Behavioral and psychological symptoms of dementia (BPSD) are common in the patients with dementia.Creative arts therapies (CAT) are one of the safe and effective non-pharmacological interventions for BPSD.This paper elaborates on the therapeutic effects of four common CAT,including art therapy,music therapy,dance therapy,and drama therapy,on BPSD.Despite the shortcomings,CAT offer a new gateway for the safe and noninvasive treatment of BPSD.
Humans ; Art Therapy ; Music Therapy ; Dementia/psychology*

OBJECTIVE: To observe the efficacy and safety of electroacupuncture (EA) on improving mini-mental state examination (MMSE) in patients with Alzheimer's disease (AD), and to evaluate the efficacy during follow-up visit. METHODS: Forty patients were randomly divided into a treatment group and a control group, 20 patients in each one (3 patients dropped off in the treatment group and 4 patients in the control group). The patients in the treatment group were treated with acupuncture at Baihui (GV 20), Fengfu (GV 16), Shenting (GV 24), Taiyang (EX-HN 5), Shangyintang (Extra 3) and Dazhong (KI 14); besides, EA was applied at Taiyang (EX-HN 5), Baihui (GV 20) and Shenting (GV 24) with dilatational wave, 10 Hz/50 Hz in frequency, 0.5 to 5.0 mA in intensity, once every two days, three treatments per week. The patients in the control group were treated with oral administration of donepezil hydrochloride tablets, once a day, taken before sleep. The treatment was given for 12 weeks in the two groups. The MMSE was evaluated before treatment, 12 weeks±3 days into treatment, and 24 weeks±7 days after treatment, respectively. RESULTS: The difference of total score of MMSE before and 12 weeks±3 days into treatment was not significant between the two groups (>0.05); the total score of MMSE after treatment was higher than that before treatment (both <0.05); compared before treatment, the short-term memory score was increased in the treatment group (<0.05), and the increasing range was superior to that in the control group (<0.05). Compared before treatment, the total score of MMSE in the two groups were reduced 24 weeks ±7 days after treatment (both <0.05), and the reduction in the treatment group was less than that in the control group (<0.05); the differences of short-term memory score before and after treatment was significant between the two groups (<0.05). No adverse reaction occurred in the two groups. CONCLUSION The effect of EA on improving MMSE in patients with AD is similar to donepezil supported by evidence-based medicine. The effect of EA may have a certain continuous effect, and may have advantages in instantaneous memory. In addition, the EA is safe.
Acupuncture Points ; Acupuncture Therapy ; Alzheimer Disease ; psychology ; therapy ; Case-Control Studies ; Electroacupuncture ; Humans ; Mental Status and Dementia Tests

The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.
Attitude of Health Personnel ; Caregivers ; psychology ; Clinical Competence ; Dementia ; diagnosis ; therapy ; General Practitioners ; psychology ; Humans ; Self Efficacy ; Singapore ; Surveys and Questionnaires

BACKGROUND: As society is aging, the number of elderly patients with psychiatric disorder, such as dementia, is increasing. The hospitalization period of elderly patients in psychiatric wards tends to be prolonged. In this study, we have determined the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients in Japan. METHODS: The information was collected from patients admitted to our hospital's emergency ward for elderly patients with psychiatric disorders between May 2015 and April 2016. We compared various factors between the early discharge group and the non-early discharge group. In addition, we used a multiple logistic regression model to clarify the risk factors for non-early discharge. RESULTS: Of the 208 elderly patients, body mass index (BMI) and serum albumin level were significantly lower in the non-early discharge group. In addition, we also showed that higher serum C-reactive protein (CRP) (> 0.5 mg/dL) and use of seclusion or physical restraint significantly inhibited the early discharge of patients. The results of multiple logistic analysis showed that the BMI ≤ 17.5 kg/m (OR, 2.41 [95% confidence interval (CI) 1.06-5.46]), serum albumin level ≤ 30 g/L (OR, 3.78 [95% CI 1.28-11.16]), and use of seclusion or physical restraint (OR 3.78 [95% CI 1.53-9.37]) are particularly important explanatory factors. CONCLUSIONS Hypoalbuminemia, low BMI, and the use of seclusion or physical restraint were identified as the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients. These factors reflect malnutrition and extremely serious psychiatric symptoms.
Aged ; Aged, 80 and over ; Dementia ; diagnosis ; psychology ; therapy ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Hospitalization ; statistics & numerical data ; Hospitals, Psychiatric ; statistics & numerical data ; Humans ; Japan ; Length of Stay ; statistics & numerical data ; Male ; Patient Discharge ; statistics & numerical data ; Risk Factors

Shouwu is a traditional Chinese medicine (TCM) with neuroprotective effect. Shouwu Yizhi decoction (SYD) was designed based on TCM theory. However, little is known about the roles of SYD in Vascular dementia (VaD). The present study aimed to evaluate the potential effects of SYD on the vascular cognitive impairment and explore the underlying mechanism by establishing focal cerebral ischemia/reperfusion (I/R) rat model to induce VaD. SYD administration (54 mg·kg) for 40 days obviously improved the vascular cognitive impairment in the middle cerebral artery occlusion (MCAO) rats as evidenced by the declined neurological deficit score and shortened escape latency via neurological deficit assessment and Morris water maze test. Moreover, SYD decreased neuron damage-induced cell death and ameliorated the ultrastructure of endothelial cells in the MCAO rats, thereby alleviating VaD. Mechanistically, SYD caused increases in the expression of vascular endothelial growth factor (VEGF), CD34 and CD31, compared with the MCAO rats in coronal hippocampus. Simultaneously, the expression level of miR-210 was elevated significantly after SYD administration, compared with the vehicle rats (P < 0.01). The expression of Notch 4 at both mRNA and protein levels was upregulated remarkably along with the notably downregulated DLL4 expression under SYD administration compared with the vehicle rats (P < 0.05). Overall, the above results indicated that SYD promoted angiogenesis by upregulating VEGF-induced miR210 expression to activate Notch pathway, and further alleviated neuron damage and ameliorated the ultrastructure of endothelial cells in the MCAO rats, ultimately enhancing the cognition and memory of MCAO rats. Therefore, our findings preliminarily identified the effect and the mechanism of action for SYD on VaD in rats. SYD could be a potential candidate in treatment of VaD.
Angiogenesis Inducing Agents ; administration & dosage ; Animals ; Dementia, Vascular ; drug therapy ; genetics ; metabolism ; psychology ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; Male ; Membrane Proteins ; genetics ; metabolism ; Memory ; drug effects ; Neuroprotective Agents ; administration & dosage ; Rats ; Rats, Wistar ; Receptor, Notch4 ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

The present study was aimed at determining the effects of Tongqiao Huoxue Decoction (TQHXD) on the Ca(2+)-CaMKII-CREB pathway and the memory and learning capacities of rats with vascular dementia (VD). The rat VD model was established by using an improved bilateral carotid artery ligation method. The Morris water maze experiment was used to evaluate the ethology of the VD rats following treatments with TQHXD at 3.01, 6.02, and 12.04 g·kg(-1) per day for 31 days. At the end of experiment, the hippocampus were harvested and analyzed. Western blotting and RT-PCR were used to measure the expression levels of calmodulin-binding protein kinase II(CaMKII), protein kinase A(PKA), cAMP-response element binding protein(CREB), and three N-methyl-D-aspartic acid receptor subunits (NR1, NR2A, and NR2B). Our results revealed that TQHXD could alleviate the loss of learning abilities and increase the memory capacity (P < 0.05 and P < 0.01 vs the model group, respectively). The treatment with 6.02 and 12.04 g·kg(-1) of TQHXD significantly up-regulated the Ca(2+)-CaMKII-CREB pathway in the hippocampus. In conclusion, TQHXD showed therapeutic effects on a bilateral carotid artery ligation-induced vascular dementia model, through the up-regulation of calcium signalling pathways.
Animals ; Calcium ; metabolism ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; metabolism ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Dementia, Vascular ; complications ; drug therapy ; metabolism ; psychology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Hippocampus ; drug effects ; metabolism ; Learning Disabilities ; drug therapy ; etiology ; metabolism ; Male ; Maze Learning ; drug effects ; Memory ; drug effects ; Memory Disorders ; drug therapy ; etiology ; metabolism ; Phytotherapy ; Rats, Sprague-Dawley ; Signal Transduction ; Up-Regulation

OBJECTIVETo compare the therapeutic differences among scalp acupuncture combined with auricular point sticking, body acupuncture and western medication for treatment of vascular dementia (VD).

METHODSNinety cases were randomly divided into a combined therapy group (31 cases), a body acupuncture group (29 cases) and a western medication group (30 cases). The combined therapy group was treated with scalp acupuncture at forehead middle line, parieral middle line, temporal front line and temporal rear line as well as auricular point sticking at naogan (AT3,41), shen (CO10), shenmen (TF4), zhen (AT3), once a day; the body acupuncture group was treated with acupuncture at Baihui (GV 20), Fengchi (GB 20), Zusanli (ST 36) and so on, once a day; the western medication group was treated with oral administration of aniracetam tablets, 0.2 g per time, twice a day. Fourteen days were considered as a treatment course, and totally 3 courses were required. The mini-mental state examination (MMSE) and activities of daily living (ADL) were applied to assess the changes of cognitive behavior ability before and after treatment among three groups. Also the efficacy among three groups were compared.

RESULTSOne case dropped out in the body acupuncture group and western medication group, respectively. The total effective rate was 90.334 (28/31) in the combined therapy group, which was superior to 85.734 (24/28) in the body acupuncture group and 79.3% (23/29) in the western medication group (both P < 0.05). After the treatment, the scores of MMSE and ADL were all improved among three groups, which was the most significant in the combined therapy group (MMSE: 23.32 +/- 4.45 vs 21.23 +/- 4.13, P < 0.05; 23.32 +/- 4.45 vs 20.41 +/- 4. 01, P < 0.01; ADL: 53.18 +/- 21.55 vs 51.92 +/- 20.42, P < 0.05; 53.18 +/- 21.55 vs 49.42 +/- 19.43, P < 0.01).

CONCLUSIONThe scalp acupuncture combined with auricular point sticking could improve the clinical symptoms and cognitive behavior ability in patients with vascular dementia, which has superior total efficacy to body acupuncture and western medication aniracetam tablets.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Aged ; Cognition ; Dementia, Vascular ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Scalp

OBJECTIVETo verify the therapeutic effect of vascular dementia treated with three-line puncture on the Governor Vessel and Bladder Meridian on head.

METHODSSixty cases were randomly divided into a head-line puncture group and a routine acupuncture group, 30 cases in each group. In head-line puncture group, line puncture was applied on three lines of the Governor Vessel and Bladder Meridian from anterior hairline to occipital tuberosity. In routine acupuncture group, Yintang (GV 29), Fengchi (GB 20), Sishencong (EX-HN 1) penetrating to Baihui (GV 20) and Shenting (GV 24) penetrating to Shangxing (GV 23) were selected. Once a day, 5 times in a week and 8 weeks totally. Score was evaluated with Mini-Mental State Examination scale (MMSE) before and after treatment, and the therapeutic effects in both groups were compared.

RESULTSThe total effective rate of cognitive function was 76. 7% (23/30) in head-line puncture group, superior to that of 43.3% (13/30, P < 0.05) in routine acupuncture group. The MMSE scores in both groups were improved after treatment (both P < 0.01), and it in head-line puncture group was superior to that in routine acupuncture group (P < 0.01).

CONCLUSIONThree-line acupuncture on the Governor Vessel and Bladder Meridian on head can remarkably improve the cognitive function of vascular dementia, and the therapeutic effect is superior to that of routine acupuncture.

Acupuncture Therapy ; Aged ; Cognition ; Dementia, Vascular ; physiopathology ; psychology ; therapy ; Female ; Head ; physiopathology ; Humans ; Male ; Meridians ; Middle Aged ; Treatment Outcome

OBJECTIVETo study the effect and mechanism of ginsenoside Rg1 on the spatial learning-memory ability in rats with Alzheimer's disease after transplanted with bone marrow mesenchymal stem cells (BMSCs).

METHODSUsing digital randomization table method, seventy-five male SD rats were divided into the bilateral FF transection model group (as the model group: ambi-hippocampal fimbria-fomix transected), the sham-operative control group (the SOC group: receiving the same modeling process as the model group, but without ambi-hippocampal fimbria-fomix transected), the ginsenoside Rg1 treatment group (as the treatment group: Two weeks after modeling ginsenoside Rg1 was peritoneally injected at the dose of 5 mg/kg, once daily for four weeks in total), the BMSCs transplanted treatment group [as the control group: Two weeks after modeling every rat received transplantation of BMSCs (10 microL, 1 x 10(6) cells)], and the ginsenoside Rg1 + BMSCs treatment group (as the combination group: They received both transplantation of BMSCs and peritoneal injection of ginsenoside Rgl). The spatial learning-memory ability of rats was detected by Morris water maze and the escape latency (s) was recorded, mRNA expression of nerve growth factor (NGF) was detected using Real-time PCR.

RESULTSSix weeks after the hippocampal fimbria-fomix (FF) transection, the escape latency o feach medication group was obviously shorter than that of the model group, and the spatial learning-memory ability of dementia rats was somewhat improved. The spatial learning-memory ability of rats in the combination group was (29.95 +/- 2.03) and the mRNA expression level of NGF was (1.13 +/- 0.15), better than those in the BMSCs group (44.36 +/- 1.43, 0.78 +/- 0.09, P<0.05).

CONCLUSIONSGinsenoside Rg1 could strengthen the spatial learning-memory ability in dementia rats after transplanted with BMSCs. Its mechanism might be possibly correlated with up-regulating mRNA expression of NGF in basal forebrain after BMSCs transplantation.

Animals ; Dementia ; psychology ; therapy ; Ginsenosides ; pharmacology ; therapeutic use ; Learning ; drug effects ; Male ; Memory ; drug effects ; Mesenchymal Stem Cell Transplantation ; Rats ; Rats, Sprague-Dawley

PURPOSE: The purpose of this study was to identify the effects on the cognitive function, Activities of Daily Living (ADL), mood, social behaviors, and problematic behaviors of robot pet-assisted program for elderly people with dementia. METHODS: This study was a nonequivalent control group pretest-posttest design. The participants were 32 elders with dementia. Seventeen were assigned to the experimental group and 15 to the control group. The intervention was conducted twice a week for 6 weeks. RESULTS: 1) After the program, cognitive function, ADL, and social behaviors did not show significant differences. 2) After the program, mood of experimental group was significantly better than that of the control group. 3) After the program, problematic behaviors of the experimental group were significantly more diminished than those of control group. 4) As a result of analyzing the response, robot pet-assisted program was effective such as inducing a positive emotional state and increasing communication and interaction. CONCLUSION: The robot pet-assisted program was effective in changing the mood and diminishing problematic behaviors and had positive effects such as increasing communication and interaction for elders with dementia. Therefore, this program should be considered as a positive program for physical and emotional support for elders with dementia.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Aggression ; Cognition ; Dementia/*psychology/therapy ; Emotions ; Female ; Humans ; Program Evaluation ; *Robotics ; Social Behavior