Receptive music interventions improve apathy and depression in elderly patients with dementia

Individuals with dementia and their families often experience poor quality of life due to patient's behavioral and psychological symptoms. Increasing evidence has mounted on the potential role of music in improving social, emotional and cognitive skills. In the present study we aim to investigate whether a receptive music intervention might reduce apathy and depression in elderly patients with Alzheimer's disease (AD) or vascular dementia (VaD) and improve their caregivers' burden. Among patients attending to a Memory Clinic, we have enrolled 48 AD or VaD elderly subjects. They were divided into two groups on the basis of family agreement to musictherapy. The experimental group (n=15) was asked to listen to a 80-minute audio CD, for at least 15 minutes per day, at least once a week, for three months. The overall sample was evaluated at baseline, at week 4 and at week 12 through the Mini Mental State Examination (MMSE), the Cornel- Brown Scale QoL in Dementia (CBSQoLD) and the Apathy Evaluation Scale (AES); caregiver stress was assessed using the Caregiver Burden Inventory (CBI). Apathy and depression were significantly improved among patients treated with music interventions compared to control group (treatment effect =43.667; P<0.001 and treatment effect =61.238; P<0.001 respectively). Caregiver burden was significantly reduced after three months of receptive music approach (treatment effect =15.759; P<0.001). The results of this study are consistent with the efficacy of receptive music interventions on improving apathy and depression in AD or VaD elderly patients and lowering associated caregiver's burden

Musical hallucinations in elderly patients with visuospatial impairment: two case reports

Musical hallucinations are an uncommon type of auditory hallucinations, they widely occur in elderly. Our group analyzed medical history, pharmacological therapy, neuropsychological pattern, audiometric testing, electroencephalogram, cerebral magnetic resonance and cerebral fludeoxyglucose-positron emission tomography (FDG-PET) of two patients. FDGPET showed in both patients hypometabolism pronounced in posterior regions. In particular the medial-inferior temporal cortex and the occipital associative areas were affected. Moreover, neuropsychological pattern suggested a visuospatial-executive deficit, conformed to the occipital involvement. Our reported cases might suggest that musical hallucinations have been arisen from a combination of peripheral and central dysfunction. A further explanation might be that musical hallucinations result from multiple white matter lacunar lesions due to small vascular events. A question is whether musical hallucinations might be primarily associated with occipital areas hypometabolism and visuospatial alterations typically associated with Levy body dementia (LBD)

Efficacy of Doll thErapy compared with standard treatment in the control of behavioral and psychologic Symptoms and CaRegIver Burden in dEmentia: DESCRIBE a randomized, controlled study

Behavioral and psychologic symptoms of dementia (BPSD) are frequent and represent a burden for patients and caregivers; in particular, the presence of agitation and aggression (A/A) has an important impact on patients’ quality of life. As psychotropic drugs can induce severe collateral effects, the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) on A/A in geriatric patients with moderate to severe dementia hospitalized in an acute geriatric unit. We enrolled fifty-two acute in-patients with dementia and A/A. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured agitation and caregiver burden with standard clinical scales at baseline and during treatment. In order to evaluate the effect of DT withdrawal, we carried out a telephonic follow-up interview after 1 and 4 weeks from hospital discharge. DT is more effective than ST in the control of agitation, but not in reducing the professional caregiver burden. The use of pro re nata psychotropic drugs was reduced in patients treated with DT. After DT withdrawal, A/A progressively increased. In conclusion we show that DT may be more effective than ST in the control of A/A in acute geriatric in-patients affected by dementia. Our results suggest that, in patients affected by severe to moderate forms of dementia with A/A, DT may be used as a first line treatment, not only in nursing home residents, but also in acute care geriatric in-patients