Annotated Bibliography on Interventions for Dementia Patients

This annotated bibliography provides an overview of three research articles on interventions for dementia patients, including individual music therapy, high-intensity exercise programs, and fall prevention programs. The studies suggest that these interventions can improve physical and mental health outcomes for dementia patients, including reducing agitation, improving balance and muscle strength, and preventing falls. Nursing professionals can use these findings to inform their practice and enhance the quality of life for dementia patients.

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Student Name: (Your name here)
Essay/Report title: Assessment Item 1: Annotated Bibliography
Word count: (1018) (excluding title page and reference list).
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Article 1
Ridder, H. M. O., Stige, B., Qvale, L. G., & Gold, C. (2013). Individual music therapy for
agitation in dementia: an exploratory randomized controlled trial. Aging & mental
health, 17(6), 667-678. https://doi.org/10.1080/13607863.2013.790926
Annotation
In this research, Ridder, Stige, Qvale and Gold (2013) reported on a study that was
conducted with the aim of examining the effects of individual music therapy on symptoms
related to agitation, in person suffering from moderate to severe dementia, at nursing homes.
The authors elaborated on the fact that agitation develops in the later stages of dementia and
is one of the most noteworthy symptoms that lead to subsequent distress among the patients
and increases the burden on the caregivers as well. Although antipsychotics have long been
considered the mainstay treatment for agitation symptoms, the authors argued that these
drugs have restricted benefits in the long-term. The trial recruited 42 patients and randomised
them to a series of individual music therapy and standard care sessions, each for six weeks.
The trial found that disruptiveness of agitation symptoms got elevated during the standard
care sessions. On the other hand, the individual music therapy sessions were able to reduce
agitation among the patients significantly. The difference was around −6.77 (95% CI: −12.71,
−0.83, p=0.027). Furthermore, psychotropic medication prescription increased significantly
during standard care, compared to the intervention therapy (p=0.02). These findings support
the effectiveness of individual music therapy sessions in reducing agitation that commonly
occurs among dementia patients. Non-blinding the respondents and interviewers were
accredited by the authors as one major study limitation. Moreover, inadequate demographic,
medical and diagnostic data might have also contributed to bias in the results. Ridder, Stige,
Qvale and Gold (2013) also specified that failure to establish music therapy sessions in most
nursing homes might have prevented improvements in the patients. Thus, the authors were
successful in recommending music therapy as a valid treatment method for agitation in
dementia and also identified it as an effective measure to reduce the use of psychotropic
medications. Nursing professionals, healthcare staff and the relatives of patients with
dementia must have a sound understanding of their role in deriving patient gains from the
therapy session and enhancing their quality of life. Future recommendations include focusing
on documenting the impact of music therapy as an integrated method, based on
multidisciplinary collaboration.
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Abstract
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Article 2
Telenius, E. W., Engedal, K., & Bergland, A. (2015). Effect of a high-intensity exercise
program on physical function and mental health in nursing home residents with
dementia: an assessor blinded randomized controlled trial. PloS one, 10(5), e0126102.
https://doi.org/10.1371/journal.pone.0126102
Annotation
This research conducted by Telenius, Engedal and Bergland (2015) had the objective
of assessing the impacts of high intensity functional exercises on balance in dementia
patients. The authors recognised the impact of dementia on disability and also stated that gait
performance, mobility and balance are most affected by this form of impairment. However,
they also identified the increased risks of falls due to lower limb weakness among dementia
patients. The study recruited 170 dementia patients who lived in nursing homes and
randomised 87 of them to the intervention group, and the rest to the control group. Those in
the intervention group were subjected to intensive balance and strengthening exercise twice a
week, for a time period of 12 weeks. The control group was based on leisure activities. The
authors found that patients in the intervention group had improved Bergs Balance Scale score
by 2.9 points, (1.2 points, p=0.02). Furthermore, patients who participated in exercise for 12
times showed significant enhancement in their muscle strength (p<0.05), and lower levels of
apathy (p=0.048). These results support the efficiency of high intensity functional exercise
programs on improving the muscle strength and balance of dementia patients. The study also
elaborated on the presence of apathy in dementia patients that make them show reduced goal
directed tasks, indifference and lack of motivation, all of which were considerably reduced by
the intervention (Telenius, Engedal & Bergland, 2015). The authors recognised limitations in
their inclusion criteria based on selecting patients who had the ability to rise from chairs with
help, and walk up to 6 metres. This might have prevented them from including the frail
patients. Nursing professionals can enhance the muscle strength and mobility of dementia in-
patients by making them adhere to similar physical exercise programs twice a week for a
considerable period of time to improve their health outcomes. Further recommendations
include conducting similar researches to investigate the role of these exercise based
interventions on muscle strength of frail dementia patients, and that on cognition and
neuropsychiatric symptoms.
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Abstract
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Article 3
Wesson, J., Clemson, L., Brodaty, H., Lord, S., Taylor, M., Gitlin, L., & Close, J. (2013). A
feasibility study and pilot randomised trial of a tailored prevention program to reduce
falls in older people with mild dementia. BMC geriatrics, 13(1), 89.
https://doi.org/10.1186/1471-2318-13-89
Annotation
This study by Wesson et al. (2013) was based on a randomised controlled trial design
that aimed to assess the feasibility of a strength and balance exercise based fall prevention
and home hazard reduction program on patients with mild dementia. The authors accurately
identified the health risks associated with dementia and also used evidences to establish a
correlation between dementia and falls among the patients. However, they placed the
argument that there exist lack of evidence realted to fall prevention among older adults with
dementia, despite the high prevalence of falls and subsequent fractures. Following
randomisation of the participants into the intervention and usual care group, those in the
former group were subjected to a 12 week long program that focused on physiotherapy,
occupational therapy, home visits and telephone calls. The authors found that the
implemented intervention was received well by both the patients and their carers. An
estimated 72% of the intervention group were found to adhere to the exercise programs. Less
significant reductions in risks of fall and its rates were found in the intervention group (RR=
0.50 (95% CI 0.11-2.19). Furthermore, no momentous differences were observed in the
physiological outcomes of the patients in both the groups. These findings established the fact
that although such home hazard reduction and exercise based programs are feasible for
conduction upon patients suffering from mild dementia, there is a need to conduct larger
trials to determine the exact benefits of the same on fall reduction and prevention. The
authors identified the failure to consider patients with moderate to severe forms of dementia
as a major limitation that might have caused bias in the results (Wesson et al., 2013).
Moreover, lack of IPEQ-W validation, and larger participants in the control group were other
limitations. Nursing professionals can implement this home-based intervention program to
reduce the likelihood of dementia patients from suffering falls. However, the intervention
should be refined and enhanced, followed by their testing in a randomised design to
determine the larger impacts of fall related health outcomes.
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Abstract
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References
Ridder, H. M. O., Stige, B., Qvale, L. G., & Gold, C. (2013). Individual music therapy for
agitation in dementia: an exploratory randomized controlled trial. Aging & mental
health, 17(6), 667-678. https://doi.org/10.1080/13607863.2013.790926
Telenius, E. W., Engedal, K., & Bergland, A. (2015). Effect of a high-intensity exercise
program on physical function and mental health in nursing home residents with
dementia: an assessor blinded randomized controlled trial. PloS one, 10(5), e0126102.
https://doi.org/10.1371/journal.pone.0126102
Wesson, J., Clemson, L., Brodaty, H., Lord, S., Taylor, M., Gitlin, L., & Close, J. (2013). A
feasibility study and pilot randomised trial of a tailored prevention program to reduce
falls in older people with mild dementia. BMC geriatrics, 13(1), 89.
https://doi.org/10.1186/1471-2318-13-89
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