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Non‐pharmacological treatment reducing not only behavioral symptoms, but also psychotic symptoms of older adults with dementia: A prospective cohort study in T aiwan
Author(s) -
Chen RueChuan,
Liu ChienLiang,
Lin MingHsien,
Peng LiNing,
Chen LiangYu,
Liu LiKuo,
Chen LiangKung
Publication year - 2014
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12126
Subject(s) - medicine , dementia , tinetti test , prospective cohort study , activities of daily living , geriatric depression scale , cohort , psychological intervention , mini–mental state examination , delusion , psychiatry , physical therapy , cognition , depressive symptoms , gait , disease
Aim The clinical effectiveness of non‐pharmacological interventions on behavioral and psychological symptoms of dementia ( BPSD ) among older C hinese with dementia remains unclear, and the evidence supporting the benefits of a non‐pharmacological approach on psychotic symptoms is scarce. Methods A prospective cohort study including 104 older men with dementia living in two veterans homes in T aiwan was carried out in 2011. An organized program of music therapy, orientation training, art‐cognitive activities and physical activities was carried out for the intervention group. All participants were evaluated for neuropsychiatric inventory (NPI), defined daily dose of psychotropic drug use, B arthel I ndex, I nstrumental A ctivities of D aily L iving, M ini‐ M ental S tate E xamination, G eriatric D epression S cale, T inetti balance score and T inetti gait score. Results Overall, 104 residents were enrolled and 92 of them completed the study. The intervention group had a more significant reduction than the reference group in the overall NPI score (−2.36, P = 0.046), and in the subcategories of delusion (−0.9, P = 0.018), hallucination (−0.82, P = 0.004) and agitation (−0.91, P = 0.038). Multivariate analysis showed that the non‐pharmacological intervention was associated with a favorable outcome in overall NPI score ( OR 4.113, P = 0.013) and in the subcategories of hallucination ( OR 14.309, P = 0.049) and agitation ( OR 6.604, P = 0.037). Meanwhile, a higher baseline NPI score was also associated with a favorable outcome in overall NPI score, and in the subcategories of delusion, hallucination and agitation. Conclusion Non‐pharmacological interventions have a positive effect on behavioral and psychological symptoms of dementia, not only in outward symptoms like agitation, but also intrinsic psychotic symptoms like hallucination and delusion, and agitation in older Chinese men with dementia. Geriatr Gerontol Int 2013; 14: 440–446.