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Dance Workshop for Institutionalized Seniors With Behavioral and Psychological Symptoms of Dementia

Not Applicable
Recruiting
Conditions
Dementia
Registration Number
NCT05799001
Lead Sponsor
Centre Hospitalier Emile Roux
Brief Summary

It is estimated that the prevalence of dementia in France is 5% for people over 65 years of age and that this increases to 18% for people over 75 years of age. Behavioral disorders are frequent in patients with dementia and are the main cause of institutionalization, representing up to 50% of cases. Dementia syndromes can be translated into behavioral and psychological symptoms of dementia (BPSD), which are defined as perceptual, mood or behavioral disorders. To date, there is no cure for dementia, but certain measures can be taken to reduce symptoms. The HAS suggests that physical exercise would reduce BPSD and could improve the ability to perform activities of daily living or slow down the cognitive decline of this type of patient. Indeed, several articles have highlighted the benefits of physical activity in demented patients. A meta-analysis has shown a significant decrease in BPSD via the Neuropsychiatric Inventory (NPI) score. Nevertheless, it is often observed that there is a difficulty in adhering to the program in very elderly population groups. Dance is a complete physical activity that integrates physical, cognitive and social elements. A meta-analysis has shown that dance has a significant effect on global cognition but also on neuroplasticity and physical functioning in patients with mental disorders. The music component of dance also has an effect on the behavioral problems of demented patients, stimulating language ability and social and emotional function.

However, at present, no study of good methodological quality has been able to demonstrate the effectiveness of dance-based physical activity for the treatment of dementia symptoms. As a result of these findings, the APAISE project was developed and should help slow the onset of BPSD in patients with dementia.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
180
Inclusion Criteria
  1. Institutionalized patient (male or female) over 65 years of age ;
  2. Patient with behavioral problems, as measured by an NPI-ES ≥ 4 on any item and an NPI-ES impact scale ≥ 3 ;
  3. Patient able to mobilize the upper body at a minimum (arms, trunk, head);
  4. Medication (antipsychotics, antidepressants, anxiolytics and related hypnotics) without major modification for at least 30 days prior to inclusion after medical advice;
  5. Possibility of including patients under guardianship or curatorship;
  6. Patient affiliated to a social security plan;
  7. Obtaining consent from the patient or legal representative.
Exclusion Criteria
  1. Inability of the patient to follow the sessions (e.g., major visual/auditory disabilities), difficult follow-up, or any other reason at the discretion of the investigator;
  2. Inability of the health care team to complete the NPI-ES questionnaire for the patient;
  3. Patient has a concurrent psychiatric disorder (e.g., bipolar disorder, schizophrenia, or other).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Compare the effectiveness of adding biweekly dance class for 4 months on behavioral and psychological symptoms of dementia in institutionalized older adults compared to usual care alone.4 months

The primary endpoint was the overall score on the validated Neuropsychiatric Inventory questionnaire, completed by the health care teams. This questionnaire will be done at inclusion (day 0) and after 4 months of dance therapy for the experimental group or usual care alone for the control group.This questionnaire allows to highlight behavioral disorders in patients suffering from dementia according to 10 behavioral domains and 2 neurovegetative variables (sleep and appetite).

Secondary Outcome Measures
NameTimeMethod
evolution of behavioral problems- 8 and 12 months for the experimental group- 12 and 16 months for the control group

Neuropsychiatric Inventory (NPI-ES) score

activity frequency of dementia patients- 4 months (for the 2 groups)- 8 and 12 months for the experimental group- 12 and 16 months for the control group

Activity and Affect Indicators of Quality of Life (AAIQOL) score This questionnaire contains 21 items: 15 items relating to patient activity and 6 items relating to patient affect. The questionnaire highlights decreases in the frequency of activity in institutionalized dementia patients, as well as increases in negative affect and decreases in positive affect, both of which are indicators of worsening dementia.

collection of drugs- 4 months (for the 2 groups)- 8 and 12 months for the experimental group- 12 and 16 months for the control group

collected on the medical record : antipsychotics, antidepressants, anxiolytics and related hypnotics

evaluation of cognitive functions- 4 months (for the 2 groups)- 8 and 12 months for the experimental group- 12 and 16 months for the control group

Mini Mental State Examination (MMSE) score. The questionnaire consists of 30 items, and each correct answer is worth 1 point. The score must take into account the patient's age and level of education.

program membership12 months for the experimental group16 months for the control group

Number of sessions attended by patients.

autonomy or degree of dependence- 4 months (for the 2 groups)- 8 and 12 months for the experimental group- 12 and 16 months for the control group

Activities of Daily Living (ADL) score. This questionnaire studies the autonomy or degree of dependence of institutionalized patients in carrying out practical activities of daily living: personal hygiene, dressing, going to the toilet, locomotion, continence, eating. It is made up of 6 items, and each item has 3 possible answers. Answers must correspond to the patient's abilities. A total score of 6 indicates maximum patient autonomy.

state of depression- 4 months (for the 2 groups)- 8 and 12 months for the experimental group- 12 and 16 months for the control group

short-Geriatric Depression Scale (short-GDS) score This questionnaire is used to assess depression in the elderly and demented. The short-GDS is a shortened version (15 items) of the GDS (30 items). Each item is answered with a yes or no. Depending on the answer, a value of 0 or 1 is assigned. A total score between 0 and 5 is considered normal, between 5 and 9 indicates probable depression, and a score greater than or equal to 10 almost always indicates the existence of depression.

minimal motor and postural possibilities- 4 months (for the 2 groups)- 8 and 12 months for the experimental group- 12 and 16 months for the control group

Test Moteur Minimum (TMM) score This simple clinical test can be used to assess the minimum motor and postural capabilities of frail elderly subjects. The test assesses postural skills and protective reactions of the upper and lower limbs. Scoring calls for an affirmative or negative response. Each response is assigned a score: if the response is in favor of preserved motor capacity, the score is 1, whereas the score is 0 if the response is in favor of abnormal motor aptitude. This results in an overall score out of 20. The 20 items are divided into 4 themes: - decubitus mobility; - sitting; - standing; - walking. Retropulsion is demonstrated in this test in the sitting, standing and walking positions.

contribution of dance-based physical activity for trained caregivers8, 12 and 16 months

evaluated by :

- Frequency of sessions realised.

Trial Locations

Locations (2)

Centre Hospitalier Pays Craponne

🇫🇷

Craponne-sur-Arzon, France

Centre Hospitalier Emile Roux

🇫🇷

Le Puy-en-Velay, France

Centre Hospitalier Pays Craponne
🇫🇷Craponne-sur-Arzon, France
Sophie LENGAGNE
Contact
0471053526
sophie.lengagne@ch-lepuy.fr
Elodie FOURNIER
Principal Investigator

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