International Journal of Geriatric Psychiatry, 34(9), 2019, pp.1308-1315.
Publisher:
Wiley
... therapies. Results: The DT group showed significant improvements in agitation, irritability, apathy, depression, and delusions relative to controls. The GVT group showed significant improvements in apathy and depression with respect to controls. The DT intervention ameliorated symptoms of agitation compared to the GVT intervention whereas the GVT intervention improved apathy compared to the DT
(Edited publisher abstract)
Background: The prevalence of neuropsychiatric symptoms (NPS) diminishes the quality of life and increases the care burden in patients with dementia. Despite the clinical importance of dementia‐associated NPS, no protocols for treating NPS are already well established. Attention has turned to the effectiveness of nonpharmacological treatments for NPS since their potential safe alternative to pharmacotherapy. Objective: This study is aimed to compare the effects in older individuals with dementia living in a residential care, of two intervention programs, the gesture‐verbal treatment (GVT), a treatment implemented by us on a previous method for word retrieval in individuals with aphasia, and the better‐known doll therapy (DT). The GVT would act on both receptive and expressive language skills, the DT on attachment and emotional connections. Methods: We evaluated NPS by the neuropsychiatric inventory in a total of 30 patients divided into 3 groups, the GVT, the DT, and control groups, using a pre‐post design. The treatment groups completed 12‐week nonpharmacological interventions in addition to standard rehabilitative therapies, while the control group participated only in standard rehabilitative therapies. Results: The DT group showed significant improvements in agitation, irritability, apathy, depression, and delusions relative to controls. The GVT group showed significant improvements in apathy and depression with respect to controls. The DT intervention ameliorated symptoms of agitation compared to the GVT intervention whereas the GVT intervention improved apathy compared to the DT intervention. Conclusion: Improved understanding of the potential therapeutic benefits of different treatments for neuropsychiatric symptoms is crucial for establishing nonpharmacological interventions in dementia.
(Edited publisher abstract)
International Journal of Geriatric Psychiatry, 25(7), July 2010, pp.725-731.
Publisher:
Wiley
Agitation is commonly observed in most dementia syndromes. The aim of this exploratory study was to compare the severity of agitation and psychotropic drug use in nursing homes with different organisations and structures in 3 different countries. Baseline data for 3 different intervention studies in Austria (n = 38), England (n = 302) and Norway (n = 163) were combined posthoc for analytical purposes. Patients were grouped according to their dementia severity using the global deterioration scale (GDS), functional assessment staging (FAST) and clinical dementia rating (CDR) scales. For the measurement of agitation, the Cohen-Mansfield Agitation Inventory (CMAI) was used. Data analysis was performed using one-way ANOVA, multivariate and linear regression analysis. The results showed that CMAI scores were available for 503 subjects with dementia. There were significant differences between the nursing home residents in the 3 countries regarding age, gender and dementia severity. In the multivariate analyses, the level of agitation differed with higher mean scores in the Austrian compared to UK and Norwegian nursing homes. Similarly, the use of psychotropic drugs differed significantly, with a higher proportion of neuroleptics in UK and Austrian compared to Norwegian nursing homes. The article concludes that there are differences in agitation and antipsychotic drug use which are likely related to structural and cultural differences in nursing homes in these 3 European countries. These findings suggest that structural changes can improve quality of care and quality of life for nursing home
Agitation is commonly observed in most dementia syndromes. The aim of this exploratory study was to compare the severity of agitation and psychotropic drug use in nursing homes with different organisations and structures in 3 different countries. Baseline data for 3 different intervention studies in Austria (n = 38), England (n = 302) and Norway (n = 163) were combined posthoc for analytical purposes. Patients were grouped according to their dementia severity using the global deterioration scale (GDS), functional assessment staging (FAST) and clinical dementia rating (CDR) scales. For the measurement of agitation, the Cohen-Mansfield Agitation Inventory (CMAI) was used. Data analysis was performed using one-way ANOVA, multivariate and linear regression analysis. The results showed that CMAI scores were available for 503 subjects with dementia. There were significant differences between the nursing home residents in the 3 countries regarding age, gender and dementia severity. In the multivariate analyses, the level of agitation differed with higher mean scores in the Austrian compared to UK and Norwegian nursing homes. Similarly, the use of psychotropic drugs differed significantly, with a higher proportion of neuroleptics in UK and Austrian compared to Norwegian nursing homes. The article concludes that there are differences in agitation and antipsychotic drug use which are likely related to structural and cultural differences in nursing homes in these 3 European countries. These findings suggest that structural changes can improve quality of care and quality of life for nursing home residents.