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Tuohy D, Kingston L, Carey E, Graham M, Dore L, Doody O. A scoping review on the psychosocial interventions used in day care service for people living with dementia. PLoS One 2023; 18:e0295507. [PMID: 38079409 PMCID: PMC10712883 DOI: 10.1371/journal.pone.0295507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Adult Day care centres provide an important aspect of care provision through all phases of the dementia illness from diagnosis to the end of life (Dabelko HI 2008) supporting the well-being of both older people living with dementia and their care partners. Services within adult day care settings are designed to provide biopsychosocial health benefits to participants as well as care partner respite. OBJECTIVE To examine research studies, literature reviews and grey literature and identify and map the literature on psychosocial interventions used in day care services for older people living with dementia and chart their use, evaluation and outcomes. The research review question is "what are the psychosocial interventions used in day care service for older people living with dementia?" Psychosocial interventions are important non-pharmacological interventions which support people's wellbeing. METHODS Inclusion/Exclusion criteria were identified and guided the search strategy. Participants were people aged 60 years and over living with dementia attending day care services. The use of psychosocial interventions for this cohort was the focus of the review. Databases were searched (Cochrane Reviews, CINAHL, Embase, Medline EBSCO, Medline Ovid, Medline PubMed, PsycINFO, Scopus, Open Grey, Lenus and WHO Global Index Medicus databases) using keywords/terms with Boolean operators from 2011 to 2023. Rayyan was used to extract and manage the data. RESULTS The findings present a narrative and charting of the data from the 45 papers that met the review criteria, and this data is mapped onto the five objectives. Within this review, interventions were grouped into five broad types: nature (n = 6 papers), memory/cognitive (n = 11 papers), social (n = 17 papers), animal (n = 4 papers), or physical/sensory (n = 7 papers) based interventions. CONCLUSIONS This review has illustrated the wide variety in the types, range and facilitation of psychosocial interventions within adult day care services. This review highlights the potential benefits of these interventions. However, findings must be considered in the context that many were provided as brief intervention studies with little evidence of continuation after the study and further research is required given the complex and diverse range of interventions. Results will be of interest to practitioners planning to implement or evaluate psychosocial interventions used in day care services for older people living with dementia.
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Affiliation(s)
- Dympna Tuohy
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liz Kingston
- Department of Nursing and Midwifery, Health Research Institute, Health Implementation Science and Technology Cluster, University of Limerick, Limerick, Ireland
| | - Eileen Carey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Margaret Graham
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Liz Dore
- Research Services Department, Glucksman Library, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
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Vincent C. Roles and usages of neuro service dogs for caregivers living at home with persons with dementia: An exploratory comparative case study. DEMENTIA 2023; 22:1833-1861. [PMID: 37816224 PMCID: PMC10644692 DOI: 10.1177/14713012231204646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
The goal of the present study was to examine how canine assistance may support family caregivers and persons with dementia and to document and compare two modalities of home care support. An exploratory comparative case study research design was conducted. Three cases correspond of dyads of a caregiver, a person with mild to moderate dementia, and either a neuro service dog (NSD), a companion dog or no dog. Hypotheses are formulated to capture differences between cases. Recruitment was done in a service dog organisation, through Canadian Alzheimer associations and in records of a hospital. Data were collected through 45-60 minutes telephone interviews that included completion of the Caregiver's Burden Scale and sociodemographic questions. We used an inductive approach with qualitative data. There were five caregivers (mean age 54.8 years) who had an NSD, 28 caregivers (63.6 years) who had a companion dog, and 23 caregivers (63.8 years) without dog. In the category of roles and usages of the dog, 'Socialisation' and 'Help with a sense of direction' were the most addressed roles for dyads with the NSD. For dyads with companion dog and without dog, 'Engagement-and-meaning of life' as well as 'Physical activity with the dog' were the most discussed roles. The 'Sleep or wake up' role was the least discussed role across three cases. In the other categories, they were seven advantages and 10 inconvenients that were mentioned for canine assistance. For home care support, the presence of NSD has more positive impacts on both the person with dementia and their caregiver compared to the presence of a companion dog; the presence of a NSD results in the person with dementia accessing more indoor and outdoor public sites than with a companion dog; and dyads with a dog are informally socially engaged more frequently than those with no dog.
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Affiliation(s)
- Claude Vincent
- Claude Vincent, School of Rehabilitation Sciences, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale site de l’Institut de Réadaptation en Déficience Physique de Québec, 525, Boulevard Wilfrid-Hamel, Québec, QC G1M2S8, Canada.
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3
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Du H, Bo L, Lai X, Zhu H, Huo X. Network meta-analysis of comparative efficacy of animal-assisted therapy vs. pet-robot therapy in the management of dementia. Front Aging Neurosci 2023; 15:1095996. [PMID: 37323139 PMCID: PMC10264590 DOI: 10.3389/fnagi.2023.1095996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/21/2023] [Indexed: 06/17/2023] Open
Abstract
Objective This network meta-analysis aimed to compare and rank the efficacy of animal-assisted therapy (AAT) and pet-robotic therapy (PRT) in the management of dementia. Methods Relevant studies were identified by searching PubMed, EMBASE, the Cochrane Library, SCOPUS, and Web of Science (WoS) until October 13, 2022. Traditional meta-analysis was first conducted based on the random-effects model, then random network meta-analysis was conducted to determine the relative efficacy and rank probability of AAT and PRT. Results Nineteen randomized controlled trials (RCTs) were included in this network meta-analysis. Network meta-analysis revealed that PRT marginally benefited agitation alleviation compared with control (standard mean difference [SMD]: -0.37, 95% confidence interval [95%CI]: -0.72 to -0.01) although both AAT and PRT did not improve cognitive function, reduce depression, and improve Quality of Life (QoL). The SUCRA probabilities indicated that PRT ranked better than AAT in agitation, cognitive function, and QoL, although there were no differences between the two therapies. Conclusion The present network meta-analysis reveals that PRT may help alleviate agitated behaviors in people with dementia. However, future studies are warranted to establish evidence of the effectiveness of PRT and further evaluate the differences between different robot types in managing dementia.
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Affiliation(s)
- Hongdi Du
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lin Bo
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoxing Lai
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongwei Zhu
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaopeng Huo
- Nursing Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Shoesmith E, Surr C, Ratschen E. Animal-assisted and robotic animal-assisted interventions within dementia care: A systematic review. DEMENTIA 2023; 22:664-693. [PMID: 36765455 PMCID: PMC10014823 DOI: 10.1177/14713012231155985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Animal-assisted interventions and robotic animal interventions are becoming increasingly popular to support the care of people with dementia and may have the potential to improve a range of psychosocial outcomes. This review aims to identify, describe, and compare animal-assisted and robotic animal interventions delivered to people with dementia, their characteristics, effectiveness, and the proposed mechanisms underlying any potential impact. METHODS A systematic literature search was conducted in MEDLINE, AMED, EMBASE, PsycINFO, OVID Nursing, PubMed, CINAHL and Web of Science. Random-effects meta-analyses of randomised controlled trials (RCTs) were conducted to summarise studies that evaluated common outcomes (agitation, depression, quality of life). A narrative approach was used to synthesise other findings. RESULTS Fifty-one studies were included: 18 RCTs; 12 non-randomised trials, 13 cohort studies, 7 qualitative studies and one mixed-methods study. Meta-analyses were conducted for a small number of RCTs, with effectiveness of animal-assisted interventions demonstrated for agitation. Narrative findings suggested animal-assisted and robotic animal interventions may be promising in improving depression, agitation, and quality of life. Three potential mechanisms of action were identified for both animal-assisted and robotic animal interventions, namely enhancing social connections, providing engaging and meaningful activities, and the affect-generating aspect of the human-animal bond. A fourth mechanism was identified for animal-assisted interventions only: promoting physical activity. Robotic animals appear to have a place in complex human-animal relationships, but a greater understanding of robotic animal interventions is required to harness the benefits that may be derived from their use. CONCLUSION Delivering these interventions appear promising in improving psychosocial outcomes for people with dementia. As most included studies had methodological limitations, these findings are preliminary, but contribute to the body of evidence providing an understanding in terms of intervention characteristics and mechanisms of action. When developing intervention guidance, attention should be given to potential mechanisms and fundamental characteristics such as session content, delivery format and facilitator role.
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Affiliation(s)
| | - Claire Surr
- Centre for Dementia Research, 4467Leeds Beckett University, UK
| | - Elena Ratschen
- Department of Health Sciences, 8748University of York, UK
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Shih CA, Yang MH. Effect of Animal-Assisted Therapy (AAT) on Social Interaction and Quality of Life in Patients with Schizophrenia during the COVID-19 Pandemic: An Experimental Study. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:37-43. [PMID: 36646276 PMCID: PMC9837379 DOI: 10.1016/j.anr.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/04/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Most patients with schizophrenia exhibit low willingness to return to society because of negative social experiences. The COVID-19 pandemic led to severe social isolation for schizophrenia patients. However, animal-assisted therapy (AAT) can improve individuals' empathy, social functions, and quality of life. The study aimed to evaluate the effectiveness of AAT in improving social interactions and quality of life in patients with chronic schizophrenia during the COVID-19 pandemic. METHODS An experimental study was conducted, with six institutions for psychiatric rehabilitation in Taiwan as the case institutions. Patients in these institutions were randomly allocated to the experimental group, which received 60 minutes of AAT once a week for 12 weeks, or the control group, which engaged in routine discussion groups and watched short films about animals. Comparisons between the two groups were made before and after the intervention on social function, social adaptive function, and quality of life. Data were collected before the intervention (T1), immediately after the intervention (T2), and 3 months after the intervention (T3). RESULTS Comparison between groups showed that social functioning was significantly higher in the experimental group than in the control group at T2. However, there was no sign of improvement in social adaptive functions of the experimental group. The experimental group exhibited significantly higher quality of life than the control group at T2 and T3. CONCLUSIONS There was an impact of COVID-19 on the studied effects. AAT improved social functioning and quality of life in patients with chronic schizophrenia. The effect on quality of life lasted only up to 3 months after the intervention. AAT should be promoted for use as a community-based rehabilitation tool in patients with chronic schizophrenia. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR2200061715. https://www.chictr.org.cn.
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Affiliation(s)
| | - Man-Hua Yang
- National Yang Ming Chiao Tung University, Taiwan.
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Park JY, Ko HJ, Song JE, Ji SM, Kim SY. Pet Insects May Improve Physical Performance and Sleep in Community-Dwelling Frail Elderly People with Chronic Diseases: A Single-Arm Interventional Pilot Study. Clin Interv Aging 2022; 17:1919-1929. [PMID: 36601357 PMCID: PMC9807014 DOI: 10.2147/cia.s387603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/13/2022] [Indexed: 12/30/2022] Open
Abstract
Purpose Animal-assisted intervention (AAI) is an effective intervention that improves the mental and physical health. However, few have examined the efficacy of pet insects as a form of AAI for prefrail and frail elderly. This study aimed to ascertain the effects of pet insects on physical performance and psychological health in community-dwelling frail elderly individuals with a chronic disease. Patients and Methods This study was an 8 week prospective single-arm interventional pilot study that enrolled prefrail and frail community-dwelling adults aged 70 years and older, all of whom had a chronic disease and attended a daycare facility. Pet insects and appropriate equipment were provided, and supporting programs were used to educate participants about how to rear the insects and how to get close to them. Pre- and post-interventional physical and psychological functions were evaluated. Results A total of 23 subjects (mean age, 82.78 years) were enrolled in the final analysis. The timed up-and-go-test (TUG) was used to measure functional mobility, and grip strength was used as a measure of muscle strength; both showed significant changes after the 8-week intervention (Δ = -0.35±0.73 sec, P = 0.034; and Δ = 0.73±0.99 kg, P = 0.002, respectively). In addition, the insomnia severity index (ISI) and average sleep duration improved significantly (Δ = -2.91±5.64, P = -0.021; and Δ = 0.87±1.98, P = 0.047, respectively). There were no significant changes in the results of other psychometric tests. Logistic regression analysis using the forward stepwise selection method revealed that the baseline ISI score and the absence of other comorbidities were significantly associated with the probability of positive changes in both the TUG and HS tests after the intervention. Conclusion Pet insects may be an effective and easily applicable type of AAI, which improves physical function and sleep in prefrail and frail elderly individuals.
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Affiliation(s)
- Ji-Yeon Park
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hae-Jin Ko
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea,Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Korea,Correspondence: Hae-Jin Ko, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, Korea, Tel +82-53-200-6578, Fax +82-53-200-5480, Email
| | - Ji-Eun Song
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Sang-Min Ji
- Department of Agricultural Biology, National Institute of Agricultural Sciences, Rural Development Administration, Wanju, Korea
| | - So-Yun Kim
- Department of Agricultural Biology, National Institute of Agricultural Sciences, Rural Development Administration, Wanju, Korea
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López-García A, Sánchez-Ruíz ME. Feasible Intervention through Simple Exercise for Risk of Falls in Dementia Patients: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11854. [PMID: 36231155 PMCID: PMC9565761 DOI: 10.3390/ijerph191911854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/14/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Physical exercise can help older people maintain capacities such as muscle strength, balance, postural control, bone mass, and functionality in ADL that usually decline with age. Dementia patients can attend day care centers where they participate in activities such as cognitive training, music and art therapy, and physical exercise sessions. This research aimed to determine the effectiveness of simple lower limb strength and single leg stance training, feasible in the facilities of day care centers, to reduce the risk of falls in the elderly with dementia. Twenty patients with dementia were divided into intervention and control groups. They participated in mobility, strength, coordination, and balance exercise sessions for 45-50 min on weekdays for 5 weeks. In addition, the intervention group patients performed simple lower limb strength (sit-to-stands) and single leg stance exercises in every session. Risk of falls was assessed with the Tinetti test and the SPPB. Comparisons of post- and pre-intervention scores for the Tinetti test and SPPB were statistically increased (0.8 ± 0.7, p = 0.03; 1.5 ± 1.3 points, p = 0.02) in intervention patients. Simple lower limb strength and single leg stance exercises feasible to be done in day care facilities are effective tools for reducing the risk of falls in the elderly with dementia.
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Effects of animal-assisted therapy on patients with dementia: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2022; 314:114619. [PMID: 35623240 DOI: 10.1016/j.psychres.2022.114619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/25/2022] [Accepted: 05/08/2022] [Indexed: 11/23/2022]
Abstract
The purpose of this meta-analysis is to systematically examine the efficacy of animal-assisted therapy (AAT) for patients with dementia. PubMed, Embase, and Cochrane libraries were searched till November 2021 to collect studies in relation to AAT that had been adopted in patients with dementia. Eleven randomized controlled trials (RCTs) involving 825 participants were included. Compared with the control group, the AAT group showed a significant reduction in behavioral and psychological symptoms of dementia (BPSD), especially depression. However, no significant improvement was found in cognitive function, activities of daily living, agitation, or the quality of life. This meta-analysis shows that AAT can effectively reduce BPSD in patients with dementia.
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Välimäki T, Koivisto A, Kärkkäinen V, Selander T, Hongisto K, Rusanen M. Pet ownership supports quality of life in home-dwelling people with Alzheimer's disease. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5698. [PMID: 35286737 PMCID: PMC9314047 DOI: 10.1002/gps.5698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/01/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Human-animal interactions have beneficial psychosocial and psychophysiological effects on individuals in both the presence and absence of medical health conditions. No previous prospective studies with long follow-up have investigated the effects of domestic pets on individuals with Alzheimer's disease (AD) who live at home. We examined the effects of pets on quality of life (QoL) and general well-being during a 5-year follow-up of home-dwelling persons with AD. METHODS In a prospective study including 223 patients with very mild (Clinical Dementia Rating Scale [CDR] 0.5) or mild (CDR 1) AD at baseline who participated in the ALSOVA study, 40 (18%) had a pet. Self- and proxy-rated QoL in AD quality of life-AD (QoL-AD), 15D, and self-rated visual analogic scale (VAS) were assessed annually for 3 years and after 5 years. The Mini-Mental State Examination, Neuropsychiatric Inventory, and CDR sum of boxes (CDR sum of boxes) were measured at the same visits. RESULTS A significant positive effect of pet ownership (p = 0.003, proxy-rated QoL-AD) on QoL was found over the entire follow-up. However, self-rated QoL-AD, 15D, and VAS did not significantly differ between pet owners and non-pet owners. CONCLUSIONS The findings suggest that having a pet may support QoL in home-dwelling persons with AD. Self-rated or general QoL or well-being measurements are not an accurate method for studying QoL in individuals with dementia over time due to a lack of insight. Adding proxy-rated evaluations to this kind of study is recommended.
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Affiliation(s)
- Tarja Välimäki
- Department of Nursing ScienceUniversity of Eastern FinlandKuopioFinland
| | - Anne Koivisto
- Department of NeurologyInstitute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Neurology of Neuro CenterKuopio University HospitalKuopioFinland
- Geriatrics, Internal Medicine and Rehabilitation, Helsinki University Hospital and Department of Neurosciences, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Tuomas Selander
- Science Service CenterKuopio University HospitalKuopioFinland
| | - Kristiina Hongisto
- Department of GeriatricsInstitute of Public Health and Clinical Nutrition, University of Eastern FinlandKuopioFinland
| | - Minna Rusanen
- Department of NeurologyInstitute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Neurology of Neuro CenterKuopio University HospitalKuopioFinland
- Population Health UnitFinnish Institute for Health and WelfareHelsinkiFinland
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Understanding the impact of dog ownership on autistic adults: implications for mental health and suicide prevention. Sci Rep 2021; 11:23655. [PMID: 34880277 PMCID: PMC8655007 DOI: 10.1038/s41598-021-02504-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022] Open
Abstract
Mental health problems and suicide are more frequent in autistic adults than general population. Dog ownership can improve human well-being. This study aimed to generate a framework of well-being outcomes for dog-related activities in autistic adults and compare it to the framework generated for a general adult population. Thirty-six autistic dog owners (18–74 years old, 18 males) from diverse UK regions were interviewed and transcripts thematically analysed. 16.7% reported that their dogs prevented them from taking their own lives, mainly due to the dog's affection and the need to care for the animal. Close dog-owner interactions (e.g., cuddling, walking, dog's presence) were the most frequent activities improving emotions/moods and life functioning, whereas routine-like activities (e.g., feeding the animal) particularly enhanced life functioning. Well-being worsening was mainly linked to dog behaviour problems, dog poor health/death and obligations to the dog. Despite some negatives associated with ownership, having a dog could improve the well-being of many autistic adults and assist suicide prevention strategies in this high-risk group. The framework was consistent with that generated previously, indicating its robustness and the potential opportunity to focus on dog-related activities rather than the vague concept of “ownership” when considering the impact of ownership on well-being.
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Rodríguez-Martínez MDC, De la Plana Maestre A, Armenta-Peinado JA, Barbancho MÁ, García-Casares N. Evidence of Animal-Assisted Therapy in Neurological Diseases in Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12882. [PMID: 34948491 PMCID: PMC8701659 DOI: 10.3390/ijerph182412882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND In recent years, the possibility of intervening humans with animal-assisted therapy (AAT) has been growing due to numerous physical, psychological, and social benefits provided to humanity, enabling them to maintain or improve their quality of life. There exist different animals through which this therapy can be performed. The purpose of this systematic review will focus on the effects of AAT in several neurological diseases. METHODS The search of clinical trials was carried out in the PubMed, Scielo, Embase and PEDro databases. The selection of articles was made according to the different inclusion and exclusion criteria, incorporating those that approached neurological diseases to be reviewed. RESULTS Twenty-five clinical trials were identified, seventeen of which were finally included in the review. The results indicate that animal-assisted therapy (AAT) in different neurological diseases has many benefits in several areas, for example, in motor and physical ability as well as in mental and behavioural health. CONCLUSIONS This systematic review provides occupational therapy practitioners with evidence on the use of activity based on animal-assisted therapy as a novel field of intervention that can complement other therapies and obtain benefits in different populations.
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Affiliation(s)
| | | | - Juan Antonio Armenta-Peinado
- Department of Physical Therapy, Faculty of Health Sciences, University of Malaga, C/Arquitecto Francisco Peñalosa 3, 29071 Málaga, Spain;
| | - Miguel Ángel Barbancho
- Pathological Anatomy and Physical-Sports, Education, Department of Human Physiology, Human Histology, University of Malaga, 29016 Málaga, Spain
- Centro de Investigaciones Médico Sanitarias (CIMES), University of Malaga, 29010 Málaga, Spain;
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
| | - Natalia García-Casares
- Centro de Investigaciones Médico Sanitarias (CIMES), University of Malaga, 29010 Málaga, Spain;
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
- Department of Medicine, Faculty of Medicine, University of Malaga, 29016 Málaga, Spain
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Dincer B, Bahçecik N, Sollami A. Effect of animal assistant therapy on quality of life in older adults: A meta-analysis. Geriatr Nurs 2021; 43:38-44. [PMID: 34814014 DOI: 10.1016/j.gerinurse.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/04/2022]
Abstract
This meta-analysis was conducted to determine the effect of animal-assistant therapy on the quality of life of older adults. This research systematically searched electronic databases (CINAHL, Cochrane Central, Medline/PubMed, Web of Science, Science Direct, and the National Thesis Centre and ULAKBİM of the Council of Higher Education) for studies published between April - June 2021. Seven studies with experimental design were used, three were quasi-experimental and four were randomly controlled studies. The total sample size in the meta-analysis was 375 (experimental group: 177 and control group: 198). The mean duration of animal-assistant therapy was 38.5 ± 12.4 min. Animal-assistant therapy had a significant effect on the quality of life of older adults (mean difference: -4.59 p: 0.03, Z:2.23). Therefore, animal assistant therapy is an effective method to improve older adults' quality of life.
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Affiliation(s)
- Berna Dincer
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Medical Nursing, Istanbul Medeniyet University, Health Science Faculty, Cevizli Yerleşkesi, Şehit Hakan Kurban Caddesi, No:44, 34862, Kartal/İstanbul/Turkey.
| | - Nefise Bahçecik
- Istanbul Sabahattin Zaim University Faculty of Health Sciences, Department of Nursing, Halkalı Kampüsü Eğitim Bilimleri Binası, 2. Kat - Küçükçekmece/ İstanbul /Turkey
| | - Alfonso Sollami
- University Teaching Hospital, Via Don Tonani, 17, 43126 Parma, Italy.
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Welch V, Mathew CM, Babelmorad P, Li Y, Ghogomu ET, Borg J, Conde M, Kristjansson E, Lyddiatt A, Marcus S, Nickerson JW, Pottie K, Rogers M, Sadana R, Saran A, Shea B, Sheehy L, Sveistrup H, Tanuseputro P, Thompson‐Coon J, Walker P, Zhang W, Howe TE. Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1175. [PMID: 37051456 PMCID: PMC8988637 DOI: 10.1002/cl2.1175] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value. Objectives This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence. Search Methods We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and ClinicalTrials.gov). Selection Criteria Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on-going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps. Data Collection and Analysis We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist. Main Results After de-duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews (n = 71, 59%) were rated low or critically low for methodological quality.The most common interventions were home-based rehabilitation for older adults (n = 276) and home-based health services for disease prevention (n = 233), mostly delivered by visiting healthcare professionals (n = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental function (n = 269) and neuromusculoskeletal function (n = 164). The most measured outcomes for functional ability were basic needs (n = 277) and mobility (n = 160). There were few studies which evaluated outcome domains of social participation, financial security, ability to maintain relationships and communication.There was a lack of studies in low- and middle-income countries (LMICs) and a gap in the assessment of health equity issues. Authors' Conclusions There is substantial evidence for interventions to promote functional ability in older adults at home including mostly home-based rehabilitation for older adults and home-based health services for disease prevention. Remotely delivered home-based services are of greater importance to policy-makers and practitioners in the context of the COVID-19 pandemic. This map of studies published prior to the pandemic provides an initial resource to identify relevant home-based services which may be of interest for policy-makers and practitioners, such as home-based rehabilitation and social support, although these interventions would likely require further adaptation for online delivery during the COVID-19 pandemic. There is a need to strengthen assessment of social support and mobility interventions and outcomes related to making decisions, building relationships, financial security, and communication in future studies. More studies are needed to assess LMIC contexts and health equity issues.
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Affiliation(s)
- Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | | | | | - Yanfei Li
- Evidence‐Based Social Science Research Center, School of Public HealthLanzhou UniversityLanzhouChina
| | | | | | - Monserrat Conde
- Cochrane Campbell Global Ageing Partnership FieldFaroPortugal
| | | | | | - Sue Marcus
- Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | | | | | - Morwenna Rogers
- NIHR ARC, South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | | | | | - Beverly Shea
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Lisa Sheehy
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Heidi Sveistrup
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
- Faculty of Health SciencesUniversity of OttawaOttawaCanada
| | | | - Joanna Thompson‐Coon
- NIHR ARC South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | - Peter Walker
- Faculty of MedicineUniversity of OttawaOttawaCanada
| | - Wei Zhang
- Access to Medicines, Vaccines and Health ProductsWorld Health OrganizationGenevaSwitzerland
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Kim S, Nam Y, Ham MJ, Park C, Moon M, Yoo DH. Neurological Mechanisms of Animal-Assisted Intervention in Alzheimer's Disease: A Hypothetical Review. Front Aging Neurosci 2021; 13:682308. [PMID: 34335229 PMCID: PMC8317687 DOI: 10.3389/fnagi.2021.682308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
Alzheimer's disease (AD) is an irreversible neurodegenerative brain disorder with aggregation of amyloid-beta (Aβ) and tau as the pathological hallmarks. AD is the most common form of dementia and is characterized by a progressive decline of cognition. The failure of pharmacological approaches to treat AD has resulted in an increased focus on non-pharmacological interventions that can mitigate cognitive decline and delay disease progression in patients with AD. Animal-assisted intervention (AAI), a non-pharmacological intervention, improves emotional, social, and cognitive dysfunction in patients with neurodegenerative diseases. In particular, AAI is reported to mitigate the effects of cognitive impairment in patients with AD. Despite the positive effects of AAI on cognitive dysfunction in patients with AD, there have been no studies on how AAI affects AD-related pathologies. This review postulates potential neurological mechanisms of emotional or social interaction through AAI in countering AD-related pathologies, such as Aβ deposition, tau hyperphosphorylation, neuroinflammation, and impaired adult hippocampal neurogenesis (AHN), and proposes insights for future research by organizing accumulated previous evidence.
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Affiliation(s)
- Sujin Kim
- Department of Biochemistry, College of Medicine, Konyang University, Daejeon, South Korea
- Research Institute for Dementia Science, Konyang University, Daejeon, South Korea
| | - Yunkwon Nam
- Department of Biochemistry, College of Medicine, Konyang University, Daejeon, South Korea
| | - Min-Joo Ham
- Department of Occupational Therapy, Konyang University, Daejeon, South Korea
| | - Chisoo Park
- Department of Occupational Therapy, Konyang University, Daejeon, South Korea
| | - Minho Moon
- Department of Biochemistry, College of Medicine, Konyang University, Daejeon, South Korea
- Research Institute for Dementia Science, Konyang University, Daejeon, South Korea
| | - Doo-Han Yoo
- Research Institute for Dementia Science, Konyang University, Daejeon, South Korea
- Department of Occupational Therapy, Konyang University, Daejeon, South Korea
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15
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Ferdous F. Social Distancing vs Social Interaction for Older Adults at Long-Term Care Facilities in the Midst of the COVID-19 Pandemic: A Rapid Review and Synthesis of Action Plans. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211044287. [PMID: 34612063 PMCID: PMC8504216 DOI: 10.1177/00469580211044287] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The present study aimed to systematically analyze the impact of COVID-19-related social distancing requirements on older adults living in long-term care facilities (LTCFs) and to synthesize the literature into thematic action plans to minimize the adverse effects of social isolation. The search included articles published between December 2019 and August 2020 across four databases. The inclusion criteria were used to screen for studies that reported on social isolation and loneliness due to the COVID-19 pandemic in older adults living in LTCFs. This rapid review identified 29 relevant studies and synthesized them into four thematic action plans: technological advancement, remote communication, therapeutic care/stress management, and preventive measures. These thematic action plans and cost-effective strategies can be immediately adopted and used as a resource for all LTCF administrators, healthcare design professionals, and researchers in battling current COVID-19-related issues, and improving social interaction in older adults living in care facilities.
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Affiliation(s)
- Farhana Ferdous
- Department of Architecture, College of Engineering and Architecture, Howard University, Washington, DC, USA
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16
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Chang SJ, Lee J, An H, Hong WH, Lee JY. Animal-Assisted Therapy as an Intervention for Older Adults: A Systematic Review and Meta-Analysis to Guide Evidence-Based Practice. Worldviews Evid Based Nurs 2020; 18:60-67. [PMID: 33277977 DOI: 10.1111/wvn.12484] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Animal-assisted therapy (AAT) can ameliorate diverse health problems in older adults. However, applications of AAT have been limited because of the lack of intervention guidelines for older adults. AIMS This study aimed to explore applications of AAT to older adults, analyze its health effects, and provide evidence for future interventions. METHODS A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data were analyzed based on both a narrative synthesis and a meta-analysis specifically for depression. RESULTS A total of 47 studies were selected for analysis. About 45% focused on older adults with diseases such as dementia, and 57.4% selected dog(s) as an intervention animal. About 34.0% delivered interventions once a week, and the behavioral outcome domain was the most frequently investigated. The meta-analysis showed that the effect sizes of the AAT group were -1.310 (95% CI [-1.900, -.721]). LINKING EVIDENCE TO ACTION This review provides evidence for AAT as an intervention in the physiological, psychosocial, cognitive, and behavioral domains of older adults. When planning interventions for older adults, nurses should consider intended health outcomes, appropriate therapeutic animals, and the consequent intervention contents.
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Affiliation(s)
- Sun Ju Chang
- College of Nursing and the Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
| | - Jongeun Lee
- Department of Nursing, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Hyeran An
- College of Nursing, Incheon Catholic University, Incheon, South Korea
| | - Woi-Hyun Hong
- College of Medicine and Medical Research Information Center, Chungbuk National University, Cheongju, South Korea
| | - Joo Yun Lee
- College of Nursing, Gachon University, Incheon, South Korea
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17
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Forget S, Pennequin V, Agli O, Bailly N. Brakes and levers to implement an animal-assisted intervention in nursing homes: Preliminary study. Complement Ther Med 2020; 56:102591. [PMID: 33197666 DOI: 10.1016/j.ctim.2020.102591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Increasing numbers of scientific studies have dealt with the benefits of animal assisted intervention programs (AAI). Although many positive effects have been identified, there are still few AAI programs in nursing homes. To date, no study has investigated special the difficulties in implementing such a program. The aim of this study was to explore the representations of this type of program among caregivers. METHODS This qualitative study was conducted between January and June 2019. Psychologists conducted 11 interviews with people working in nursing homes. The sample was based on different professions and on the fact that participants had already been involved in an IAA program. RESULTS The results were organized according to two main themes: brakes and levers. The results show that the brakes were raised quickly before the implementation of the project, but once the project had been implemented, the perceived beneficial effects multiplied and all those interviewed mentioned the benefits of animals. More than half of the caregivers interviewed mentioned animals as a lever, facilitating contact with elderly people suffering from dementia. Setting up a project upstream enhanced the success of this type of program. CONCLUSION The benefits perceived by the people interviewed are consistent with the scientific literature. The obstacles mentioned for implementing this type of program can be reduced by a rigorous and well-thought-out project.
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Affiliation(s)
- Sarah Forget
- 3 rue des tanneurs, 37041, TOURS Cedex 1, France; Laboratory EA 2114 « psychologie des âges de la vie et adaptation », Department Psychology, University of Tours, Tours, France.
| | - Valérie Pennequin
- 3 rue des tanneurs, 37041, TOURS Cedex 1, France; Laboratory EA 2114 « psychologie des âges de la vie et adaptation », Department Psychology, University of Tours, Tours, France
| | - Oceane Agli
- 3 rue des tanneurs, 37041, TOURS Cedex 1, France; Laboratory EA 2114 « psychologie des âges de la vie et adaptation », Department Psychology, University of Tours, Tours, France
| | - Nathalie Bailly
- 3 rue des tanneurs, 37041, TOURS Cedex 1, France; Laboratory EA 2114 « psychologie des âges de la vie et adaptation », Department Psychology, University of Tours, Tours, France
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18
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Rodrigo-Claverol M, Malla-Clua B, Marquilles-Bonet C, Sol J, Jové-Naval J, Sole-Pujol M, Ortega-Bravo M. Animal-Assisted Therapy Improves Communication and Mobility among Institutionalized People with Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5899. [PMID: 32823839 PMCID: PMC7459682 DOI: 10.3390/ijerph17165899] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/02/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022]
Abstract
Disorders of communication, social relationships, and psychomotricity are often characterized by cognitive impairment, which hinders daily activities and increases the risk of falls. This study aimed to evaluate the efficacy of an animal-assisted therapy (AAT) program in an institutionalized geriatric population with cognitive impairment. The variables evaluated included level of communication and changes in gait and/or balance. We performed a two-arm, parallel controlled, open-label, nonrandomized cluster clinical trial in two nursing home centers from an urban area. Patients in the two centers received 12 weekly sessions of physiotherapy, but the experimental group included AAT with a therapy dog. The study included a total of 46 patients (23 Control Group [CG], 23 Experimental Group [EG]) with a median age of 85.0 years. Of these, 32.6% had mild-moderate cognitive decline (Global Deterioration Scale of Reisberg [GDS] 2-4) and 67.4% severe cognitive decline (GDS 5-6). After the intervention, patients in the CG and EG showed a statistically significant improvement in all the response variables. When comparing both groups, no statistically significant differences were found in any of the Tinetti scale results (measuring gait and balance). However, the communication of patients in the EG, measured on the Holden scale, showed a statistically significant greater improvement postintervention than that of patients in the CG. AAT can be useful as a complementary, effective treatment for patients with different degrees of cognitive decline.
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Affiliation(s)
- Maylos Rodrigo-Claverol
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
- Ilerkan Association, 25005 Lleida, Spain;
| | - Belén Malla-Clua
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
| | - Carme Marquilles-Bonet
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
| | - Joaquim Sol
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain; (J.S.); (M.O.-B.)
- Institut Català de la Salut, Atenció Primària, 25007 Lleida, Spain
- Metabolic Physiopathology Research Group, Experimental Medicine Department, Lleida University-Lleida Biochemical Research Institute (UdL-IRBLleida), 25198 Lleida, Spain
| | - Júlia Jové-Naval
- Primary Health Care Center Bordeta-Magraners, Catalan Institute of Health, 25001 Lleida, Spain; (B.M.-C.); (C.M.-B.); (J.J.-N.)
- Ilerkan Association, 25005 Lleida, Spain;
| | | | - Marta Ortega-Bravo
- Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain; (J.S.); (M.O.-B.)
- Institut Català de la Salut, Atenció Primària, 25007 Lleida, Spain
- Research Group in Therapies in Primary Care, Research Support Unit Lleida, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
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19
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Santaniello A, Garzillo S, Amato A, Sansone M, Di Palma A, Di Maggio A, Fioretti A, Menna LF. Animal-Assisted Therapy as a Non-Pharmacological Approach in Alzheimer's Disease: A Retrospective Study. Animals (Basel) 2020; 10:ani10071142. [PMID: 32640648 PMCID: PMC7401549 DOI: 10.3390/ani10071142] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Non-pharmacological approach represents a valid therapeutic option as an alternative or supplement to pharmacological treatments in patients with Alzheimer’s disease. A type of non-pharmacological therapy is animal-assisted therapy (AAT), where the dog is a valid support to improving the quality of life of patients. In patients with Alzheimer’s disease, interaction with animals can reduce behavioral, stress, and mood disorders, and it can also stimulate some cognitive functions and give benefits to the psychosocial sphere. The purpose of this study was to apply, over a long period of time (2012–2019), AAT interventions adapted to reality orientation therapy (ROT), in groups of patients with mild-to-moderate Alzheimer’s disease. The work aimed to stimulate neuro-cognitive functions such as spatio-temporal orientation, memory, the ability to calculate, and language and to improve the depressive state of patients through the interaction and carrying out of structured games with the dog. The results obtained in the present study show an improvement in both cognitive function and mood of patients who carried out the therapy with the dog. In conclusion, we can therefore affirm how the study conducted confirms the potential of animal-assisted therapy as a non-pharmacological therapy in the treatment of deficits deriving from Alzheimer’s disease patients. Abstract Recently, many efforts have been made to assess the effectiveness of non-pharmacological therapies as an alternative or supportive option to conventional approaches. Specifically, animal-assisted therapy (AAT) has recently raised a great interest and large research efforts. This work represents a retrospective study carried out over seven years (from 2012 to 2019) in 127 patients with mild-to-moderate Alzheimer’s disease. The patients were divided into three groups: an experimental group that received AAT interventions adapted to the formal reality orientation therapy (ROT), a group receiving a formal ROT, and a control group that did not perform any of the previous therapies. All sessions, for all patient groups, were held weekly for a total period of six months. The evaluation of cognitive function was performed through the Mini Mental State Examination (MMSE), while the Geriatric Depression Scale (GDS) assessed the depressive state. Test administration to all patients was performed before the start of the first session (T0) and after the last session (T1). The results obtained showed an improvement in the values in the GDS and MMSE tests. The variations between the average MMSE values between T1 and T0 were 0.94 ± 0.9 (SD), 0.15 ± 0.62, and −0.42 ± 0.45 in the AAT group, ROT group, and control (CTRL) group, respectively. The variations between the average GDS values between T1 and T0 were −1.12 ± 1.17 (SD), −0.42 ± 1.21, and 0.12 ± 0.66 in the AAT group, ROT group, and CTRL group, respectively. Based on our findings, we can therefore affirm how the study carried out confirms the potential of AAT performed by Federico II Model of Healthcare Zooanthropology, and particularly its efficacy in the treatment of cognitive deficits deriving from Alzheimer’s disease.
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Affiliation(s)
- Antonio Santaniello
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
- Correspondence: (A.S.); (M.S.); Tel.: +39-081-25-36134 (A.S.); +39-768-3807 (M.S.)
| | - Susanne Garzillo
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
| | - Alessia Amato
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
| | - Mario Sansone
- Department of Electrical Engineering and Information Technology, Federico II University of Naples, 80125 Naples, Italy
- Correspondence: (A.S.); (M.S.); Tel.: +39-081-25-36134 (A.S.); +39-768-3807 (M.S.)
| | - Annalisa Di Palma
- Department of Fragility, Alzheimer Center “Villa Walpole”, ASL Napoli 1 Centro, 80125 Naples, Italy;
| | - Annamaria Di Maggio
- Regional Reference Center of Urban Veterinary Hygiene (CRIUV), ASL Napoli 1 Centro, 80125 Naples, Italy;
| | - Alessandro Fioretti
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
| | - Lucia Francesca Menna
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
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20
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Hughes MJ, Verreynne ML, Harpur P, Pachana NA. Companion Animals and Health in Older Populations: A Systematic Review. Clin Gerontol 2020; 43:365-377. [PMID: 31423915 DOI: 10.1080/07317115.2019.1650863] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES . The aim of this systematic literature review (SLR) was to investigate the effect of companion animals (whether simply as pets or used in more formal intervention approaches) on the physical and mental health of older adults (aged 60+). METHODS . The reviewers identified key search terms and conducted a systematic search of the PsycINFO and PubMed databases. The 70 articles reviewed were evaluated through tabular and thematic analysis. RESULTS . In 52 of the studies examined, companion animals positively contributed to the mental and/or physical health of older adults. With respect to mental health, involvement with a companion animal improved participant quality of life and effectively attenuated symptoms of depression, anxiety, cognitive impairment, and the behavioral and psychiatric symptoms of dementia (BPSD). In relation to physical health, marked increases in physical activity and improvements in blood pressure and heart rate variability were the only consistent physical health improvements observed from companion animal interactions. CONCLUSIONS . Animal companionship can benefit the mental and physical health of older adults, although more and better controlled research on this topic is required. CLINICAL IMPLICATIONS . Use of companion animals has the potential to be an effective treatment or adjunct therapy to improve the health status and quality of life of older individuals.
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Affiliation(s)
- Michael J Hughes
- School of Psychology, The University of Queensland , Brisbane, Australia
| | | | - Paul Harpur
- TC Beirne School of Law, The University of Queensland , Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland , Brisbane, Australia
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21
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Park S, Bak A, Kim S, Nam Y, Kim HS, Yoo DH, Moon M. Animal-Assisted and Pet-Robot Interventions for Ameliorating Behavioral and Psychological Symptoms of Dementia: A Systematic Review and Meta-Analysis. Biomedicines 2020; 8:biomedicines8060150. [PMID: 32498454 PMCID: PMC7345589 DOI: 10.3390/biomedicines8060150] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 01/12/2023] Open
Abstract
Patients with dementia suffer from psychological symptoms such as depression, agitation, and aggression. One purpose of dementia intervention is to manage patients’ inappropriate behaviors and psychological symptoms while taking into consideration their quality of life (QOL). Animal-assisted intervention (AAI) and pet-robot intervention (PRI) are effective intervention strategies for older people with cognitive impairment and dementia. In addition, AAI and PRI have been shown to have positive effects on behavioral and psychological symptoms of dementia (BPSD). However, studies into the association between AAI/PRI and BPSD have elicited inconsistent results. Thus, we performed a meta-analysis to investigate this association. We analyzed nine randomized controlled trials on AAI and PRI for dementia patients published between January 2000 and August 2019 and evaluated the impact of AAI/PRI on agitation, depression, and QOL. We found that AAI and PRI significantly reduce depression in patients with dementia. Subsequent studies should investigate the impact of AAI and PRI on the physical ability and cognitive function of dementia patients and conduct a follow-up to investigate their effects on the rate of progression and reduction of symptoms of dementia. Our research will help with neuropsychological and environmental intervention to delay or improve the development and progression of BPSD.
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Affiliation(s)
- Sangki Park
- Department of Occupational Therapy, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea;
| | - Ahream Bak
- Department of Occupational Therapy, Jeonju Kijeon College, 267, Jeonjucheonseo-ro, Wansan-gu, Junju 54989, Korea;
| | - Sujin Kim
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Yunkwon Nam
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Hyeon soo Kim
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Doo-Han Yoo
- Department of Occupational Therapy, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea;
- Correspondence: (D.-H.Y.); ; (M.M.); Tel.: +82-42-600-8414 (D.-H.Y.); +82-42-600-8691 (M.M.)
| | - Minho Moon
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
- Correspondence: (D.-H.Y.); ; (M.M.); Tel.: +82-42-600-8414 (D.-H.Y.); +82-42-600-8691 (M.M.)
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Overgaauw PA, Vinke CM, van Hagen MA, Lipman LJ. A One Health Perspective on the Human-Companion Animal Relationship with Emphasis on Zoonotic Aspects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3789. [PMID: 32471058 PMCID: PMC7312520 DOI: 10.3390/ijerph17113789] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/21/2020] [Accepted: 05/24/2020] [Indexed: 12/15/2022]
Abstract
Over time the human-animal bond has been changed. For instance, the role of pets has changed from work animals (protecting houses, catching mice) to animals with a social function, giving companionship. Pets can be important for the physical and mental health of their owners but may also transmit zoonotic infections. The One Health initiative is a worldwide strategy for expanding collaborations in all aspects of health care for humans, animals, and the environment. However, in One Health communications the role of particularly dogs and cats is often underestimated. OBJECTIVE Evaluation of positive and negative One Health issues of the human-companion animal relationship with a focus on zoonotic aspects of cats and dogs in industrialized countries. METHOD Literature review. RESULTS Pets undoubtedly have a positive effect on human health, while owners are increasing aware of pet's health and welfare. The changing attitude of humans with regard to pets and their environment can also lead to negative effects such as changes in feeding practices, extreme breeding, and behavioral problems, and anthropozoonoses. For the human, there may be a higher risk of the transmission of zoonotic infections due to trends such as sleeping with pets, allowing pets to lick the face or wounds, bite accidents, keeping exotic animals, the importation of rescue dogs, and soil contact. CONCLUSIONS One Health issues need frequently re-evaluated as the close human-animal relationship with pet animals can totally differ compared to decennia ago. Because of the changed human-companion animal bond, recommendations regarding responsible pet-ownership, including normal hygienic practices, responsible breeding, feeding, housing, and mental and physical challenges conforming the biology of the animal are required. Education can be performed by vets and physicians as part of the One Health concept.
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Affiliation(s)
- Paul A.M. Overgaauw
- Department Population Health Sciences, Division of Veterinary Public Health, Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands;
| | - Claudia M. Vinke
- Unit Animals in Science & Society, Animal Behaviour, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80166, 3508 TD Utrecht, The Netherlands; (C.M.V.); (M.A.E.v.H.)
| | - Marjan A.E. van Hagen
- Unit Animals in Science & Society, Animal Behaviour, Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80166, 3508 TD Utrecht, The Netherlands; (C.M.V.); (M.A.E.v.H.)
| | - Len J.A. Lipman
- Department Population Health Sciences, Division of Veterinary Public Health, Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands;
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Instruments to measure quality of life in institutionalised older adults: Systematic review. Geriatr Nurs 2020; 41:445-462. [PMID: 32178880 DOI: 10.1016/j.gerinurse.2020.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
Abstract
This study analysed the available instruments intended to measure the quality of life of institutionalised older adults, the psychometric properties of said instruments, and their use. This review was conducted using six international databases. The quality of the psychometric properties was assessed using the COSMIN checklist. Risk of bias was assessed using the QUADAS-2 tool. Twenty-four instruments which measure quality of life were analysed. The instruments assessed are related to two areas, thus establishing two stages of the concept of quality of life in the ageing process. The Dementia Quality of Life (DQoL) scale and the FACIT-Sp Spiritual Well-Being Scale were found to be the instruments with the best combination of length, high methodological quality, and bias control for use in older people with and without cognitive impairment, respectively. Knowing which instruments have higher quality will facilitate the evaluation of the aspects that influence quality of life in geriatric institutions.
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Borgi M, Collacchi B, Giuliani A, Cirulli F. Dog Visiting Programs for Managing Depressive Symptoms in Older Adults: A Meta-Analysis. THE GERONTOLOGIST 2020; 60:e66-e75. [PMID: 30476083 DOI: 10.1093/geront/gny149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Depressive symptoms are highly prevalent in older adults and may contribute to functional impairment at old age. Animal-assisted interventions (AAIs), including interventions involving dog visiting, are increasingly recognized as an innovative approach to ameliorate social, behavioral, psychological, and physical outcomes among older adults. However, available data on their potential to manage depressive symptoms in the aging population are not clear cut. The aim of this review was to conduct a meta-analysis of all prospective controlled studies evaluating the effects of dog visiting on depressive symptoms in older adults. RESEARCH DESIGN AND METHODS A comprehensive literature search was conducted on the electronic databases PubMed and Scopus. Included articles were published between 1980 and 2017 and report controlled empirical studies of dog visiting interventions to ameliorate depressive symptoms in older adults. RESULTS There was substantial heterogeneity between included studies, which varied in their methodological quality, sample size, and other key features. Notwithstanding such methodological variety, results all go in the same direction and indicate a large beneficial effect of interventions involving dog visiting on depressive symptoms. DISCUSSION AND IMPLICATIONS This analysis confirms the potential value of dog visiting in ameliorating depressive symptoms in institutionalized and noninstitutionalized older adults. This is in line with previous research indicating AAIs as promising complementary programs for preserving/enhancing emotional and behavioral function in aged individuals. More research is still needed to allow AAIs to be effectively introduced in clinical practice.
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Affiliation(s)
- Marta Borgi
- Center for Behavioral Sciences and Mental Health
| | | | - Alessandro Giuliani
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
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Abstract
BACKGROUND Dementia is a chronic condition which progressively affects memory and other cognitive functions, social behaviour, and ability to carry out daily activities. To date, no treatment is clearly effective in preventing progression of the disease, and most treatments are symptomatic, often aiming to improve people's psychological symptoms or behaviours which are challenging for carers. A range of new therapeutic strategies has been evaluated in research, and the use of trained animals in therapy sessions, termed animal-assisted therapy (AAT), is receiving increasing attention. OBJECTIVES To evaluate the efficacy and safety of animal-assisted therapy for people with dementia. SEARCH METHODS We searched ALOIS: the Cochrane Dementia and Cognitive Improvement Group's Specialised Register on 5 September 2019. ALOIS contains records of clinical trials identified from monthly searches of major healthcare databases, trial registries, and grey literature sources. We also searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCOhost), ISI Web of Science, ClinicalTrials.gov, and the WHO's trial registry portal. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-randomised trials, and randomised cross-over trials that compared AAT versus no AAT, AAT using live animals versus alternatives such as robots or toys, or AAT versus any other active intervention. DATA COLLECTION AND ANALYSIS We extracted data using the standard methods of Cochrane Dementia. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using mean difference (MD), standardised mean difference (SMD), and risk ratio (RR) with their 95% confidence intervals (CIs) where appropriate. MAIN RESULTS We included nine RCTs from 10 reports. All nine studies were conducted in Europe and the US. Six studies were parallel-group, individually randomised RCTs; one was a randomised cross-over trial; and two were cluster-RCTs that were possibly related where randomisation took place at the level of the day care and nursing home. We identified two ongoing trials from trial registries. There were three comparisons: AAT versus no AAT (standard care or various non-animal-related activities), AAT using live animals versus robotic animals, and AAT using live animals versus the use of a soft animal toy. The studies evaluated 305 participants with dementia. One study used horses and the remainder used dogs as the therapy animal. The duration of the intervention ranged from six weeks to six months, and the therapy sessions lasted between 10 and 90 minutes each, with a frequency ranging from one session every two weeks to two sessions per week. There was a wide variety of instruments used to measure the outcomes. All studies were at high risk of performance bias and unclear risk of selection bias. Our certainty about the results for all major outcomes was very low to moderate. Comparing AAT versus no AAT, participants who received AAT may be slightly less depressed after the intervention (MD -2.87, 95% CI -5.24 to -0.50; 2 studies, 83 participants; low-certainty evidence), but they did not appear to have improved quality of life (MD 0.45, 95% CI -1.28 to 2.18; 3 studies, 164 participants; moderate-certainty evidence). There were no clear differences in all other major outcomes, including social functioning (MD -0.40, 95% CI -3.41 to 2.61; 1 study, 58 participants; low-certainty evidence), problematic behaviour (SMD -0.34, 95% CI -0.98 to 0.30; 3 studies, 142 participants; very-low-certainty evidence), agitation (SMD -0.39, 95% CI -0.89 to 0.10; 3 studies, 143 participants; very-low-certainty evidence), activities of daily living (MD 4.65, 95% CI -16.05 to 25.35; 1 study, 37 participants; low-certainty evidence), and self-care ability (MD 2.20, 95% CI -1.23 to 5.63; 1 study, 58 participants; low-certainty evidence). There were no data on adverse events. Comparing AAT using live animals versus robotic animals, one study (68 participants) found mixed effects on social function, with longer duration of physical contact but shorter duration of talking in participants who received AAT using live animals versus robotic animals (median: 93 seconds with live versus 28 seconds with robotic for physical contact; 164 seconds with live versus 206 seconds with robotic for talk directed at a person; 263 seconds with live versus 307 seconds with robotic for talk in total). Another study showed no clear differences between groups in behaviour measured using the Neuropsychiatric Inventory (MD -6.96, 95% CI -14.58 to 0.66; 78 participants; low-certainty evidence) or quality of life (MD -2.42, 95% CI -5.71 to 0.87; 78 participants; low-certainty evidence). There were no data on the other outcomes. Comparing AAT using live animals versus a soft toy cat, one study (64 participants) evaluated only social functioning, in the form of duration of contact and talking. The data were expressed as median and interquartile ranges. Duration of contact was slightly longer in participants in the AAT group and duration of talking slightly longer in those exposed to the toy cat. This was low-certainty evidence. AUTHORS' CONCLUSIONS We found low-certainty evidence that AAT may slightly reduce depressive symptoms in people with dementia. We found no clear evidence that AAT affects other outcomes in this population, with our certainty in the evidence ranging from very-low to moderate depending on the outcome. We found no evidence on safety or effects on the animals. Therefore, clear conclusions cannot yet be drawn about the overall benefits and risks of AAT in people with dementia. Further well-conducted RCTs are needed to improve the certainty of the evidence. In view of the difficulty in achieving blinding of participants and personnel in such trials, future RCTs should work on blinding outcome assessors, document allocation methods clearly, and include major patient-important outcomes such as affect, emotional and social functioning, quality of life, adverse events, and outcomes for animals.
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Affiliation(s)
- Nai Ming Lai
- Taylor's UniversitySchool of MedicineSubang JayaMalaysia
| | | | - Siok Shen Ng
- Hospital MelakaPharmacy Resources and Information Centre (PRIC)Jalan Mufti Haji‐KhalilMelakaMelakaMalaysia75400
- Monash University MalaysiaJeffrey Cheah School of Medicine and Health SciencesJalan Lagoon SelatanBandar SunwaySelangorMalaysia47500
| | - Shir Ley Tan
- Calvary North Adelaide HospitalHPS PharmaciesAdelaideSouth AustraliaAustralia
| | - Nathorn Chaiyakunapruk
- College of Pharmacy, University of UtahDepartment of PharmacotherapySalt Lake CityUtahUSA84112
| | - Fiona Stanaway
- University of SydneySydney School of Public Health, Faculty of Medicine and HealthEdward Ford Building A27SydneyNSWAustralia2042
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Tam W, Lo K, Woo B. Reporting sample size calculations for randomized controlled trials published in nursing journals: A cross-sectional study. Int J Nurs Stud 2019; 102:103450. [PMID: 31731176 DOI: 10.1016/j.ijnurstu.2019.103450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/10/2019] [Accepted: 10/12/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Prior sample size calculation is essential to ensure that a randomized controlled trial (RCT) has enough power to detect any statistical differences between two groups while not over-recruiting participants. However, the compliance among RCTs published in nursing field is unknown. OBJECTIVE To describe the reporting of sample size methodology and parameters used in RCTs published in nursing journals. DESIGN A cross-sectional database search of all RCTs published in nursing journals was conducted. SETTING 116 journals in the category of nursing. PARTICIPANTS Not applicable. METHODS A database search was conducted to identify all RCTs published in nursing journals from January 2016 to December 2016. Two-arm RCTs were reviewed to see if sample size estimation was mentioned in the text and if the parameters were sufficient for the estimation. For RCTs with effect size, sample sizes were recomputed and compared with the reported size. RESULTS Two hundred and twenty-three RCTs were included in this study, and 143 (64.1%) studies mentioned how they obtained their sample sizes. Among these 143 studies, 132 (92.3%), 133 (93.0%), 33 (23.1%), and 84 (58.7%) specified their levels of significance (α), powers, tails of the test, and effect size related information, respectively. Only 22 (15.4%) provided all the necessary parameters to compute their sample sizes. Out of the 84 RCTs with effect size information, 49 (58.3%) had a relative difference of less than 25%. DISCUSSION Around 36% of the RCTs published in nursing journals did not report how they reached their sample sizes. For those that had reported, only 15% provided all the necessary parameters to re-compute their sizes. It is concluded that the methodology and parameters used for sample size determination are inadequately reported in RCTs published in nursing journals.
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Affiliation(s)
- Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Kenneth Lo
- Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, Guangzhou 510080, China; Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, USA.
| | - Brigitte Woo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Chrusciel J, Letty A, Armaingaud D, Haÿ PÉ, Sanchez S. [Impact of animal-assisted interventions on the resident]. SOINS. GERONTOLOGIE 2019; 24:12-14. [PMID: 31806171 DOI: 10.1016/j.sger.2019.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Animal-assisted interventions are designed for personal well-being. The objective of this study was to evaluate the effectiveness of these interventions in the context of residential facilities for dependent elderly people. Animal-assisted therapy, which can be delivered by trained staff, could be a tool to helpinstitutionalised elderly people cope with loneliness.
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Affiliation(s)
- Jan Chrusciel
- Pôle Information médicale évaluation performance, Centre hospitalier de Troyes, 101, rue Anatole-France, 10003 Troyes, France
| | - Aude Letty
- Fondation Korian pour le bien-vieillir, 23-25, rue Balzac, 75008 Paris, France
| | - Didier Armaingaud
- Fondation Korian pour le bien-vieillir, 23-25, rue Balzac, 75008 Paris, France
| | - Paul-Émile Haÿ
- Fondation Korian pour le bien-vieillir, 23-25, rue Balzac, 75008 Paris, France
| | - Stéphane Sanchez
- Pôle Information médicale évaluation performance, Centre hospitalier de Troyes, 101, rue Anatole-France, 10003 Troyes, France; Fondation Korian pour le bien-vieillir, 23-25, rue Balzac, 75008 Paris, France.
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Klimova B, Toman J, Kuca K. Effectiveness of the dog therapy for patients with dementia - a systematic review. BMC Psychiatry 2019; 19:276. [PMID: 31492131 PMCID: PMC6731615 DOI: 10.1186/s12888-019-2245-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 08/19/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Dementia represents a mental and economic burden for both patients and their caregivers. Therefore, the aim of this study is to explore the effectiveness of animal assisted therapy (AAT) with special focus on canis therapy among people with dementia, specifically Alzheimer's disease. METHODS The key method of this review study is a systematic review of the research studies detected in the Web of Science, Scopus and PubMed. The search was conducted for the studies dating from 2016 till 31 August 2018 because several review studies were published before. Eventually, only six studies were involved into the final analysis. RESULTS The findings of this review, based on significant effect sizes, reveal that AAT may work as a beneficial and effective complementary treatment, especially in the area of behavioral and psychological symptoms, for patients with different degree of dementia severity if AAT is targeted at their specific needs and interests. CONCLUSIONS More research in the area of methodology for the implementation of AAT is necessary, and more research should be conducted with respect to the use of AAT for the improvement of cognitive functions in people with dementia.
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Affiliation(s)
- Blanka Klimova
- 0000 0000 9258 5931grid.4842.aDepartment of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Josef Toman
- 0000 0000 9258 5931grid.4842.aDepartment of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. .,Centre for Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Kralove, Sokolska 581, Hradec Kralove, Czech Republic.
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Ritchie L, Quinn S, Tolson D, Jenkins N, Sharp B. Exposing the mechanisms underlying successful animal-assisted interventions for people with dementia: A realistic evaluation of the Dementia Dog Project. DEMENTIA 2019; 20:66-83. [PMID: 31335169 DOI: 10.1177/1471301219864505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is increasing recognition of animal-assisted interventions as a promising area of practice within health and social care for people living with dementia. However, much of the research focuses on benefits for those living in care homes and not in their own homes. The Dementia Dog Project is an innovative project that aims to support people with dementia to engage with dogs and to promote the use of dogs in dementia care in the community. The pilot project introduced a dementia assistance dog to four couples where one person had a diagnosis of dementia. The aim of this paper is to explore the mechanisms that can successfully expose the benefits of integrating dogs into dementia care by drawing on the findings of a realistic evaluation of the pilot phase of the Dementia Dog Project (2013-2015). A realistic evaluation, with its focus on context, mechanisms and outcomes illuminates why an approach may work in some situations but not in others. This makes it especially appropriate to the unique, complex experience of living with dementia and the early development stage of the programme. The analysis triangulated data from a range of primary and secondary sources including interviews with the project team, case reports, team meeting notes and transcripts of interviews with participants. The findings identified three mechanisms that help to unlock the most positive outcomes for both the participants and the dogs. These were (1) the human-animal bond, (2) relationship dynamics and (3) responsibility of caring. The findings presented within this paper provide essential information to inform and advance the planning for the use of assistance dogs for people with dementia.
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Affiliation(s)
- Louise Ritchie
- School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, UK
| | - Samuel Quinn
- School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, UK
| | - Debbie Tolson
- School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, UK
| | - Nick Jenkins
- School of Media, Culture and Society, University of the West of Scotland, South Lanarkshire, UK
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Wesenberg S, Mueller C, Nestmann F, Holthoff-Detto V. Effects of an animal-assisted intervention on social behaviour, emotions, and behavioural and psychological symptoms in nursing home residents with dementia. Psychogeriatrics 2019; 19:219-227. [PMID: 30393989 DOI: 10.1111/psyg.12385] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/12/2018] [Accepted: 09/24/2018] [Indexed: 11/30/2022]
Abstract
AIM The positive effects of animal-assisted interventions (AAIs) in people with dementia have been frequently reported in the literature. However, it remains unclear if the positive effects are directly due to the presence of the animal. The aim of this study was to investigate if the inclusion of an animal adds value to psychosocial interventions for people with dementia. METHODS The study followed a within-subject design with two studied conditions (AAI and control intervention) and several measurement points (baseline (i.e. at beginning of the intervention), after 3 months, and after 6 months). Nineteen nursing home residents with dementia participated in the AAI (with a dog) and the control intervention. Both interventions were delivered as weekly group sessions over a period of 6 months. Outcomes examined were social interaction, emotional expression, and behavioural and psychological symptoms. These outcomes were evaluated by using video recordings at baseline and after 3 and 6 months. RESULTS Nineteen patients with moderate to moderately severe dementia who lived in two nursing homes in Germany were included. During the AAI, we detected significantly longer and more frequent periods of positive emotions (pleasure) and social interaction (e.g. touch, body movements) than during the control intervention. CONCLUSION The presence of a dog appears to have beneficial effects on psychosocial intervention for people with dementia.
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Affiliation(s)
- Sandra Wesenberg
- Alice Salomon Hochschule - University of Applied Sciences, Berlin, Germany
| | | | - Frank Nestmann
- Faculty of Education, Technische Universität Dresden, Dresden, Germany
| | - Vjera Holthoff-Detto
- Department of Psychiatry, Psychotherapy and Psychosomatics at the Alexianer Hospital Hedwigshoehe, Berlin, Germany
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Effects of dog-assisted therapy in adults with dementia: a systematic review and meta-analysis. BMC Psychiatry 2019; 19:41. [PMID: 30678665 PMCID: PMC6345014 DOI: 10.1186/s12888-018-2009-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 12/28/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Dog-assisted therapy (DAT) is a non-pharmacological intervention based on the interaction between patients and dogs, which has been proposed to help adults with dementia. However, evidence to support it is lacking. Thus, we aim to evaluate the effects of DAT on this population and to assess the certainty of the evidence of the RCTs estimates. METHODS A systematic search was performed. We included randomized controlled trials (RCTs) and quasi-experimental (QE) controlled studies published up to March 2018, which evaluated the beneficial and deleterious effects of DAT in adults with dementia. Mean differences (MD) or standardized mean differences (SMD) and their 95% confidence intervals (95% CI) were calculated and random effects meta-analyses were performed. Certainty of evidence was assessed for RCTs estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol has been registered in PROSPERO (CRD42018090434). RESULTS Ten studies (six RCTs and four QE controlled studies) were eligible for inclusion. Meta-analysis of RCTs showed no effect of DAT in daily life activities (SMD: 0.16; 95% CI: -0.80 to 1.12), depression (SMD: -0.45; 95% CI: -2.81 to 1.91), agitation (SDM: -1.12; 95% CI: -2.67 to 0.43), quality of life (SDM: 0.16; 95% CI: -0.41 to 0.73), and cognitive impairment (SDM: -0.52; 95% CI: -1.33 to 0.30), but it found a beneficial effect in apathy (1 study, n = 37, MD: 1.81; 95% CI: 1.26 to 2.36). All outcomes had a very low certainty of evidence according to GRADE methodology. CONCLUSIONS RCTs evidence of very low certainty suggests that, in adults with dementia, DAT has no effect in daily life activities, depression, agitation, quality of life, and cognitive impairment, although one small study found an apparent beneficial effect in apathy. More well-designed and correctly reported studies are needed in order to provide a conclusion. TRIAL REGISTRATION CRD42018090434 (PROSPERO).
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Kårefjärd A, Nordgren L. Effects of dog-assisted intervention on quality of life in nursing home residents with dementia. Scand J Occup Ther 2018; 26:433-440. [PMID: 29693512 DOI: 10.1080/11038128.2018.1467486] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND People with dementia often have a poor quality of life. Therefore, methods that can improve their life situation must be identified. One promising method is dog-assisted intervention. AIM This study aimed to investigate the effects of dog-assisted intervention on quality of life in nursing home residents with dementia. MATERIALS AND METHODS A one-group, pretest post-test study design was used. Quality of life was measured using the QUALID in 59 nursing home residents prior to and after a dog-assisted intervention. Non-parametric tests were used to analyze the data, and effect sizes were calculated. RESULTS The participants' total scores improved significantly between baseline and post-test 1 (p = < 0.001) and worsened significantly at post-test 2 (p = 0.025). The largest effect size was found for the item 'Verbalization suggests discomfort' (p = 0.001). CONCLUSION The results indicate that dog-assisted interventions can have positive effects on quality of life in nursing home residents with moderate to severe dementia. SIGNIFICANCE The results contribute to a growing knowledge base about non-pharmacological methods that can be used in dementia care. Occupational therapists should consider dog-assisted interventions when planning activities that can reduce the illness burden and improve the quality of life for people with dementia.
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Affiliation(s)
- Ann Kårefjärd
- a ReHabenheten , Vård-och omsorgsförvaltningen , Eskilstuna , Sweden
| | - Lena Nordgren
- b Centre for Research and Development , Sörmland County Council, Centre for Clinical Research Sörmland, Uppsala University , Uppsala , Sweden
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Yakimicki ML, Edwards NE, Richards E, Beck AM. Animal-Assisted Intervention and Dementia: A Systematic Review. Clin Nurs Res 2018; 28:9-29. [PMID: 29441797 DOI: 10.1177/1054773818756987] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies. Eleven of 12 studies demonstrated increased social interaction with AAI. Mood had mixed results in nine studies. Quality of life was increased in three of four studies. Resident activity and nutritional intake were each increased in two studies. Animal assisted activities/interventions showed a strong positive effect on social behaviors, physical activity, and dietary intake in dementia patients and a positive effect on agitation/aggression and quality of life.
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Affiliation(s)
| | | | | | - Alan M Beck
- 1 Purdue University, West Lafayette, IN, USA
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Hu M, Zhang P, Leng M, Li C, Chen L. Animal-assisted intervention for individuals with cognitive impairment: A meta-analysis of randomized controlled trials and quasi-randomized controlled trials. Psychiatry Res 2018; 260:418-427. [PMID: 29268204 DOI: 10.1016/j.psychres.2017.12.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/10/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
The aim of this meta-analysis was to systematically examine the efficacy of animal-assisted intervention (AAI) for cognitive impairment patients. PubMed, Embase, the Cochrane library, PsycINFO, and Web of Science databases were searched up to June 2017 to collect studies related to AAI conducted in patients with cognitive impairment. Five randomized controlled trials (RCTs) and five quasi-randomized controlled trials (quasi-RCTs) involving 413 participants were included. Compared with control groups, AAI groups exhibited significantly fewer behavioral and psychological symptoms of dementia (BPSD), especially depression and agitation. In both the short and long term, AAI had beneficial effects on BPSD in cognitive impairment patients. However, no significant improvements were found in daily living activities, quality of life or cognitive score. The present meta-analysis showed that AAI can be effective in reducing BPSD in patients with cognitive impairment.
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Affiliation(s)
- Mingyue Hu
- College of Nursing, Jilin University, Changchun, China
| | - Ping Zhang
- College of Nursing, Jilin University, Changchun, China
| | - Minmin Leng
- College of Nursing, Jilin University, Changchun, China
| | - Chen Li
- College of Nursing, Jilin University, Changchun, China
| | - Li Chen
- College of Nursing, Jilin University, Changchun, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China.
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