Abstract
Objectives: Behavioral and Psychological Symptoms of Dementia (BPSD) are very frequent, and they affect approximately 90% of the patients with dementia (PwD). Disinhibition refers to inappropriate behavior, and involves impulsivity, social difficulties, and poor risk assessments. Disinhibition can lead to reduced social acceptance, early institutionalization, poor prognosis, and affects the quality of life of both patient and his/her caregiver.
Methods / Design: A cross-over randomized controlled trial with 60 patients with PwD and disinhibition symptoms was conducted in Greece. The patients were randomly assigned to 6 different groups of ten participants each and received three non-pharmacological interventions: a) Aromatherapy and Massage b) Body Exercise (BE) and c) Psycho-educational program of caregivers. The interventions lasted for 5 days and there was two days off, as a wash-out period. There was no drop-out rate. The measurements which were used are MMSE, ACE-R, GDS, FRSSD, NPI questionnaires at baseline and NPI after each intervention.
Results: No effective combination of non-pharmacological interventions was found for the patients. For the caregivers’ burden the most effective combination for the reduction of their distress was: Psycho-educational program (p=0.014), followed by BE (p=0.018), followed by aromatherapy and massage (p=0.027).
Conclusions: An effective combination of non-pharmacological interventions that can reduce caregivers’ burden because of the disinhibition symptoms of their patients is Psycho-educational program, followed by BE, followed by aromatherapy and massage.
Keywords
- dementia
- Alzheimer’s disease
- BPSD
- non-pharmacological interventions
- Disinhibition
- cross-over randomized controlled trial.