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- QUESTION
In people with advanced dementia, is there evidence to suggest that non pharmacological methods, when compared with pharmacological methods, reduces the incidence of challenging behaviours in residential care facilities?
| Subject | Nursing | Pages | 30 | Style | APA |
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Answer
Evidence Of Effectiveness Of Non-Pharmacological Therapy Inventions In Reducing The Incidence Of Challenging Behaviours In Residential Care Facilities For People With Dementia
Introduction
Introduction to the Review
Studies that have examined aggression in people with dementia characteristically define aggression in terms of various physical and/or verbal behaviours. Approximations of the incidence and prevalence of aggression in people who are mentally impaired vary significantly from one study to another possibly because of differences in the definition of aggression along with how aggression was measured. The approximations vary between 13 and 86% (Forbes et al. 2015; Choi et al. 2009; Han et al. 2016). Aggressive bevahiours have been shown to have severe implications for individuals with dementia as well as their caregivers because it increases burden and distress for caregivers (Huang et al. 2015; Staedtler & Nunez, 2015; Testad et al. 2014). Additionally, about 50% of nursing assistants have been reported to have been injured during occupant assaults (Raglio et al. 2010; Pariente et al. 2012; Petersen et al. 2017; Pieper et al. 2013). Residents may as well be at risk of suffering injuries when involved in aggressive behaviours (Han et al. 2016; Spector et al. 2013; Strøm et al. 2016). Aggressive inhabitants within long-care amenities may be labeled as “combative” or “difficult,” which can lead to social isolation as well as modifications in care provision that can ultimately exacerbate problems. Husebo et al. (2011) and Randall and Clissett (2016) add that due to the aversive nature surrounding working with patients that is usually hostile, the association between patients and their caregivers is often compromised, thus decreasing the quality of life for the two parties.
Another implication of aggression regards administration of medication to manage the challenge. Typically, the treatment of aggression has been by use of atypical or conventional antipsychotic therapies. Studies have shown that these treatment options produce just self-effacing paybacks in people with dementia as well as carry substantial harms, like increased exacerbation of cognitive decline, stroke, and increased risks of death (Cameron et al. 2011; Randall & Clissett 2016; Sánchez et al. 2013; Scherder et al. 2010). Excessive sedation is equally common consequences linked with antipsychotic treatment and these adverse repercussions can lead to a decline in a person’s behavioural repertoire with regard to language impairment, cause of gait disturbance that can lead to falls, reduction of one’s potential to access preferred activities/events, and cause of further cognitive decline or confusion (Raglio et al. 2010; Spector et al. 2013; Trahan et al. 2014).
Recommended management for people with dementia-linked agitation along with other behavioural symptoms are pharmacotherapy and non-pharmacological interventions. The American, Canadian and British Geriatrics Societies recommend non-pharmacotherapy interventions as the number one approach in the management of dementia-linked agitation. Nonetheless, in emergency conditions when non-pharmacotherapy intervention is not feasible as a result of an impending harm to patient’s health and safety, drug therapies are recommended as the number one treatment therapy.
Some research have indicated that non-pharmacological interventions pose fewer side effects, while at the same time rendering them as safer treatment options (Kales et al. 2012; Petersen et al. 2017; Pieper et al. 2013). Non-pharmacological interventions, like music therapy, aromatherapy, reality orientation, behavioral therapy, art therapy, physical exercises and tailored activities, have revealed promising results for BPSD management (Huang et al. 2015; Husebo et al. 2011; Hussey et al. 2014). It is on this background that this review answers the question: “In people with advanced dementia, is there evidence to suggest that non-pharmacological methods, when compared with pharmacological methods, reduces the incidence of challenging behaviours in residential care facilities?”
Background
Dementia refers to a neuropsychiatric syndrome that is characterized by mental decline along with progressive worsening of a person’s daily function, usually linked with behavioural disturbances (Kales et al. 2012; Tuohy et al. 2015; Zimmerman et al. 2013). Currently, the pervasiveness of dementia in aged individuals is reported to be approximately 6% globally and, with the worldwide population continuing to age, this prevalence is expected to rise despite some recent researches have shown decreasing trends in the frequency of dementia (Forbes et al. 2015; Pariente et al. 2012; increased risks of death (Cameron et al. 2011; Randall & Clissett 2016; Sánchez et al. 2013; Scherder et al. 2010; Schneider et al. 2011). Among the most common forms of dementia in older individuals is Alzheimer's disease (AD), which is accounting for about 60% of cases (Hussey et al. 2014; Zimmerman et al. 2014).
About 80% of patients with dementia will develop psychological and behavioural symptoms in dementia (BPSD) whenever affected by a disease (Choi et al., 2009). BPSD refers to symptoms and signs of distributed mood, thought, behavior, perception, or mood (Kales et al. 2014; Kales et al. 2015). These disturbances (elation, depression, agitation, hallucinations and delusions) are strongly associated with one another (Livingston et al. 2014).
Presently, options that are available for treating and managing BPSD include non-pharmacological and pharmacological therapies (Millán-Calenti et al. 2016). Psychotropic treatments are usually used in reducing the severity as well as frequency of BPSD, however in most patients, they give just modest symptom control (Kales et al. 2014). A recent experiment showed that an addition of citalopram to psychosocial treatment and/or support substantially minimized caregiver distress and agitation (Kales et al. 2015; Sánchez et al. 2013; Schneider et al. 2011; Seitz et al. 2012; Zimmerman et al. 2014). Nonetheless, there adverse impacts are problematic and common, especially the increased danger of fractures and falls, stroke and even death (Ballard et al. 2009). Additionally, there is some proof that the employment of benzodiazepines in the treatment and management of agitation in patients suffering from dementia may raise the patients’ cognitive decline (Millán-Calenti et al. 2016) and may as well expose patients to some instant dangers of harmful falls (Livingston et al. 2014; Zimmerman et al. 2013). Lastly, cholinesterase and memantine inhibitors are regarded to be of very restricted value to better agitation in people with AD (Lowery et al. 2014).
Generally, non-pharmacological interventions are regarded as a preferable alternative to psychotropic pharmacotherapy for medicating or treating BPSD (Ballard et al. 2009; Trahan et al. 2014). Nonetheless, there are conflicting proof regarding the practicality and efficacy of non-pharmacological therapies or interventions to better BPSD, especially agitation (Kales et al. 2012).
Aim and Purpose of This Review
The aim of this review is to determine whether in people with advanced dementia, there is proof to suggest that non-pharmacological methods, when compared with pharmacological methods, reduces the incidence of challenging behaviours in residential care facilities.
The purpose of this present review is to evaluate evidence backing up these non-pharmacological methods with the aim of providing a working collection for non-pharmacological treatment and management of BPSD.
Methodology
Search for Evidence
The researchers systematically searched CINAHL, PubMed, the Cochrane Database of Systematic Reviews, Embase, and PsycINFO databases using various keywords, like dementia, behavioral symptoms, psychological symptoms, and non-pharmacological interventions. Only literatures that were published between 2009 and 2019 were selected for the review. The chosen literatures’ abstracts were assessed based on whether (1) a publication was defined as meta-analysis or review; and (2) the publication employed any kind of non-pharmacological therapy or intervention to manage behavioural disorder in people suffering from dementia.
Inclusion Criteria
To be included in this review, literatures that were written in English and had appropriate descriptions of the study design, like interventional studies, clinical trials, or clinical studies were considered.
After choosing as well as analyzing the literatures in accordance with to the afore-mentioned criteria, various variables were obtained and organized. The variables included: (1) Overview: authors, publication years, and study design employed; (2) demographic: total sample and location; and (3) evaluation of BPSD. A critical evaluation was carried out to investigate the reaction of patients who presented with diverse signs and symptoms of BPSD to various non-pharmacological approaches.
Additionally, full-texts of pertinent abstracts were gotten and careened to recognize systematic reviews of interest based upon (1) the employment of at least a medical literature database; (2) the employment of at least a non-pharmacological intervention to manage behavioural disturbances in individuals aged 60 years and above; and (3) the inclusion of at least a primary study. An assessment of the methodological quality of each of the systematic reviews was done using the A Measurement Tool to Assess Reviews (AMSTAR) instrument.
Results
The search strategy indentified a total of 4,392 abstracts out of which 2,549 were found to be duplicates and were removed subsequently. After screening of the abstracts, 67 studies were identified for full-text evaluation. Out of the 67, 38 reviews were included in this present review. From these systematic reviews, 20 studies did meet the inclusion criteria and were considered for this review. Figure 1 below shows the screening process.
Figure 1 Screening process of the articles that were used in this study.
Table 1 below shows a summary of the details of the reviews as was found out.
Table 1 Summary of the Articles That Were Reviewed
|
Name of author(s) & publication year |
Aim & Objective(s) |
Sample size & Selection criteria |
Assessment, Outcome Measures, Methods used, Data collection instrument & Analysis process |
Major finding(s) |
Limitations of the study |
Significance to this study |
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Brunelle-Hamann et al. (2015) [1] |
This study aimed at evaluating the effect of a cognitive rehabilitation programme upon BPSD in patients with moderate and mild AD |
15 |
Neuropsychiatric Inventory-12 Single-blind block-randomized cross-over controlled research |
The study found out that a personalized cognitive rehabilitation intervention was largely well-accepted by moderate to mild AD patients. |
There is a need that the study should have also considered aberrant motor behavior symptom and sign changes |
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Burns et al. (2011) [3] |
The study aimed at assessing the effectiveness of Melissa aromatherapy in the management and treatment of agitated people with AD in a sufficiently powered and strongly blinded randomized controlled trial and comparing it with an anticholinesterase drug, donepezil that is employed with certain benefits in the treatment of BPSD. |
81 |
-Pittsburgh Agitation Scale -Neuropsychiatric Inventory
|
The researchers found out that there were no substantial differences between aromatherapy, placebo and donepezil both at weeks 4 and 12, yet significantly there significant improvements in all the three groups with an 18% betterment in the Pittsburgh Agitation Scale along with a 37% improvement in the NPI after a span of more than 12 weeks. |
No identified limitation.
|
This study was important to this review since it showed that bright light therapy is a good alternative therapy to drug treatment in individual with dementia who are (were) agitated. |
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Lowery et al. 2014 [12] |
This study aimed at evaluating the effectiveness of a simple dyadic exercise regimen as a therapeutic intervention for the BPSD symptoms of dementia. |
131 |
Neuropsychiatric Inventory
A two arm, controlled, randomized, parallel-group, and single-blind trial of a dyadic exercise regimen was carried out. |
There was noted no substantial difference in BPSD symptoms as measured suing the NPI at week 12 between the group that received the dyadic exercise regimen and those people who did not receive the same (-1.53, p = 0.6, 95%), Cl (-7.37, 4.32). There was noted a substantial difference between group difference in care giver’s burden as was measured using the Zarit Caregiver Burden Inventory after 12 weeks (OR = 0.18, p = 0.01), Cl (0.05, 0.69)., and this favoured group exercise group.
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The study implied that aromatherapy is effective in the management and treatment of BPSD. |
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Neville et al. 2014 [13] |
The study aimed at exploring the effects of a dementia-specific, aquatic exercise therapy on BPSD in individuals with dementia. |
11 |
The Psychological Wellbeing in Cognitively Impaired Persons Scale Revised Memory and Behavior Problem Checklist |
Statistically substantial declines in revised memory and behaviour problems checklist psychological wellbeing and in cognitively impaired persons scale were noted. |
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O'Connor et al. 2014 [14] |
This randomized trial aimed at investigating the effectiveness of tailored activities program (TAP) for minimizing the burden of BPSD on people with dementia along with family caregivers in an Australian population. |
180 |
Neuropsychiatric Inventory Clinician |
The study found out that 86% of care givers registered less upset with BPSD, insinuating the potential for TAP to deter institutionalization. |
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Svansdottir and Snaedal
Critical ReviewOccupational activities. The employment of non-pharmacological therapies for individuals with dementia has shown significant benefits in the quality of life along with in minimizing depression and agitation (Lowery et al. 2014). Five studies examined the impacts of activities in BPSD in patients who were suffering from dementia, three of which addressed “Tailored Activities Program” (TAP). TAP refers to an occupational therapy that concentrates upon minimizing undesirable behaviours that are linked with dementia (Gitlin et al. 2012). TAP is based upon the principle of selecting activities that are particularly tailored to the patient in accordance with the patient’s abilities, roles, and interests. Additionally, the program offers training for caregivers with the ultimate goal of simplifying activities and adapting them for future operational activities falls of the patient and generalizing strategies to other settings, thus the program helps caregivers to develop a raised sense of self-efficacy. Gitlin et al. (2015), using the US-TAP, showed that decrease in the general occurrence or prevalence of BPSD along with specific behaviours like agitation, shadowing, repetitive questioning, and argumentation is a sample within a span of 60 days, proved effectual and helpful in minimizing shadowing (p = 0.003) as well as behavioural occurrences (p = 0.009). Music therapy. Among the non-pharmacological techniques employed in minimizing BPSD is music therapy (Sung et al. 2010; Spiro, 2010). This review found 4 studies regarding the effectiveness and efficiency of music therapy for BPSD management in people with dementia. One of the studies found did examine the impacts of two interventions, preferred music along with simulated family presence, where participants were subjected to sessions of fifteen-minute audiotape, which is supported by Spiro (2010). One group of the study’s participants listened to audiotape with conversations regarding positive experiences from past records while another group was subjected to assort of songs the participants used to cherish and enjoy during their youth stages. Both therapies proved effectual and useful in minimizing agitation (Sung et al. 2010). Ueda et al. (2013) related two techniques of presenting music, prerecorded or live, in the treatment and management of apathy. Music sessions entailed three dissimilar activities each of which lasted 30 minutes. The 30-minutes session only comprised of silence, while another 30-minute session comprised of background prerecorded songs, and the last 30-minutes session comprised of watching live music sessions. Music that was played during the prerecorded and live sessions was the same besides consisting of a blend of favourite songs in accordance with the participants’ age. The live interactive music sessions proved extra effectual relative to the prerecorded music in minimizing apathy in severe and moderate dementia patients during the short term. No pre-recorded music achieved no perceptible efficacy in bettering apathy. Sung et al. (2012) examined the impacts of group music therapy upon agitation and anxiety in elders who were suffering from dementia within an institution. The elders who took part in this study actively took part in a music group session that lasted for 30 minutes, two times per week for a period of six weeks. The 30 minutes of therapy comprised of a 5-minutes warm-up sessions with breathing as well as movements and a 20-minutes of lively/rigorous music participation using beating devices. Further, the last five minutes were for cool-down sessions and were characterized with very cool and soft music. Participants who were used as the control group were subjected to routine care: basic nursing care, activities of day to day living, some social activities, and meal provision. Results revealed that music therapy had a substantial impact in minimizing apprehension (p = 0.004) Svansdottir and Snaedal (2010) examined the impact of music intervention a case-control research with a sample size of 38 patients. The study registered substantial improvement in anxiety and aggressiveness. In this therapy intervention, therapists and patients sang songs selected by the group. Each selected song was sung two times and was accompanied by a guitar along with other musical devices of their preference. The therapy group obtained 18 music session intervention therapies, each lasting for a span of 30 minutes for three times for six weeks, whereas the control group never changed their day to daycare routine. The study concluded that music therapy substantially minimized anxiety and agitation (p = 0.02) in severe and moderate dementia. Aromatherapy. This review found three studies that investigated the employment of aromatherapy in the treatment of BPSD. Cameron et al. (2011) state that aromatherapy entails the distribution, circulation, or spread of aromatic oil or fume into a given environment. Press-Sandler et al. 2016) used two oils, Melissa and lavender, to treat anxiety and agitation. The researchers compared lavender inhalation (control group) and sunflower inhalation (placebo group). On every side of the participants’ pillows, diffusers were placed during night sleep for a span of at least an hour. Each participant received the two treatments for three weeks. At the end of the study, lavender was found to be extra effective as an adjunctive curative intervention in lessening agitation in patients with dementia as compared to Melissa (p < 0.001). Burns et al. (2011) investigated Melissa aromatherapy’s efficacy in treating agitation in dementia. The study revealed that there were no substantial dissimilarities between placebo, aromatherapy, and medication (donepezil), with the three participant groups registering improvements in PAS and in NPI. Forrester et al. (2014) assessed aroma and aromatherapy. The aromatherapy along with control groups never received any other interventions. The study found out that aromatherapy and aroma-acupressure had substantial impact in minimizing agitation and anxiety (p = 0.01 and p = 0.01 respectively) relative to the study’s control group. Physical exercise. Three articles were found regarding the impact of physical exercises upon BPSD. Nonetheless, one was dropped was dropped because it was merely a study protocol. Neville et al. (2014) studied about aquatic exercises, which entailed a 45-minutes group session, which was followed by a session of relaxation. The sessions were delivered two times for a span of 12 weeks with coached instructors and some assistants. The study revealed a substantial fall in the BPSD number (p= 001), enhancement in the participants’ welfare, and minimization in staff/caregiver distress linked with BPSD (p = 0.001). Another study concentrated on the impact of physical exercises upon BPSD, considering customized regimen that were formulated to become gradually intensive and lasted between 20 and 30 minutes at worst for five minutes a week. The study’s findings indicated that exercises never bettered BPSD. However, the exercises were found effective in the attenuation of caregivers’ burdens. Bright light therapy (BLT). BLT has been employed in various results with patients with dementia. Studies have shown that BLT has the positive effect of improving people’s cognitive performance, night-time sleep, and reducing agitation and anxiety. Hanford and Figueiro (2013) investigated the impact of BLT upon BPSD. The study found out that the quality of sleep was specifically improved for the 48 people with dementia who participated in the study. The study found out that agitation and anxiety improved. Nonetheless, there was no statistically substantial impact. Forbes et al. (2014) investigated the effects of BLT, with the BLT being administered for a period of an hour for two weeks. One of the study’s groups was subjected to light in the morning, the second, afternoon, and the third, indoor light. Substantial dissimilarities between afternoon light exposure and morning light exposure in aggression/agitation scores were registered (p = 0.032) as well as between indoor light and morning light were also registered (p = 0.021). These findings are supported by Gitlin et al. (2012). Touch therapy. Some of the touch therapies mostly employed include therapeutic touch, craniosacral techniques, and massage. Moyle et al. (2013) explored the impact of touch therapy upon BPSD. The therapeutic touch group registered a statistically substantial impact in minimizing behavioural signs and symptoms compared to the group that did not have any touch intervention (p = 0.036). These findings are in agreement with the findings of Moyle et al. (2013). Combined activities. A study examined the efficiency and effectiveness of combining non-pharmacological therapy interventions upon BPSD among aged Taiwan men (23). The combination comprised of orientation training, physical exercise, and art cognitive activities. The intervention group realized extra substantial decrease compared to the reference group according to the NPI score (p = 0.046), together with hallucination (p = 0.004), agitation (p = 0.038), and delusion (p = 0.018). Cognitive rehabilitation. Only one research addressed cognitive rehabilitation for BPSD. Brunelle-Hamann et al. (2015) investigated a cognitive program in sick individuals who had moderate and mild AD. The study revealed that there was a substantial reduction of delusional signs and symptoms with a large effect size. DiscussionOwing to the well known negative repercussions associated with usually drugs that are prescribed for the management and control of BPSD in people with dementia, non-pharmacological therapies have in lately gained increasing focus and intention as a substitute as a number one intervention to treat and manage BPSD. This review addresses some of the proofs supporting the effectiveness and efficacy of the non-pharmacological interventions both in residential and community care environments. This review identified several systematic reviews, which usually concentrated upon one intervention although, in most cases, multi-component therapies were equally examined. This review provides an overview of present proof of the efficacy of non-pharmacological interventions in minimizing BPSD published between 2009 and 2019. 5 studies explored the efficacy of activity program and showed positive outcomes. Nonetheless, the intervention techniques were different across the studies. The researches also employed diverse theoretical backgrounds and explored the impact of individualized activities. The greatest impact size was registered in cases where treatments were customized to the participants’ skills and interests. 4 studies evaluated the effect of music therapy. These showed positive impacts. The employment of familiar songs significantly role plays in minimizing agitation and anxiety (Gómez-Romero et al. 2017). According to Spiro (2010), music has the capability of changing the focus of one’s attention and providing an interpretable stimulus that can elicit positive recollections from past periods/stages of a person’s life, which would alleviate or prevent agitation or anxiety. Live music presentation was found to present efficacy during the short-term management of agitation, anxiety, and apathy in patients with severe and moderate dementia, while pre-recorded music generates an extra limited impact (Seitz et al. 2012). The researchers have explored therapeutic touch Moyle et al. (2013) established that therapeutic touch can be employed in decreasing behavioural symptoms of dementia. However, the machinery of action of therapeutic touch is yet unknown. BLT studies that were used in this review showed substantial positive impacts of this therapy in BPSD, especially in sleep disturbance as well as agitated behavior. Additionally, aromatherapy was found to have beneficial impacts upon agitated patients with dementia. Nonetheless, varying extents of anosmia have been registered in people suffering from dementia, which may lead to analytical bias. While most studies that were used in this review either reported or focused on behavioural abnormalities like agitation, one showed that a planned non-pharmacological intervention program had effectiveness in managing both intrinsic and outward symptoms, like delusion and hallucination, of BPSD. Studies that focused on the employment of physical exercises interventions showed reduction in BPSD and betterment of psychological welfare in people with dementia. Nonetheless, the studies were based upon small samples, warranting further studies. In this review, 10 out of the recognized 20 studies showed that non-pharmacological interventions are effective in minimizing agitation. According to Ballard et al. (2010), agitation is one common, distressing, and persistent symptom among individuals with severe and moderate dementia, affecting about 30% of the people living at home. Ballard et al. (2009) add that agitation in dementia is linked to poorer life quality and impairs the involvement in everyday activities as well as relationships. Limitations and Recommendations for Further StudiesThe variation in the features of therapies was especially pronounced in the trials that were ascribed to behavioural management methods. The trials employed various conceptual frameworks, and sometimes quite and broad generic descriptions, to explain or describe the interventions that were sometimes difficult to interpret and which even influenced the quality and content of proof of the systematic reviews. Regarding this, it is hard to produce satisfactory classifications, implying that various systematic reviews do not take into consideration the same group of researches/studies, even when they vividly examined non-pharmacological therapies specifically formulated to better behavioural management. The arbitrary cut-off age for the patients (60 years and above) along with the exclusion of reviews published before 2009 constitute other restrictions of the present overview. This review did not assess the methodological quality of the studies that were included in the reviews. This limited the scope of this review’s coverage. Some of the limitations characteristic in this study need address. Regarding BPSD measures, most scales employed depend upon information provided by care givers, being thus exposed to interferences of variables like care give’s burden, personality, and even their ability to see changes in their patients’ behavior. Nevertheless, the studies addressed in this review used tools that are validated as well as widely employed in dementia research. This review largely entailed double-blind, double-blind, prospective, and case-control studies. Despite the studies used in this study being heterogeneous with reference to intervention methods, design, and measures of results, bias can be minimized using statistical approaches. Some of the studies used in this review addressed customized interventions. According to Ballard et al. (2010), dementia patients get agitated when their individual needs are not addressed or perceived by care givers. These needs are addressable by a person-centred care model. ConclusionThis review succeeded in providing an up-to-date and complete compendium regarding non-pharmacological interventions in aged people with dementia, using lately published systematic reviews and meta-analyses. Of the interventions that were considered, music therapy seemed to be the most promising. Notwithstanding the considerable number of articles that were included in this review, proof backing up the efficacy of non-pharmacological interventions is restricted due to sample size and methodological quantity and the presence of crucial variations in the taxonomy of non-pharmacological therapy interventions, the results evaluated and the instruments employed in the evaluation of the results. 2010 [18] |
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38 |
Behavioral Pathology in Alzheimer's Disease Rating Scale |
The study revealed a substantial drop in activity disturbances within the music therapy group within a span of six weeks measured by Behaviour Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD).
There was equally a substantial drop in the total sum of scores of participants’ activity disturbances, anxiety and aggressiveness.
Other signs and symptoms that are rated by the BEHAVE-AD subscales never showed a significant decrease.
The effects had disappeared by the fourth week. |
Small study sample and the 20% drop ratio, which may be anticipated in a vulnerable patient group.
Just a few of the patients who participated in the study had significant signs and symptoms.
The study did not address other kinds of music therapies like singing or passive listening.
The study lacked comparison between various types of music. |
This review was significant since it showed that music therapy is an effective and safe technique for managing and treating anxiety and agitation in severe and moderately severe AD. |
References
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Ballard, C, Hanney, ML, Theodoulou, M, et al. 2009, ‘The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomized placebo-controlled trial’, The Lancet Neurology, vol. 8, no. 2, pp. 151–157. Ballard, CG, O'Brien, JT, Reichelt, K, & Perry, EK. 2010, ‘Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double-blind, placebo-controlled trial with Melissa’, J Clin Psychiatry, vol. 63, no. 7, pp. 553-558. Brunelle-Hamann, L, Thivierge, S, & Simard, M 2015, ‘Impact of a cognitive rehabilitation intervention on neuropsychiatric symptoms in mild to moderate Alzheimer's disease’, Neuropsychological Rehabilitation, vol. 25, no. 5, pp. 677–707. Burns, A, Perry, E, Holmes, C, et al. 2011, ‘A double-blind placebo-controlled randomized trial of Melissa officinalis oil and donepezil for the treatment of agitation in Alzheimer's disease’, Dementia and Geriatric Cognitive Disorders, vol. 31, no. 2, pp. 158–164. Cameron, H, du Toit, S, Richard, G, et al. 2011, ‘Using lemon balm oil to reduce aggression and agitation in dementia: results of a pilot study’, J Dement Care, vol. 19, pp. 36–38. Cerga-Pashoja, A, Lowery, D, Bhattacharya, R, et al. 2010, ‘Evaluation of exercise on individuals with dementia and their carers: a randomized controlled trial’, Trials, vol. 11, no. 53, pp. 363-373. Chen, RC, Liu, CL, Lin, MH, et al. 2014, ‘Non-pharmacological treatment reducing not only behavioral symptoms, but also psychotic symptoms of older adults with dementia: a prospective cohort study in Taiwan’, Geriatrics and Gerontology International, vol. 14, no. 2, pp. 440–446. Choi, AN, Lee, MS, Cheong, KJ, et al. 2009, ‘Effects of group music intervention on behavioral and psychological symptoms in patients with dementia: a pilot-controlled trial’, Int J Neurosci, vol. 119, pp. 471–481. Forbes, D, Forbes, SC, Blake, CM, Thiessen, EJ, & Forbes, S 2015, ‘Exercise programs for people with dementia’, Cochrane Database of Systematic Reviews, vol. 12, pp. 1–73. Forbes, D, Blake, CM, Thiessen, E J, Peacock, S, & Hawranik, P 2014, ‘Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia’, Cochrane Database of Systematic Reviews, vol. 2, pp. 1–64. Forrester, LT, Maayan, N, Orrell, M, Spector, AE, Buchan, LD, & Soares-Weiser, K 2014, ‘Aromatherapy for dementia’, Cochrane Database of Systematic Reviews, vol. 2, pp. 1–60. Gitlin, LN, Kales, HC, & Lyketsos, CG 2012, ‘Nonpharmacologic management of behavioral symptoms in dementia’, Journal of the American Medical Association, vol. 308, pp. 2020–2029. Gitlin, LN, Marx, K, Stanley, IH, & Hodgson, N 2015, ‘Translating evidence-based dementia caregiving interventions into practice: State-of-the-science and next steps’, The Gerontologist, vol. 55, pp. 210–226. Gómez-Romero, M, Jiménez-Palomares, M, Rodríguez-Mansilla, J, Flores-Nieto, A, Garrido-Ardila, EM, & González López-Arza, MV 2017, ‘Benefits of music therapy on behaviour disorders in subjects diagnosed with dementia: A systematic review’, Neurologia, vol. 32, pp. 253–263. Han, A, Radel, J, McDowd, JM, & Sabata, D 2016, ‘The benefits of individualized leisure and social activity interventions for people with dementia: A systematic review’, Activities, Adaptation & Aging, vol. 40, pp. 219–265. Hanford, N, & Figueiro, M 2013, ‘Light therapy and Alzheimer’s disease and related dementia: Past, present, and future’, Journal of Alzheimer’s Disease, vol. 33, pp. 913–922. Huang, HC, Chen, YT, Chen, PY, Huey-Lan, HS, Liu, F, Kuo, YL, & Chiu, HY 2015, ‘Reminiscence therapy improves cognitive functions and reduces depressive symptoms in elderly people with dementia: A meta-analysis of randomized controlled trials’, Journal of the American Medical Directors Association, vol. 16, pp. 1087–1094. Husebo, BS, Ballard, C, & Aarsland, D 2011, ‘Pain treatment of agitation in patients with dementia: A systematic review’, International Journal of Geriatric Psychiatry, vol. 26, pp. 1012–1018. Hussey, PS, Schneider, EC, Rudin, RS, Fox, DS, Lai, J, & Pollack, CE 2014, ‘Continuity and the costs of care for chronic disease’, JAMA Internal Medicine, vol. 174, pp. 742–748. Kales, HC, Gitlin, LN, & Lyketsos, CG 2015, ‘Assessment and management of behavioral and psychological symptoms of dementia’, British Medical Journal, vol. 350, pp. 369. Kales, HC, Gitlin, LN, & Lyketsos, CG, Detroit Expert Panel on Assessment and Management of Neuropsychiatric Symptoms of Dementia 2014, ‘Management of neuropsychiatric symptoms of dementia in clinical settings: Recommendations from a multidisciplinary expert panel’, Journal of the American Geriatrics Society, vol. 62, pp. 762–769. Kales, HC, Kim, HM, Zivin, K, et al. 2012, ‘Risk of mortality among individual antipsychotics in patients with dementia’, The American Journal of Psychiatry, vol. 169, no. 1, pp. 71–79. Kales, HC, Kim, HM, Zivin, K, Valenstein, M, Seyfried, LS, Chiang, C, & Blow, FC 2012, ‘Risk of mortality among individual antipsychotics in patients with dementia’, The American Journal of Psychiatry, vol. 169, pp. 71–79. Kolanowski, A, Litaker, M, Buettner, L, Moeller, J, & Costa, PT, Jr 2011, ‘A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents’, Journal of the American Geriatrics Society, vol. 59, no. 6, pp. 1032–1041. Livingston, G, Kelly, L, Lewis-Holmes, E, Baio, G, Morris, S, Patel, N, & Cooper, C 2014, ‘Non-pharmacological interventions for agitation in dementia: Systematic review of randomized controlled trials’, The British Journal of Psychiatry, vol. 205, pp. 436–442. Lowery, D, Cerga-Pashoja, A, Iliffe, S, et al. 2014, ‘The effect of exercise on behavioural and psychological symptoms of dementia: the EVIDEM-E randomized controlled clinical trial’, International Journal of Geriatric Psychiatry, vol. 29, no. 8, pp. 819–827. Maseda, A, Sánchez, A, Marante, MP, González-Abraldes, I, de Labra, C, & Millán-Calenti, JC, 2014, ‘Multisensory stimulation on mood, behavior, and biomedical parameters in people with dementia: Is it more effective than conventional one-to-one stimulation?’American Journal of Alzheimer’s Disease and Other Dementias, vol. 29, pp. 637–647. Millán-Calenti, JC, Lorenzo-López, L, Alonso-Búa, B, de Labra, C, González-Abraldes, I, & Maseda, A 2016, ‘Optimal nonpharmacological management of agitation in Alzheimer’s disease: Challenges and solutions’, Clinical Interventions in Aging, vol. 11, pp. 175–184. Moyle, W, Murfield, JE, O’Dwyer, S, & Van Wyk, S 2013, ‘The effect of massage on agitated behaviours in older people with dementia: A literature review’, Journal of Clinical Nursing, vol. 22, pp. 601–610. Neville, C, Henwood, T, Beattie, E, & Fielding, E 2014, ‘Exploring the effect of aquatic exercise on behaviour and psychological well-being in people with moderate to severe dementia: a pilot study of the Watermemories Swimming Club’, Australasian Journal on Ageing, vol. 33, no. 2, pp. 124–127. O'Connor, CM, Clemson, L, Brodaty, H, Jeon, YH, Mioshi, E, & Gitlin, LN 2014, ‘Use of the Tailored Activities Program to reduce neuropsychiatric behaviors in dementia: an Australian protocol for a randomized trial to evaluate its effectiveness’, International Psychogeriatrics, vol. 26, no. 5, pp. 857–869. Pariente, A, Fourrier-Réglat, A, Ducruet, T, Farrington, P, Béland, SG, Dartigues, JF, & Moride, Y 2012, ‘Antipsychotic use and myocardial infarction in older patients with treated dementia’, Archives of Internal Medicine, vol. 172, pp. 648–653. Petersen, S, Houston, S, Qin, H, Tague, C, & Studley, J 2017, ‘The utilization of robotic pets in dementia care. Journal of Alzheimer’s Disease, vol. 55, pp. 569–574. Pieper, MJ, van Dalen-Kok, AH, Francke, AL, van der Steen, JT., Scherder, EJ, Husebø, BS, & Achterberg, WP 2013, ‘Interventions targeting pain or behaviour in dementia: A systematic review’, Ageing Research Reviews, vol. 12, pp. 1042–1055. Potter, R, Ellard, D, Rees, K, & Thorogood, M 2011, ‘A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia’, International Journal of Geriatric Psychiatry, vol. 26, pp. 1000–1011. Press-Sandler, O, Freud, T, Volkov, I, Peleg, R, & Press, Y 2016, ‘Aromatherapy for the treatment of patients with behavioral and psychological symptoms of dementia: A descriptive analysis of RCTs’, Journal of Alternative and Complementary Medicine, vol. 22, pp. 422–428. Raglio, A, Bellelli, G, Traficante, D, et al. 2010, ‘Efficacy of music therapy treatment based on cycles of sessions: a randomized controlled trial’, Aging Ment Health, vol. 14, pp. 900–904. Randall, EW, & Clissett, PC 2016, ‘What are the relative merits of interventions used to reduce the occurrences of disruptive vocalization in persons with dementia? A systematic review’, International Journal of Older People Nursing, vol. 11, pp. 4–17. doi:10.1111/opn.12083. Riemersma-van der Lek, RF, Swaab, DF, Twisk, J, et al. 2009, ‘Effect of bright light and melatonin on cognitive and non-cognitive function in elderly residents of group care facilities: a randomized controlled trial’, JAMA, vol. 299, pp. 2642–55. Sánchez, A, Millán-Calenti, JC, Lorenzo-López, L, & Maseda, A 2013, ‘Multisensory stimulation for people with dementia: A review of the literature’, American Journal of Alzheimer’s Disease and Other Dementias, vol. 28, pp. 7–14. Scherder, EJ, Bogen, T, Eggermont, LH, Hamers, JP, & Swaab, DF 2010, ‘The more physical inactivity, the more agitation in dementia’, International Psychogeriatrics, vol. 22, pp. 1203–1208. Schneider, JM, Gopinath, B, McMahon, CM, Leeder, SR, Mitchell, P, & Wang, JJ 2011, ‘Dual sensory impairment in older age’, Journal of Aging and Health, vol. 23, pp. 1309–1324. Seitz, DP, Brisbin, S, Herrmann, N, Rapoport, MJ, Wilson, K, Gill, SS, & Conn, D 2012, ‘Efficacy and feasibility of nonpharmacological interventions for neuropsychiatric symptoms of dementia in long term care: A systematic review’, Journal of the American Medical Directors Association, vol. 13, pp. 503–506.e2. Spector, A, Orrell, M, & Goyder, J 2013, ‘A systematic review of staff training interventions to reduce the behavioural and psychological symptoms of dementia’, Ageing Research Reviews, vol. 12, pp. 354–364. Spiro, N 2010, ‘Music and dementia: Observing effects and searching for underlying theories’, Aging & Mental Health, vol. 14, pp. 891–899. Staedtler, AV, & Nunez, D 2015, ‘Non-pharmacological therapy for the management of neuropsychiatric symptoms of Alzheimer’s disease: Linking evidence to practice’, Worldviews on Evidence-Based Nursing, vol. 12, pp. 108–115. Strøm, BS, Ytrehus, S, & Grov, EK 2016, ‘Sensory stimulation for persons with dementia: A review of the literature’, Journal of Clinical Nursing, vol. 25, pp. 1805–1834. Sung, HC, Chang, AM, & Lee, WL 2010, ‘A preferred music listening intervention to reduce anxiety in older adults with dementia in nursing homes’, Journal of Clinical Nursing, vol. 19, pp. 1056–1064. Sung, HC, Lee, WL, & Li, TL, & Watson, R. 2012, ‘A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia’, International Journal of Geriatric Psychiatry, vol. 27, no. 6, pp. 621–627. Svansdottir, HB & Snaedal, J 2010, ‘Music therapy in moderate and severe dementia of Alzheimer's type: a case–control study’, International Psychogeriatrics, vol. 18, no. 4, pp. 613–621. Testad, I, Corbett, A, Aarsland, D, Lexow, KO, Fossey, J, Woods, B, & Ballard, C 2014, ‘The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: A systematic review’, International Psychogeriatrics, vol. 26, pp. 1083–1098. Trahan, MA, Kuo, J, Carlson, MC, & Gitlin, LN 2014, ‘A systematic review of strategies to foster activity engagement in persons with dementia’, Health Education & Behavior, vol. 41, no. 1, pp. 70S–83S. Tuohy, D, Graham, MM, Johnson, K, Tuohy, T, & Burke, K 2015, ‘Developing an educational DVD on the use of hand massage in the care of people with dementia: An innovation’, Nurse Education in Practice, vol. 15, pp. 299–303. Ueda, T, Suzukamo, Y, Sato, M, & Izumi, S 2013, ‘Effects of music therapy on behavioral and psychological symptoms of dementia: A systematic review and meta-analysis’, Ageing Research Reviews, vol. 12, pp. 628–641. van der Ploeg, ES, Eppingstall, B, & O'Connor, DW 2010, ‘The study protocol of a blinded randomized-controlled cross-over trial of lavender oil as a treatment of behavioural symptoms in dementia’, BMC Geriatrics, vol. 10, no. 49, pp. 234-239. Zimmerman, S, Anderson, WL, Brode, S, Jonas, D, Lux, L, Beeber, AS, & Sloane, PD 2013, ‘Systematic review: Effective characteristics of nursing homes and other residential long-term care settings for people with dementia’, Journal of the American Geriatrics Society, vol. 61, pp. 1399–1409. Zimmerman, S, Sloane, PD, Cohen, LW, & Barrick, AL 2014, ‘Changing the culture of mouth care: Mouth care without a battle’, The Gerontologist, vol. 54, no. 1, pp. S25–S34.
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