Doll therapy for improving behavior, psychology and cognition among older nursing home residents with dementia: A systematic review and meta-analysis

•Dementia is associated with the appearance of behavioral and psychological symptoms and varying degrees of deterioration in cognitive function among older nursing home residents.•The DT process is advocated as a cost-efficient, sustainable and safe approach to ameliorate behavioral and psychological disturbances among older nursing home residents with dementia.•Administering empathy dolls and coordinating with caregivers may be the most appropriate and effective approach. To explore the effectiveness of doll therapy (DT) on behavior, psychology and cognition among older nursing home residents with dementia. A systematic review and meta-analysis was conducted. Subgroup analyses were performed to determine whether the intervention characteristics influenced effect sizes. Ten studies met the inclusion criteria and were selected for qualitative and quantitative synthesis. The overall methodological quality was relatively high. DT significantly improved all behaviors [SMD=-0.42, P=0.01], including agitation [SMD=-0.94, P