Doll Therapy Reduced Dementia Symptoms, Caregiver Burden

Doll therapy was more effective than standard therapy in controlling symptoms of dementia in older adults and reducing caregiver burden, according to findings recently published in BMC Geriatrics.

Fifty-two older adults with moderate to severe dementia across two nursing homes were randomly assigned to two groups. In the control group, a physician freely administered pharmacological interventions according to standard care; in the doll therapy group, patients were given an empathy doll, along with pharmacological therapies if symptoms persisted.

The doll was administered for two hours in the morning, two hours in the afternoon, and as needed when patients exhibited agitation, aggression, and/or wandering. Patients could freely interact with the doll, and caregivers did not insist on doll administration if a patient refused.

Researchers used the Neuropsychiatric Inventory scale and the A.Di.CO scale (derived from the DISCO scale) to measure behavioral and psychologic symptoms, the Confusion Assessment method to measure delirium, and the Greutzner scale to measure caregiver burden. Measurements were taken at baseline, 45 days, and 90 days.

Doll therapy effectively reduced agitation and aggressiveness compared to standard care. Researchers also noted “a significant amelioration of dysphoria, wandering, and apathy.” Doll therapy was administered as needed 32 times, 28 of which proved effective at calming patients.

“The reduction of apathy and dysphoria observed in our study confirms the results of previous non-randomized controlled studies suggesting that [doll therapy] may stimulate patients’ perception,” researchers wrote, “ameliorating their communication abilities, their self-esteem, and overall quality of life.”

There was also a significant reduction in caregiver burden and delirium. Study authors noted, however, that the exact mechanism of doll therapy in reducing delirium is unknown.

Researchers sought to alleviate concerns over infantilizing patients by informing caregivers, family members, and patients about doll therapy before beginning the study.

“The use of doll treatment may be useful as a non-pharmacologic approach to control [behavioral and psychologic symptoms] in patients with moderate to advanced forms of dementia,” researchers concluded.

Reference:
Santagata F, Massaia M, D’Amelio P. The doll therapy as a first line treatment for behavioral and psychologic symptoms of dementia in nursing homes residents: A randomized, controlled study. BMC Geriatr. 2021 Oct 12;21(1):545. doi:10.1186/s12877-021-02496-0