Kosar, C., Gadbois, E. A., Osakwe, Z. T., Gozalo, P., \u0026amp; Rahman, M. (2023). Advanced practice clinician care and end-of-life outcomes for community- and nursing home-dwelling Medicare beneficiaries with dementia. \u003cem\u003eAlzheimer\u0026rsquo;s \u0026amp; Dementia\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(9), 3946\u0026ndash;3964. https://doi.org/10.1002/ALZ.13052\u003c/li\u003e\n\u003cli\u003eOrganization, W. H. (2021). Global status report on the public health response to dementia. \u003cem\u003eSecurity Research Hub Reports\u003c/em\u003e. https://digitalcommons.fiu.edu/srhreports/health/health/65\u003c/li\u003e\n\u003cli\u003ePawson, R., Greenhalgh, T., Harvey, G., \u0026amp; Walshe, K. (2005). Realist review - A new method of systematic review designed for complex policy interventions. \u003cem\u003eJournal of Health Services Research and Policy\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(SUPPL. 1), 21\u0026ndash;34. https://doi.org/10.1258/1355819054308530;CTYPE:STRING:JOURNAL\u003c/li\u003e\n\u003cli\u003ePrince, M., Acosta, D., Albanese, E., Arizaga, R., Ferri, C. P., Guerra, M., Huang, Y., Jacob, K. S., Jimenez-Velazquez, I. Z., Rodriguez, J. L., Salas, A., Sosa, A. L., Sousa, R., Uwakwe, R., Van Der Poel, R., Williams, J., \u0026amp; Wortmann, M. (2008). Ageing and dementia in low and middle income countries\u0026ndash;Using research to engage with public and policy makers. \u003cem\u003eInternational Review of Psychiatry\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(4), 332\u0026ndash;343. https://doi.org/10.1080/09540260802094712\u003c/li\u003e\n\u003cli\u003eSteen, J. T. van der, Klapwijk, M. S., \u0026amp; Achterberg, W. P. (2020). Palliative care and impact of the COVID-19 pandemic on nursing home residents with dementia. \u003cem\u003eRivista Italiana Di Cure Palliative\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(3), 129\u0026ndash;139. https://doi.org/10.1726/3439.34275\u003c/li\u003e\n\u003cli\u003eThelwall, M., \u0026amp; Maflahi, N. (2020). Academic collaboration rates and citation associations vary substantially between countries and fields. \u003cem\u003eJournal of the Association for Information Science and Technology\u003c/em\u003e, \u003cem\u003e71\u003c/em\u003e(8), 968\u0026ndash;978. https://doi.org/10.1002/ASI.24315;WEBSITE:WEBSITE:ASISTDL;REQUESTEDJOURNAL:JOURNAL:23301643;WGROUP:STRING:PUBLICATION\u003c/li\u003e\n\u003cli\u003eVan Der Ploeg, E. S., Eppingstall, B., Camp, C. J., Runci, S. J., Taffe, J., \u0026amp; O\u0026rsquo;Connor, D. W. (2013). A randomized crossover trial to study the effect of personalized, one-to-one interaction using Montessori-based activities on agitation, affect, and engagement in nursing home residents with Dementia. \u003cem\u003eInternational Psychogeriatrics\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(4), 565\u0026ndash;575. https://doi.org/10.1017/S1041610212002128\u003c/li\u003e\n\u003cli\u003evan Eck, N. J., \u0026amp; Waltman, L. (2009). Software survey: VOSviewer, a computer program for bibliometric mapping. \u003cem\u003eScientometrics\u003c/em\u003e, \u003cem\u003e84\u003c/em\u003e(2), 523\u0026ndash;538. https://doi.org/10.1007/S11192-009-0146-3\u003c/li\u003e\n\u003cli\u003evan Eck, N. J., \u0026amp; Waltman, L. (2017). Citation-based clustering of publications using CitNetExplorer and VOSviewer. \u003cem\u003eSpringerNJ Van Eck, L WaltmanScientometrics, 2017\u0026bull;Springer\u003c/em\u003e, \u003cem\u003e111\u003c/em\u003e(2), 1053\u0026ndash;1070. https://doi.org/10.1007/S11192-017-2300-7\u003c/li\u003e\n\u003cli\u003eYnalvez, M. A., \u0026amp; Shrum, W. M. (2011). Professional networks, scientific collaboration, and publication productivity in resource-constrained research institutions in a developing country. \u003cem\u003eResearch Policy\u003c/em\u003e, \u003cem\u003e40\u003c/em\u003e(2), 204\u0026ndash;216. https://doi.org/10.1016/j.respol.2010.10.004\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Bibliometric Analysis, Dementia, Global Research Trends, Long-Term Care, Non-Pharmacologic Interventions, VOS viewer","lastPublishedDoi":"10.21203/rs.3.rs-7967273/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7967273/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective:\u003c/h2\u003e\u003cp\u003eTo analyze global research on non-pharmacologic interventions for dementia in long-term care settings using bibliometric methods and to identify research hotspots, intellectual structures, and emerging thematic trends.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eData were retrieved from the Scopus database on May 29, 2025. A total of 424 eligible publications from 1990 to 2024 were included. VOSviewer (v1.6.20) was used to construct co-authorship networks, keyword co-occurrence maps, and institutional collaboration visualizations. Microsoft Excel 2019 was employed to visualize annual publication trends and citation metrics.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eThe number of publications related to NPIs for dementia in LTC has steadily increased over the past three decades. The most frequently occurring keywords included \u0026ldquo;music therapy,\u0026rdquo; \u0026ldquo;cognitive behavioral therapy,\u0026rdquo; and \u0026ldquo;long-term care.\u0026rdquo; Four thematic clusters emerged: psychological interventions, residential care environments, methodological design, and long-term care. The United States led in publication output, while the United Kingdom had the highest citation impact and H-index. Taiwan and the Netherlands also demonstrated high citation averages, indicating influential research. Leading journals included \u003cem\u003eAging and Mental Health\u003c/em\u003e and the \u003cem\u003eJournal of Music Therapy\u003c/em\u003e, while top contributing institutions were the National Institute on Aging and the National Institutes of Health.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e\u003cp\u003eResearch on non-pharmacologic dementia interventions in LTC settings is gaining global momentum. Key areas of focus include behavioral therapies, sensory stimulation, and institutional care practices. However, gaps remain in culturally sensitive interventions and contributions from underrepresented regions. Future studies should prioritize equitable representation, interdisciplinary collaboration, and scalable models of care to enhance the real-world applicability of non-pharmacologic dementia strategies.\u003c/p\u003e","manuscriptTitle":"Global Research Trends on Non-Pharmacologic Interventions for Dementia in Long-Term Care Settings: A Bibliometric Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-30 06:09:48","doi":"10.21203/rs.3.rs-7967273/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"75d71a32-2518-4a98-8025-fcec6a9a4bfa","owner":[],"postedDate":"October 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-21T15:24:02+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-30 06:09:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7967273","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7967273","identity":"rs-7967273","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}