Abstract
Background: Aberrant motor behaviour or wandering refers to aimless movement without a specific purpose. Wandering is common in patients with dementia and leads to early institutionalization and caregivers’ burden. Non-pharmacological interventions should be also considered as a first-line solution for the wandering because current pharmacological treatment has serious side-effects. Methods: A cross-over randomised controlled trial (RCT) with 60 participants of all stages and different types of dementia was conducted in Greece. The sample was randomly assigned in 6 different groups of 10 participants each. Every intervention lasted for 5 days, and there were 2 days as a wash-out period. There was no drop-out rate. The measurements used were the Mini Mental State Examination (MMSE), Addenbrooke’s Cognitive Examination Revised (ACE-R), Geriatric Depression Scale (GDS), Functional Rating Scale for Symptoms in Dementia (FRSSD), and Neuropsychiatric Inventory (NPI). The interventions that were evaluated were reminiscence therapy (RT), music therapy (MT), and physical exercise (PE). Results: NPI scores were reduced in the group receiving PE (p = 0.006). When MT (p = 0.018) follows PE, wandering symptoms are reduced further. RT should follow MT in order to reduce wandering more (p = 0.034). The same combination was effective for the caregivers’ burden as well; PE (p = 0.004), MT (p = 0.036), RT (p = 0.039). Conclusions: An effective combination that can reduce wandering symptoms in all stages and types of dementia was found: The best order was PH-MT-RT. The same combination in the same order reduced caregivers’ burden.
Highlights
Dementia is a term that is used for a range of diseases that cause cognitive impairment, most often in the elderly, resulting in difficulty in performing everyday activities [1]
A total of 60% of the sample suffered from Alzheimer’s disease (AD), 5% from vascular dementia (VD), 5% from DLB, 5% from PDD, 10% from frontotemporal dementia (FTD), and 15% from mixed dementia (AD and VD)
This study found an effective combination of non-pharmacological interventions that can reduce wandering in patient with dementia (PwD) and caregivers’ burden as well
Summary
Dementia is a term that is used for a range of diseases that cause cognitive impairment, most often in the elderly, resulting in difficulty in performing everyday activities [1]. When a patient with dementia (PwD) has become lost in the community, it is often described as “wandering” [5] This behaviour has been found to occur in 65% of patients with Alzheimer’s disease (AD) [6]. Wandering may be a way to escape from an unpleasant situation, such as isolation, loneliness, boredom, or frustration [9] It is a very critical behaviour because, according to the literature [10], if a PwD, who has been lost has not been found within 24 h, up to half of those patients will suffer from injuries or death. Conclusions: An effective combination that can reduce wandering symptoms in all stages and types of dementia was found: The best order was PH-MT-RT.
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