Tatiana-Danai Dimitriou, John Papatriantafyllou, Anastasia Konsta, Dimitrios Kazis, Loukas Athanasiadis, Panagiotis Ioannidis, Efrosini Koutsouraki, Thomas Tegos, Magda Tsolaki
1 Department of Neurology, Aristotle University of Thessaloniki, Greece.
2 Neurology Department, University of Athens, 'Attikon' Hospital, Greece.
J Clin Cases Rep. 2022;5(4):139-148. Epub 2022 Jan 31.
Hallucinations is a core characteristic symptom in Lewy Body Dementia (DLB) and Parkinson's Dementia (PDD). It may also appear at the late stages of Alzheimer's disease (AD). They are not easily managed, and they are associated with cognitive decline, earlier institutionalization, increased mortality, and increased caregivers' burden.
DESIGN/SETTING: This is a cross-over RCT. The participants were randomly assigned in 6 different groups of 10 patients each.
60 dementia patients (different types and stages of dementia).
The three non-pharmacological interventions used are: A) Validation therapy (VT) in a Psycho-educational program, B) Reminiscence therapy (RT) and C) Music therapy (MT). Each intervention lasted for 5 days and there was an interval of two days, as a wash-out period (all the interventions had a duration of 3 weeks).
The measurements which were used at baseline were: MMSE, ACE-R, GDS, FRSDD and NPI questionnaire at baseline and after each intervention.
The most effective combination for the reduction of the hallucinations is: VT/Psycho-educational program (p = 0.005), MT (p = 0.007) and RT (p = 0.022). The same combination applies for the caregivers' distress: VT/Psychoeducational program (p = 0.010) - MT (p = 0.023) - RT (p = 0.036).
VT/Psycho-educational program followed by MT, followed by RT is an effective combination of non-pharmacological interventions that can reduce hallucinations in patients with dementia and caregivers' burden. Non-pharmacological interventions should be further examined as an effective alternative for the reduction of the hallucinations in dementia.
幻觉是路易体痴呆（DLB）和帕金森病痴呆（PDD）的核心特征性症状。它也可能出现在阿尔茨海默病（AD）的晚期。幻觉不易控制，且与认知衰退、更早入住机构、死亡率增加以及护理人员负担加重相关。
设计/背景：这是一项交叉随机对照试验。参与者被随机分为6组，每组10名患者。
60名痴呆患者（不同类型和阶段的痴呆）。
使用的三种非药物干预措施为：A）心理教育项目中的验证疗法（VT），B）回忆疗法（RT），C）音乐疗法（MT）。每种干预持续5天，中间间隔两天作为洗脱期（所有干预持续3周）。
基线时使用的测量指标为：简易精神状态检查表（MMSE）、认知能力快速筛查量表（ACE-R）、老年抑郁量表（GDS）、功能性评定抑郁量表（FRSDD）以及基线时和每次干预后的神经精神症状问卷（NPI）。
减少幻觉最有效的组合是：VT/心理教育项目（p = 0.005）、MT（p = 0.007）和RT（p = 0.022）。对护理人员的痛苦而言，相同的组合也适用：VT/心理教育项目（p = 0.010） - MT（p = 0.023） - RT（p = 0.036）。
先进行VT/心理教育项目，接着是MT，然后是RT，这种非药物干预措施的有效组合可减少痴呆患者的幻觉及护理人员的负担。非药物干预措施应作为减少痴呆患者幻觉的有效替代方法作进一步研究。
