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Randomized Controlled Trial
. 2021 Oct 12;21(1):545.
doi: 10.1186/s12877-021-02496-0.

The doll therapy as a first line treatment for behavioral and psychologic symptoms of dementia in nursing homes residents: a randomized, controlled study

Francesca Santagata  1 , Massimiliano Massaia  1 , Patrizia D'Amelio  2   3
Affiliations
Randomized Controlled Trial

The doll therapy as a first line treatment for behavioral and psychologic symptoms of dementia in nursing homes residents: a randomized, controlled study

Francesca Santagata et al. BMC Geriatr. .

Abstract

Background: Patients living with dementia are severely affected by the development of behavioral and psychologic symptoms (BPSD) which represent a burden for patients and caregivers. The use of psychotropic drugs in the control of BPSD is widely diffused, however the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) in the management of BPSD, on the reduction of caregiver burden and delirium incidence in nursing home residents by a randomized controlled trial.

Methods: We enrolled fifty-two nursing homes residents living with dementia and BPSD. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured BPSD, caregiver burden and delirium with standard clinical scales at baseline, after 45 and 90 days. In order to evaluate the presence of BPSD we used Neuropsychiatric Inventory (NPI) scale and the A.Di.CO scale, the caregiver burden was measured by the Greutzner scale and delirium by the Confusion Assessment Method (CAM) scale.

Results: DT was more effective in reducing agitation and aggressiveness as respect to ST. Moreover DT globally reduced the presence of BPSD as dysphoria, wandering and apathy. We observed a significant reduction of the professional caregiver burden and the incidence of delirium was significantly reduced in subjects treated with DT.

Conclusions: We show that DT is more effective that ST in the control of BSPD in patients affected by moderate to severe dementia. Moreover we suggest that DT may effective in reducing the incidence of delirium.

Trial registration: Retrospectively registered in ClinicalTrials.gov the 10th June 2, 2021 trial registration number NCT04920591.

Keywords: Behavioral and psychologic symptoms of dementia; Delirium; Dementia; Doll therapy; Non-pharmacological approach; Nursing home.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Empathy dolls. The pictures show the dolls used in the study (panel A), interaction between patient and doll (panel B)
Fig. 2
Fig. 2
Study flow chart. The diagram shows the study design with the number of patients at each visit
Fig. 3
Fig. 3
Doll therapy is effective in the control of BPSD. Effect of DT versus ST on the control of BPSD measures by A.Di.CO (panel A), NPI global score (Panel B), NPI score for agitation (panel C), NPI score for dysphoria (panel D), NPI score for apathy (panel E), NPI score for wandering (panel F). Results of two-way ANOVA for repeated measurements are shown in the box, significant differences versus baseline are indicated by the star (*)
Fig. 4
Fig. 4
Doll therapy is effective in reducing the caregiver burden and the incidence of delirium. Effect of DT versus ST on the caregiver burden measured with the Greutzner scale (panel A) the results of two-way ANOVA for repeated measurements are shown in the box in panel A, significant differences versus baseline are indicated by the star (*). Incidence of delirium in DT group (panels B) and in ST group (panel C), both absolute number and percentage of patients is shown. Results for the χ2 test for trends are shown in the box
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