Department of Geriatric Medicine, Gerontopole Alzheimer Clinical & Research Center, University Hospital of Toulouse, Gérontopôle de Toulouse, 224, avenue de Casselardit, INSERM CERPOP 1295, 31059, Cedex 9, Toulouse, France.
Aging Clin Exp Res. 2021 Dec;33(12):3379-3383. doi: 10.1007/s40520-021-01916-w. Epub 2021 Jul 6.
Our 1-year pilot study aims to compare Behavioral and Psychological Symptoms of Dementia (BPSDs): number and frequency, globally an in sub-domains, and distress, of 20 residents with dementia, during periods with companion clown intervention and BPSDs during periods without companion clown intervention.
A duo of accompanying clowns intervened 24 times for a total of 72 h (two interventions of 3 h each per week for 4 weeks, 3 months of the year spaced 13 weeks apart) in the Special Care Unit. This unit was dedicated to residents with severe BPSDs. BPSDs were measured monthly by Health Care Professional using Neuro-Psychiatric Inventory (NPI).
Baseline NPI total score of the 20 residents (10 women, mean age 76.9 years; standard deviation, SD 8.1, 70.6% with Alzheimer's disease) was 37.5 (SD = ± 19.7). The total score of the NPI was not significantly different between the periods with the clowns (median total score at 63; 25p-75p = 57-67) and the periods without the clowns (59; 25p-75p = 43-76) (p = 0.08). Compared to the period without clowns, residents presented significantly fewer delusions, hallucinations, euphoria, aberrant motor behavior but significantly more depression, apathy, disinhibition and more appetite disorders (all p value < 0.05). No statistically significant difference was observed on the distress the symptoms caused on the HCP during periods with the clowns.
Accompanying clowns may not significantly reduce the overall BPSD of the residents, but may have beneficial effects in some behavioral issues.
我们为期 1 年的试点研究旨在比较有陪伴小丑干预和无陪伴小丑干预期间，20 名痴呆症患者的行为和心理症状（BPSD）：数量和频率，总体上和亚领域，以及困扰，20 名痴呆症患者的行为和心理症状（BPSD）。
一对陪伴小丑在特殊护理单元进行了 24 次干预，总时长为 72 小时（每周两次，每次 3 小时，共 4 周，每年分 4 次进行，每次间隔 13 周）。该单元专门为有严重 BPSD 的患者提供服务。每月由医疗保健专业人员使用神经精神疾病问卷（NPI）测量 BPSD。
20 名患者（10 名女性，平均年龄 76.9 岁；标准差 8.1，70.6%为阿尔茨海默病患者）的基线 NPI 总分为 37.5（标准差 ±19.7）。有小丑和没有小丑的时期之间，NPI 总分没有显著差异（中位数总分分别为 63；25p-75p=57-67 和 59；25p-75p=43-76）（p=0.08）。与无小丑干预期相比，患者出现的妄想、幻觉、欣快、异常运动行为显著减少，但抑郁、淡漠、失抑制和食欲障碍显著增加（所有 p 值均<0.05）。在有小丑干预期间，患者的症状对 HCP 造成的困扰并没有显著差异。
陪伴小丑可能不会显著减少患者的总体 BPSD，但可能对某些行为问题有有益的影响。
