Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei City Hospital Zhonghsiao Branch, Taipei, Taiwan.
Geriatr Gerontol Int. 2014 Apr;14(2):440-6. doi: 10.1111/ggi.12126. Epub 2013 Aug 1.
The clinical effectiveness of non-pharmacological interventions on behavioral and psychological symptoms of dementia (BPSD) among older Chinese with dementia remains unclear, and the evidence supporting the benefits of a non-pharmacological approach on psychotic symptoms is scarce.
A prospective cohort study including 104 older men with dementia living in two veterans homes in Taiwan was carried out in 2011. An organized program of music therapy, orientation training, art-cognitive activities and physical activities was carried out for the intervention group. All participants were evaluated for neuropsychiatric inventory (NPI), defined daily dose of psychotropic drug use, Barthel Index, Instrumental Activities of Daily Living, Mini-Mental State Examination, Geriatric Depression Scale, Tinetti balance score and Tinetti gait score.
Overall, 104 residents were enrolled and 92 of them completed the study. The intervention group had a more significant reduction than the reference group in the overall NPI score (-2.36, P = 0.046), and in the subcategories of delusion (-0.9, P = 0.018), hallucination (-0.82, P = 0.004) and agitation (-0.91, P = 0.038). Multivariate analysis showed that the non-pharmacological intervention was associated with a favorable outcome in overall NPI score (OR 4.113, P = 0.013) and in the subcategories of hallucination (OR 14.309, P = 0.049) and agitation (OR 6.604, P = 0.037). Meanwhile, a higher baseline NPI score was also associated with a favorable outcome in overall NPI score, and in the subcategories of delusion, hallucination and agitation.
Non-pharmacological interventions have a positive effect on behavioral and psychological symptoms of dementia, not only in outward symptoms like agitation, but also intrinsic psychotic symptoms like hallucination and delusion, and agitation in older Chinese men with dementia.
非药物干预对中国老年痴呆症患者行为和心理症状（BPSD）的临床疗效尚不清楚，并且支持非药物干预对精神病症状有益的证据也很少。
2011 年，对台湾两家退伍军人之家的 104 名老年痴呆症男性进行了一项前瞻性队列研究。为干预组开展了音乐疗法、定向训练、艺术认知活动和体育活动等有组织的方案。所有参与者均接受神经精神病学检查（NPI）、精神药物使用的定义日剂量、巴氏量表、日常生活活动能力量表、简易精神状态检查、老年抑郁量表、Tinetti 平衡评分和 Tinetti 步态评分评估。
共有 104 名居民入组，其中 92 名完成了研究。与对照组相比，干预组的总体 NPI 评分（-2.36，P=0.046）以及妄想（-0.9，P=0.018）、幻觉（-0.82，P=0.004）和激越（-0.91，P=0.038）的亚组评分下降更为显著。多变量分析显示，非药物干预与 NPI 总分（OR 4.113，P=0.013）和幻觉（OR 14.309，P=0.049）和激越（OR 6.604，P=0.037）亚组的有利结局相关。同时，较高的基线 NPI 评分也与 NPI 总分和妄想、幻觉和激越等亚组的有利结局相关。
非药物干预对老年痴呆症患者的行为和心理症状有积极影响，不仅对外在症状如激越，而且对内在的精神病症状如幻觉和妄想也有积极影响，对老年中国男性痴呆症患者的激越症状也有积极影响。
