Clinical Validation Studies Of Non-drug Intervention In Rich Environmental Treatment In The Old Age Dementia

Objective:This study was carried to try to use the intervention technique of �rich environment treatment' in the Ningbo kangning hospital geriatric ward of old age patients with dementia and try to explore the effectiveness of rich environment as the main body of the non-drug therapy.If we can prove rich environment intervention can improve the prognosis of dementia by non-drug intervention treatment,reduce the length of hospital stay,improve the patient's quality of life;It can not only solve the problems of the medical resources nervous,also can reduce the burden of disease.And also it can provide certain theoretical basis and technical support in the community to carry out the non-drug intervention treatment in the future.Methods:We screened the patients in three geriatric wards in Ningbo kangning hospital from November 2015 to March 2016.Choosed 60 patients aged over 65 with a diagnosis of dementia,MMSE(simple mental state evaluation questionnaire)score should greater than 10 points,carries on the simple random sampling ratio,group,patients were randomly divided into the standard treatment group,standard treatment + 3 entries rich environment group,standard treatment + 5 entries rich environment group.Three entries rich environment for: puzzle game,music therapy,exercise therapy;5 entries rich environment for: puzzle game,music therapy,exercise therapy,mahjong,reading therapy.Training time: rich environment intervention treatment 5 times a week,and each entry intervention time for half an hour at a time.Use a pedometer to record the patient's physiological load of exercise.Use MMSE scale,HAMD scale,ADL scale for patients with cognitive function,daily life ability,emotional change for objective evaluation,etc.The experimental group was given standard treatment with rich environment of non-drug intervention 12 weeks.using the scale to assess in intervention(baseline)before and after the intervention to assess by the end of the fourth week,eighth week and the twelfth week.For evaluation of personnel training,and as a consistency check,adop ting the way of the patients with cognitive function assessment,daily life ability and depression assessment,and by psychiatric doctor involved in quality control.Epidata3.1 is adopted to establish the database,data entry method adopts double entry at the same time.Statistical analysis,using SPSS15.0 count data by chi-square test,and its comparison data using rank and inspection,measurement data with mean �standard deviation((?)�s,the T test and variance analysis.: difference was statistically significant(P < 0.05).Results:There are 5 patients left the study.Experimental group a total of 19 men and 18 women old age dementia patients completed the study,age 66 ~ 76 years,an average of 72.9�2.3 years old;The control group a total of nine men and nine women of dementia patients completed the study,67 ~ 78 years old,average age71.3�3.5years old.After the intervention of EE(enriched environment)the improvement of cognitive function between the three groups showed that the baseline MMSE score of experimental group and control group had no significantly statistical change(P > 0.05);By the end of the4 th,8th and 12 th week,the MMSE score of experimental group patients were higher than control group(P < 0.05),and between the two the experimental group,5 items EE intervention shows higher MMSE score than 3items EE intervention.The mood change after the EE intervention between three groups showed that the total score of HAMD scale of experimental group is lower than control group by the end of the4 th,8th and 12 th week(P < 0.05).But there is no significant change between experimental group1 and group2.The change of BI(Barthel Index)of the ADL(ability of daily life)scale showed that all three groups of elderly patients with dementia their BI score were improved,and difference was statistically significant(P < 0.05).And by the end of the 4th,8th,12 th week,BI score in the experimental group was higher than the control group.The Comparison of subjective activity between the three groups of elderly patients with dementia showed: no significant differences between the three groups(P > 0.05).Conclusion: Non-drug intervention of EE(Enriched Environment)for old age dementia is effective;The intervention can significantly improve cognitive function,emotional problems and ability of daily life,improve the social function,improve the quality of life in patients with aged dementia.It is of great significance to reduce the level of disability,old age dementia patients disease burden,promote patients return to society.It is very simple,convenient,safe,costless to carry out the EE intervention and it is worth popularization and application in the community and family.