Non-Pharmacological interventions for the anxiety in patients with dementia. A cross-over randomised controlled trial
Non-Pharmacological interventions for the anxiety in patients with dementia. A cross-over randomised controlled trial
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DOI：
10.1016/j.bbr.2020.112617
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发表时间：
2020-07-15
影响因子：
2.7
通讯作者：
Tsolaki, Magda
中科院分区：
文献类型：
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作者：
Dimitriou, Tatiana-Danai;Verykouki, Eleni;Tsolaki, Magda
背景：痴呆的行为和精神症状（BPSD）往往是痴呆的一个关键和大问题。焦虑多次被低估，因为它通常被认为是对认知能力下降的心理反应。由于只有10%的患者得到正确治疗，因此应充分考虑药物治疗。本研究的目的是评估三个非药物干预治疗焦虑dementions.Methods：交叉随机对照试验，60名参与者（不同类型和阶段的痴呆症）在希腊进行。样本被随机分配到6个不同的组，每组10名参与者。已评估的非药物干预措施有：a）音乐疗法B）运动和c）芳香疗法和按摩。所用的测量指标为：MMSE、ACE-R、GDS、FRSSD和NPI问卷。干预持续5天，有两天作为洗脱期。结果：音乐疗法是最有效的干预方法。第二个最有效的干预措施是运动，第三个是芳香疗法和按摩。括号中的p结果表明，与运动、芳香疗法和按摩相比，音乐疗法的p小于0.05，因此干预的顺序不会干扰结果。（相应地，p = < 0.05，p = 0.55）。MT也减轻了照顾者的负担。括号中的p结果表明，音乐治疗与其他两种干预措施相比，p <0.05，因此干预措施的顺序也不会干扰结果（p = < 0.05，p = 0.19）。结论：我们的结果与当前文献一致。音乐疗法是治疗PwD焦虑症的一种有前途的替代干预措施。音乐治疗是一种有效的非药物治疗，用于减轻照顾者的负担，因为PwD的焦虑症状，如睡眠不足，缺乏个人时间，不健康的生活方式，缺乏解决方案，如何与患者相处等。音乐的类型，干预的持续时间和长期效益尚不清楚。有一个很大的需要进一步的研究与更强大的可能的评价方法。
Background: Behavioural and Psychiatric Symptoms in dementia (BPSD) tend to be a crucial and big problem in dementia. Anxiety several times remains under-diagnosed because it is often considered to be a psychological response to cognitive decline. As only the 10 % of patients were correctly treated, the pharmacological treatment should be well-considered. The aim of this study was to evaluate three non-pharmacological interventions for the treatment of anxiety in dementia.Methods: A cross-over randomised controlled trial with 60 participants (different types and stages of dementia) conducted in Greece. The sample was randomly assigned to 6 different groups of 10 participants each. The non-pharmacological interventions that have been evaluated are: a) Music Therapy b) Exercise and c) Aromatherapy & Massage. The measurements that were used are: MMSE, ACE-R, GDS, FRSSD and NPI questionnaire. The interventions lasted 5 days and there was two days off as a wash-out period. There was no drop-out rate.Results: The study showed that the most effective intervention is Music therapy. The second most effective intervention is Exercise and the third one is Aromatherapy and Massage. In the parenthesis p results indicate that Music Therapy's p is less than 0.05 in comparison with Exercise and Aromatherapy and Massage and therefore the sequence of the interventions does not interfere with the results. (p = < 0.05, = 0.55, accordingly). Caregivers' burden also reduced with MT. In the parenthesis p results indicate Music Therapy's p is less than 0.05 in comparison with the two other interventions and therefore the sequence of the interventions does not interfere with the results, as well (p = < 0.05, p = 0.19).Conclusions: Our results are in accordance with the current literature. Music Therapy is a promising alternative intervention for the treatment of anxiety in PwD. Music Therapy is an effective non-pharmacological treatment for the reduction of the caregivers' burden, because of the anxiety symptoms in PwD, such as lack of sleep, lack of personal time, unhealthy lifestyle, lack of solutions on what to do with their patients etc. The type of music, the duration of the intervention and the long-term benefits remain unclear. There is a big need of further research with stronger possible evaluation methods.