COMPARATIVE STUDY
JOURNAL ARTICLE

Predictors of non-pharmacological intervention effect on cognitive function and behavioral and psychological symptoms of older people with dementia

Ting-Jung Hsu, Hui-Te Tsai, An-Chun Hwang, Liang-Yu Chen, Liang-Kung Chen
Geriatrics & Gerontology International 2017, 17 Suppl 1: 28-35
28436192

AIM: Our previous work showed that non-pharmacological interventions could effectively reduce the severity of behavioral and psychological symptoms of dementia (BPSD), while the factors influencing the effect of intervention were less explored. Therefore, the main purpose of the present study was to investigate the predictors of the non-pharmacological intervention effect for old veterans with dementia and BPSD.

METHODS: A total of 141 old veterans with dementia living in two veterans' homes in northern Taiwan were recruited. The participants received an organized non-pharmacological intervention program of physical activity/exercise, music therapy, reality orientation, art therapy, reminiscence therapy and horticultural therapy once every week for 6 months. All participants were evaluated by the Barthel Index, Lawton-Brody Instrumental Activities of Daily Living Scale, Mini-Mental State Examination, neuropsychiatric inventory (NPI), and the Cornell Scale for Depression in Dementia before and after the intervention. Logistic regression was used to investigate factors associated with improvement/maintenance of cognition (measured by the Mini-Mental State Examination), and improvement of BPSD (measured by NPI) and its subdomains during the intervention period.

RESULTS: Multivariate logistic regression analysis showed that the improvement/maintenance of cognitive function was independently associated with a lower Mini-Mental State Examination score at baseline (odds ratio [OR] 0.88, 95% CI 0.80-0.97, P = 0.008), whereas participants with antipsychotic use were less likely to gain the effect (OR 0.42, 95% CI 0.17-1.04, P = 0.061). In addition, the improvement of BPSD was associated with a higher baseline total NPI score (OR 1.33, 95% CI 1.15-1.55, P < 0.001), and the result was consistent in different NPI subdomains (psychotic domain: OR 1.96, 95% CI 0.83-4.58, P = 0.123; affective domain: OR 1.63, 95% CI 1.25-2.13, P < 0.001; behavior domain: OR 2.25, 95% CI 1.53-3.30, P < 0.001) and caregiver burden (OR 1.63, 95% CI 1.24-2.14, P < 0.001). In addition, a higher Cornell Scale for Depression in Dementia score was correlated with an improvement in the NPI behavior domain (OR 1.48, 95% CI 1.01-2.18, P = 0.047), whereas participants with hearing impairment had a lower chance of improvement in the NPI behavior domain (OR 0.11, 95% CI 0.01-1.23, P = 0.073) and care burden (OR 0.17, 95% CI 0.03-0.99, P = 0.050).

CONCLUSIONS: Our findings show that non-pharmacological intervention programs have a significant effect on reducing overall NPI score, NPI caregiver burden score and NPI subdomains - psychotic, affective and behavior syndrome - in old veterans with dementia. In addition, participants with lower cognitive performance, more severe BPSD and depressive symptoms at baseline were more likely to gain benefit from the intervention, whereas antipsychotic use and hearing impairment were negative predictors of improvement of cognition and BPSD, respectively. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 28-35.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
28436192
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"