**3. Cognitive and emotion-oriented interventions**

Cognitive and emotion-oriented care approach seeks to improve cognitive, emotional and social functioning by supporting patients with dementia [36]. The treatments commonly used are reminiscence therapy, reality orientation therapy and validation therapy.

#### **3.1. Reminiscence therapy**

Reminiscence therapy is a common and widely diffused intervention in dementia care although based on a few high-quality and sufficiently robust studies. Two studies explored group reminiscence [37, 38]. A study evaluated effects on neuropsychiatric and cognitive symptoms [37]. Another reminiscence group intervention [38] evaluated effectiveness in preventing cognitive impairment progression and enhancing affective function. The results showed improvement in most variables including cognition and depression than controls.

#### **3.2. Reality orientation therapy**

Reality orientation (RO) is a technique of cognitive stimulation [39, 40]. It entails presenting the patient by continuous memory and orientation information associated with personal environment and issues. Several methods of implementing RO have been explained [40–42]. Throughout the treatment sessions, the patient is supported to talk about various arguments linked to his daily routine and recent events. Encouraging the patient to connect socially is a very significant component of the therapy [40, 42, 43]. Following the first publication of a review about RO, interest in the subject increased dramatically and most subsequent articles reported substantial benefits following the use of these strategies [40, 42, 44].

RO focuses on new cognitive stimulation strategies emerged in recent studies. The cognitive stimulation therapy (CST) is an example [40, 45]. Beyond the features assessed in RO, the CST is based also on multi-sensory stimulation and reminiscence [40, 44, 46].

Some reviews about RO confirmed earlier findings of substantial benefits and also identified existing and new areas where further work is required [39–41].

#### **3.3. Validation therapy**

The validation therapy (VT) was developed stages: to address the shortcomings of other approaches, such as RO, in approaching patients who have more advanced dementia. The VT was the result of an attempt to provide practical solutions for difficulties experienced by patients and caregivers.

Important characteristics of VT include: means of classifying behaviours, provision of simple, practical techniques that help restore dignity, provision of an empathic listener, respect and empathy for older adults with dementia and acceptance of the person's reality [47].

The way in which these rules are applied to provide specific interventions depends on the dementia severity categorized into mal orientation, time confusion, repetitive motion and vegetation. Each stage is recognized through defined cognitive and behavioural features and defined VT interventions address the various cognitive and neuropsychiatric characteristics showed by dementia people at each stage [47]. Various observational studies have indicated that the application of VT determine positive effects about amount and duration of interactions that participants are able to make during validation groups session [48, 49]. Though, other studies showed no significant effects of VT [50].
