An Indoor Therapeutic Garden for Behavioral Symptoms in Alzheimer's Disease: A Randomized Controlled Trial.

BACKGROUND

Behavioral and psychological symptoms of dementia (BPSD) affect 60-90% of patients with Alzheimer's disease (AD).

OBJECTIVE

To determine if environmental therapy is an effective strategy to reduce BPSD, we tested 163 patients with AD with Neuropsychiatric Inventory (NPI) before and after 6 months of an indoor therapeutic garden (TG) or standard environment.

METHODS

A single-blind randomized controlled trial on AD patients with BPSD. Participants were randomized to an indoor TG (N = 82), or standard environment (control, N = 81) for 6 months.

PRIMARY OUTCOME

change in the NPI score from baseline (T0) to end of treatment (T1).

SECONDARY OUTCOMES

change in use of quetiapine, cognition, activities of daily living, salivary cortisol, blood pressure from T0 to T1.

RESULTS

NPI score significantly ameliorated (TG versus control: -31.8 points), quetiapine dosage (-150 mg), blood pressure (-2.6 mm Hg), and salivary cortisol (-6.4 to -2.1 Nmol/l) were significantly reduced, the Mini-Mental State Examination significantly improved (1.8 points) in the TG versus control arm at T1 (p < 0.001). No adverse events were reported.

CONCLUSION

The indoor TG seems safe and may reduce BPSD, medication intake, and cortisol levels in AD.