An Indoor Therapeutic Garden for Behavioral Symptoms in Alzheimer's Disease: A Randomized Controlled Trial.


Journal

Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863

Informations de publication

Date de publication:
2019
Historique:
pubmed: 20 8 2019
medline: 6 11 2020
entrez: 20 8 2019
Statut: ppublish

Résumé

Behavioral and psychological symptoms of dementia (BPSD) affect 60-90% of patients with Alzheimer's disease (AD). To determine if environmental therapy is an effective strategy to reduce BPSD, we tested 163 patients with AD with Neuropsychiatric Inventory (NPI) before and after 6 months of an indoor therapeutic garden (TG) or standard environment. A single-blind randomized controlled trial on AD patients with BPSD. Participants were randomized to an indoor TG (N = 82), or standard environment (control, N = 81) for 6 months. change in the NPI score from baseline (T0) to end of treatment (T1). change in use of quetiapine, cognition, activities of daily living, salivary cortisol, blood pressure from T0 to T1. NPI score significantly ameliorated (TG versus control: -31.8 points), quetiapine dosage (-150 mg), blood pressure (-2.6 mm Hg), and salivary cortisol (-6.4 to -2.1 Nmol/l) were significantly reduced, the Mini-Mental State Examination significantly improved (1.8 points) in the TG versus control arm at T1 (p < 0.001). No adverse events were reported. The indoor TG seems safe and may reduce BPSD, medication intake, and cortisol levels in AD.

Sections du résumé

BACKGROUND
Behavioral and psychological symptoms of dementia (BPSD) affect 60-90% of patients with Alzheimer's disease (AD).
OBJECTIVE
To determine if environmental therapy is an effective strategy to reduce BPSD, we tested 163 patients with AD with Neuropsychiatric Inventory (NPI) before and after 6 months of an indoor therapeutic garden (TG) or standard environment.
METHODS
A single-blind randomized controlled trial on AD patients with BPSD. Participants were randomized to an indoor TG (N = 82), or standard environment (control, N = 81) for 6 months.
PRIMARY OUTCOME
change in the NPI score from baseline (T0) to end of treatment (T1).
SECONDARY OUTCOMES
change in use of quetiapine, cognition, activities of daily living, salivary cortisol, blood pressure from T0 to T1.
RESULTS
NPI score significantly ameliorated (TG versus control: -31.8 points), quetiapine dosage (-150 mg), blood pressure (-2.6 mm Hg), and salivary cortisol (-6.4 to -2.1 Nmol/l) were significantly reduced, the Mini-Mental State Examination significantly improved (1.8 points) in the TG versus control arm at T1 (p < 0.001). No adverse events were reported.
CONCLUSION
The indoor TG seems safe and may reduce BPSD, medication intake, and cortisol levels in AD.

Identifiants

pubmed: 31424399
pii: JAD190394
doi: 10.3233/JAD-190394
doi:

Substances chimiques

Antipsychotic Agents 0
Quetiapine Fumarate 2S3PL1B6UJ
Hydrocortisone WI4X0X7BPJ

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

813-823

Auteurs

Anna Pedrinolla (A)

Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.

Stefano Tamburin (S)

Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.

Anna Brasioli (A)

Monsignor Mazzali Foundation, Mantua, Italy.

Alessio Sollima (A)

Department of Clinical and Experimental Sciences, University Health and Wealth of Brescia, Brescia, Italy.

Cristina Fonte (C)

Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.

Ettore Muti (E)

Monsignor Mazzali Foundation, Mantua, Italy.

Nicola Smania (N)

Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.

Federico Schena (F)

Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.

Massimo Venturelli (M)

Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.
Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.

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Classifications MeSH