Effects of Animal-Assisted Therapy (AAT) in Alzheimer’s Disease: A Case Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Approval and Informed Consent
2.2. Study Population
2.3. Experimental Design and Data Collection
2.4. Assessment of Neuropsychological Function
2.5. Statistical Analysis
3. Results and Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
Appendix A. Questionnaire Checklist
- Date:
- Place:
- User name and surname:
- Center of origin:
- Filling operator name:
- Dog operator name:
- Dog name:
- Emotional State
- Fear
- Discomfort
- Indifference
- Pleasure
- Relaxation
- Increased ability to concentrate
- Other (specify: )
- Motor Level
- Moves in a rigid way
- Moves in a stereotyped way
- Opposes resistance
- Is relaxed
- Follows the dog in its movements
- Looks for contact with the dog
- Demonstrates greater fluency
- Stiffens
- Is involved
- Is detached
- Moves away
- Affective Appearance (Relational aspects with the dog)
- Recognizes the dog
- Looks for contact with the dog
- Looks for the dog with his eyes
- Is indifferent
- Prefers an activity to do with the dog (lead it, play with it, do exercises ...)
- Prefers emotional contact (pamper him, brush him, feed him ...)
- Refuses contact with the dog
- Touches the dog on request
- Does not touch the dog even on request
- Emotional state prior to the session: ____________________________________________
- Emotional state immediately after the session: _________________________________________
- Emotional state during the rest of the day: _________________________________________
- Communication Level
- Verbal communication
- Non-verbal communication
- The dog operator interrupts
- The user loses interest or leaves
- Time is over
- The whole session
- Only during certain activities (specify: )
- A little
- Talks about the dog
- When talking about the dog, he/she expresses joy and a desire to see it again
- When talking about the dog, he/she is indifferent
- Expresses fear and anxiety at the thought of seeing the dog again
- Yes
- No
References
- Cibeira, N.; Maseda, A.; Lorenzo-López, L.; González-Abraldes, I.; López-López, R.; Rodríguez-Villamil, J.L.; Millán-Calenti, J.C. Bright Light Therapy in Older Adults with Moderate to Very Severe Dementia: Immediate Effects on Behavior, Mood, and Physiological Parameters. Healthcare 2021, 9, 1065. [Google Scholar] [CrossRef] [PubMed]
- Lashley, T.; Schott, J.M.; Weston, P.; Murray, C.E.; Wellington, H.; Keshavan, A.; Foti, S.C.; Foiani, M.; Toombs, J.; Rohrer, J.D.; et al. Molecular biomarkers of Alzheimer's disease: Progress and prospects. Dis. Model. Mech. 2018, 11, dmm031781. [Google Scholar] [CrossRef] [Green Version]
- Breijyeh, Z.; Karaman, R. Comprehensive Review on Alzheimer's Disease: Causes and Treatment. Molecules 2020, 25, 5789. [Google Scholar] [CrossRef] [PubMed]
- Serrano-Pozo, A.; Das, S.; Hyman, B.T. APOE and Alzheimer's disease: Advances in genetics, pathophysiology, and therapeutic approaches. Lancet Neurol. 2021, 20, 68–80. [Google Scholar] [CrossRef]
- Fakhoury, M. Microglia and Astrocytes in Alzheimer's Disease: Implications for Therapy. Curr. Neuropharmacol. 2018, 16, 508–518. [Google Scholar] [CrossRef]
- Tönnies, E.; Trushina, E. Oxidative Stress, Synaptic Dysfunction, and Alzheimer's Disease. J. Alzheimers Dis. Actions 2017, 57, 1105–1121. [Google Scholar] [CrossRef] [Green Version]
- Robinson, M.; Lee, B.Y.; Hane, F.T. Recent Progress in Alzheimer’s Disease Research, Part 2: Genetics and Epidemiology. J. Alzheimers Dis. 2017, 57, 317–330. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Vasic, V.; Barth, K.; Schmidt, M.H.H. Neurodegeneration and Neuro-Regeneration-Alzheimer’s Disease and Stem Cell Therapy. Int. J. Mol. Sci. 2019, 20, 4272. [Google Scholar] [CrossRef] [Green Version]
- Swerdlow, R.H. Mitochondria and Mitochondrial Cascades in Alzheimer’s Disease. J. Alzheimers Dis. 2018, 62, 1403–1416. [Google Scholar] [CrossRef] [Green Version]
- Sochocka, M.; Donskow-Łysoniewska, K.; Diniz, B.S.; Kurpas, D.; Brzozowska, E.; Leszek, J. The Gut Microbiome Alterations and Inflammation-Driven Pathogenesis of Alzheimer’s Disease-a Critical Review. Mol. Neurobiol. 2019, 56, 1841–1851. [Google Scholar] [CrossRef] [Green Version]
- Eikelboom, W.S.; van den Berg, E.; Singleton, E.H.; Baart, S.J.; Coesmans, M.; Leeuwis, A.E.; Teunissen, C.E.; van Berckel, B.N.M.; Pijnenburg, Y.A.L.; Scheltens, P.; et al. Neuropsychiatric and Cognitive Symptoms Across the Alzheimer Disease Clinical Spectrum: Cross-sectional and Longitudinal Associations. Neurology 2021, 97, e1276–e1287. [Google Scholar] [CrossRef] [PubMed]
- Carrion, C.; Folkvord, F.; Anastasiadou, D. Cognitive Therapy for Dementia Patients: A Systematic Review. Dement. Geriatr. Cogn. Disord. 2018, 46, 1–26. [Google Scholar] [CrossRef] [PubMed]
- Swedish Council on Health Technology Assessment. Dementia—Etiology and Epidemiology: A Systematic Review [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2008 June SBU Assessment No. 172E/1. Available online: https://www.sbu.se/en/publications/sbu-assesses/dementia/dementia--etiology-and-epidemiology/ (accessed on 13 January 2022).
- Swedish Council on Health Technology Assessment. Dementia—Diagnostic and Therapeutic Interventions: A Systematic Review [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2008 June SBU Assessment No. 172E/2. Available online: https://www.sbu.se/en/publications/sbu-assesses/dementia/dementia--diagnostic-and-therapeutic-interventions-vol-2/ (accessed on 13 January 2022).
- Swedish Council on Health Technology Assessment. Dementia—Caring, Ethics, Ethnical and Economical Aspects: A Systematic Review [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2008 June SBU Assessment No. 172E/3. Available online: https://www.ncbi.nlm.nih.gov/books/NBK447961/ (accessed on 13 January 2022).
- van der Steen, J.T.; Smaling, H.J.; van der Wouden, J.C.; Bruinsma, M.S.; Scholten, R.J.; Vink, A.C. Music-based therapeutic interventions for people with dementia. Cochrane Database Syst. Rev. 2018, 7, CD003477. [Google Scholar] [CrossRef] [Green Version]
- Iahaio (International Association of Human-Animal Interaction Organizations). The Iahaio Definitions for Animal Assisted Intervention and Guidelines for Wellness of Animals Involved in AAI. IAHAIO White Paper 2014, Updated for 2018. Available online: https://iahaio.org/wp/wp-content/uploads/2021/01/iahaio-white-paper-2018-english.pdf (accessed on 12 January 2021).
- O’Haire, M. Research on animal-assisted intervention and autism spectrum disorder, 2012–2015. Appl. Dev. Sci. 2017, 21, 200–216. [Google Scholar] [CrossRef] [PubMed]
- Lavín-Pérez, A.M.; Martín-Sánchez, C.; Martínez-Núñez, B.; Lobato-Rincón, L.L.; Villafaina, S.; González-García, I.; Mata-Cantero, A.; Graell, M.; Merellano-Navarro, E.; Collado-Mateo, D. Effects of Dog-Assisted Therapy in Adolescents with Eating Disorders: A Study Protocol for a Pilot Controlled Trial. Animals 2021, 11, 2784. [Google Scholar] [CrossRef]
- Sbrizzi, C.; Sapuppo, W. Effects of Pet Therapy in Elderly Patients with Neurocognitive Disorders: A Brief Review. Dement. Geriatr. Cogn. Dis. Extra 2021, 11, 198–206. [Google Scholar] [CrossRef]
- Menna, L.F.; Santaniello, A.; Todisco, M.; Amato, A.; Borrelli, L.; Scandurra, C.; Fioretti, A. The Human-Animal Relationship as the Focus of Animal-Assisted Interventions: A One Health Approach. Int. J. Environ. Res. Public Health 2019, 16, 3660. [Google Scholar] [CrossRef] [Green Version]
- Corson, S.A.; Corson, E.O. Companion Animals as Bonding Catalysts in Geriatric Institutions. In Interrelations Between People and Pets; Charles, C., Fogle, B., Eds.; Thomas: Springfield, IL, USA, 1981; pp. 146–174. [Google Scholar]
- Quintavalla, F.; Cao, S.; Spinelli, D.; Caffarra, P.; Rossi, F.M.; Basini, G.; Sabbioni, A. Effects of Dog-Assisted Therapies on Cognitive Mnemonic Capabilities in People Affected by Alzheimer’s Disease. Animals 2021, 11, 1366. [Google Scholar] [CrossRef]
- Kanamori, M.; Suzuki, M.; Yamamoto, K.; Kanda, M.; Matsui, Y.; Kojima, E.; Fukawa, H.; Sugita, T.; Oshiro, H. A day care program and evaluation of animal-assisted therapy (AAT) for the elderly with senile dementia. Am. J. Alzheimers Dis. Other Demen. 2001, 16, 234–239. [Google Scholar] [CrossRef]
- Sheikh, A.B.; Javed, N.; Leyba, K.; Khair, A.H.; Ijaz, Z.; Dar, A.A.; Hanif, H.; Farooq, A.; Shekhar, R. Pet-Assisted Therapy for Delirium and Agitation in Hospitalized Patients with Neurocognitive Impairment: A Review of Literature. Geriatrics 2021, 6, 96. [Google Scholar] [CrossRef]
- Moretti, F.; De Ronchi, D.; Bernabei, V.; Marchetti, L.; Ferrari, B.; Forlani, C.; Negretti, F.; Sacchetti, C.; Atti, A.R. Pet therapy in elderly patients with mental illness. Psychogeriatrics 2011, 1, 125–129. [Google Scholar] [CrossRef] [PubMed]
- Invernizzi, S.; Simoes Loureiro, I.; Kandana Arachchige, K.G.; Lefebvre, L. Late-Life Depression, Cognitive Impairment, and Relationship with Alzheimer’s Disease. Dement. Geriatr. Cogn. Disord. 2021, 25, 1–11. [Google Scholar] [CrossRef] [PubMed]
- Tublin, J.M.; Adelstein, J.M.; Del Monte, F.; Combs, C.K.; Wold, L.E. Getting to the Heart of Alzheimer Disease. Circ. Res. 2019, 124, 142–149. [Google Scholar] [CrossRef] [PubMed]
- Yang, M.; Li, C.; Zhang, Y.; Ren, J. Interrelationship between Alzheimer’s disease and cardiac dysfunction: The brain-heart continuum? Acta Biochim. Biophys. Sin. 2020, 52, 1–8. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- World Health Organization. International Classification of Disease, Injuries, and Causes of Death, 10th ed.; World Health Organization (WHO): Malta, 1992; Volume 1, Chapter V(F). [Google Scholar]
- Folstein, M.F.; Folstein, S.E.; McHugh, P.R. Mini Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician. J. Psychiatr. Res. 1975, 12, 189–198. [Google Scholar] [CrossRef]
- Yesavage, J.A.; Brink, T.L. Development and Validation of a Geriatric Depression Screening Scale: A preliminary report. J. Psychiatr. Res. 1983, 17, 37–49. [Google Scholar] [CrossRef]
- Cherniack, E.P.; Cherniack, A.R. The benefit of pets and animal-assisted therapy to the health of older individuals. Curr. Gerontol. Geriatr. Res. 2014, 2014, 623203. [Google Scholar] [CrossRef] [Green Version]
- Ortmeyer, H.K.; Katzel, L.I. Effects of Proximity between Companion Dogs and Their Caregivers on Heart Rate Variability Measures in Older Adults: A Pilot Study. Int. J. Environ. Res. Public Health 2020, 17, 2674. [Google Scholar] [CrossRef]
- Wołyńczyk-Gmaj, D.; Ziółkowska, A.; Rogala, P.; Ścigała, D.; Bryła, L.; Gmaj, B.; Wojnar, M. Can Dog-Assisted Intervention Decrease Anxiety Level and Autonomic Agitation in Patients with Anxiety Disorders? J. Clin. Med. 2021, 10, 5171. [Google Scholar] [CrossRef]
- An, H.J.; Park, S.J. Effects of Animal-Assisted Therapy on Gait Performance, Respiratory Function, and Psychological Variables in Patients Post-Stroke. Int. J. Environ. Res. Public Health 2021, 18, 5818. [Google Scholar] [CrossRef]
- Cole, K.M.; Gawlinski, A.; Steers, N.; Kotlerman, J. Animal-assisted therapy in patients hospitalized with heart failure. Am. J. Crit. Care 2007, 16, 575–585. [Google Scholar] [CrossRef] [PubMed]
- Rodrigo-Claverol, M.; Malla-Clua, B.; Marquilles-Bonet, C.; Sol, J.; Jové-Naval, J.; Sole-Pujol, M.; Ortega-Bravo, M. Animal-Assisted Therapy Improves Communication and Mobility among Institutionalized People with Cognitive Impairment. Int. J. Environ. Res. Public Health 2020, 17, 5899. [Google Scholar] [CrossRef] [PubMed]
- Santaniello, A.; Garzillo, S.; Amato, A.; Sansone, M.; Di Palma, A.; Di Maggio, A.; Fioretti, A.; Menna, L.F. Animal-Assisted Therapy as a Non-Pharmacological Approach in Alzheimer’s Disease: A Retrospective Study. Animals 2020, 10, 1142. [Google Scholar] [CrossRef] [PubMed]
- Peluso, S.; De Rosa, A.; De Lucia, N.; Antenora, A.; Illario, M.; Esposito, M.; De Michele, G. Animal-Assisted Therapy in Elderly Patients: Evidence and Controversies in Dementia and Psychiatric Disorders and Future Perspectives in Other Neurological Diseases. J. Geriatr. Psychiatry Neurol. 2018, 31, 149–157. [Google Scholar] [CrossRef]
Demographic, Clinical and Neuropsychological Parameters | nAD | AD | ||||
---|---|---|---|---|---|---|
Ctrl | AAT | Total | Ctrl | AAT | Total | |
Age (years) | 79.33 ± 3.78 | 84.67 ± 8.38 | 82.00 ± 6.80 | 86.38 ± 3.88 | 81.67 ± 6.06 | 84.00 ± 5.43 |
Gender (F/M) | 4/2 | 4/2 | 8/4 | 4/2 | 6/0 | 10/2 |
SP (mmHg) | ||||||
T1 | 123.33 ± 12.58 | 111.67 ± 3.93 | 117.50 ± 10.78 | 126.67 ± 18.93 | 140.00 ± 23.81 | 133.33 ± 21.66 |
T10 | 120.00 ± 9.57 | 108.33 ± 11.91 | 114.17 ± 11.97 | 116.67 ± 14.43 | 123.33 ± 19.02 | 120.00 ± 16.47 |
T+15 | 140.00 ± 35.85 | 146.67 ± 21.45 | 143.33 ± 28.38 | 135.00 ± 42.90 | 135.00 ± 34.08 | 135.00 ± 36.94 |
DP (mmHg) | ||||||
T1 | 68.33 ± 4.27 | 70.00 ± 9.68 | 69.17 ± 7.18 | 63.33 ± 5.50 | 83.33 ± 14.14 | 73.33 ± 14.62 |
T10 | 73.33 ± 5.65 | 65.00 ± 8.46 | 69.17 ± 8.12 | 66.67 ± 11.04 | 73.33 ± 14.02 | 70.00 ± 12.53 |
T+15 | 85.00 ± 8.97 | 83.33 ± 3.14 | 84.17 ± 6.46 | 76.67 ± 11.76 | 75.00 ± 5.62 | 75.83 ± 8.83 |
HR (beats/min) | ||||||
T1 | 68.67 ± 6.77 | 69.00 ± 13.49 | 68.83 ± 10.18 | 91.33 ± 29.25 | 72.00 ± 9.96 | 81.67 ± 23.15 |
T10 | 69.33 ± 4.55 | 72.00 ± 8.32 | 70.67 ± 6.54 | 75.00 ± 16.43 | 80.00 ± 20.83 | 77.50 ± 18.08 |
T+15 | 68.33 ± 5.65 | 76.00 ± 8.00 | 72.17 ± 7.72 | 84.33 ± 31.49 | 80.33 ± 26.27 | 82.33 ± 27.73 |
MMSE (score) | ||||||
T1 | 24.57 ± 3.09 | 20.33 ± 2.75 | 22.45 ± 3.56 | 9.77 ± 3.58 | 13.67 ± 4.26 | 11.72 ± 4.27 |
T5 | 25.90 ± 3.20 | 20.00 ± 1.73 | 22.95 ± 3.94 | 12.43 ± 3.42 | 16.00 ± 4.84 | 14.22 ± 4.41 |
T10 | 22.60 ± 3.79 | 21.00 ± 2.67 | 21.80 ± 3.23 | 10.77 ± 3.21 | 15.00 ± 3.59 | 12.88 ± 3.93 |
T+15 | 26.50 ± 3.01 | 22.33 ± 4.29 | 24.42 ± 4.15 | 13.10 ± 5.07 | 17.00 ± 2.58 | 15.05 ± 4.34 |
GDS (score) | ||||||
T1 | 12.67 ± 2.25 | 7.00 ± 0.89 | 9.83 ± 3.38 | 13.67 ± 2.73 | 10.67 ± 4.03 | 12.17 ± 3.64 |
T5 | 12.00 ± 0.89 | 6.33 ± 1.03 | 9.17 ± 3.10 | 19.33 ± 2.73 | 14.67 ± 5.96 | 17.00 ± 5.05 |
T10 | 10.67 ± 2.88 | 9.00 ± 2.37 | 9.83 ± 2.66 | 16.00 ± 4.73 | 13.67 ± 5.47 | 14.83 ± 5.02 |
T+15 | 9.67 ± 3.72 | 7.33 ± 1.37 | 8.50 ± 2.94 | 14.33 ± 3.62 | 12.33 ± 3.39 | 13.33 ± 3.50 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Gregorini, A.; Di Canio, A.; Palmucci, E.; Tomasetti, M.; Rocchi, M.B.L.; Colomba, M. Effects of Animal-Assisted Therapy (AAT) in Alzheimer’s Disease: A Case Study. Healthcare 2022, 10, 567. https://doi.org/10.3390/healthcare10030567
Gregorini A, Di Canio A, Palmucci E, Tomasetti M, Rocchi MBL, Colomba M. Effects of Animal-Assisted Therapy (AAT) in Alzheimer’s Disease: A Case Study. Healthcare. 2022; 10(3):567. https://doi.org/10.3390/healthcare10030567
Chicago/Turabian StyleGregorini, Armando, Angela Di Canio, Emanuele Palmucci, Marco Tomasetti, Marco B. L. Rocchi, and Mariastella Colomba. 2022. "Effects of Animal-Assisted Therapy (AAT) in Alzheimer’s Disease: A Case Study" Healthcare 10, no. 3: 567. https://doi.org/10.3390/healthcare10030567