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Monday, January 21, 2013

Aquariums for the Treatment of Dementia (Alzheimer’s) in Nursing Homes

Dementia is a disorder characterized by a significant loss of intellectual and cognitive abilities without impairment of perception or consciousness. There are many different cause of dementia such as severe traumatic brain injury, stroke, and progressive neurological disorders.

Of the progressive types of dementia, Alzheimer’s disease is the most common form of dementia in the elderly. Dementia is very common (>50% prevalence) in people living in nursing homes.

There are many signs of symptoms of dementia such as memory loss, language impairment, emotional blunting, decreased energy, and weight loss due to poor nutritional intake. Weight loss leads to many problems in patients with dementia, particularly those with advanced forms of the disease. For example, because the person has less muscle mass, they are more prone to falls and injuries that can result for this such as bone breaks. Due to decreased mobility, weight loss can also increase the risk for pressure sores (skin ulcers), pneumonia, and other health problems. Decreased food intake also results in costly waste of food for uneaten prepared meals.

As a result, interventions are needed to help increase weight in people with dementia. While there are medications designed to increase appetite, they have had mixed results and can lead to numerous side effects including sedation, blood clots, and edema (swelling). Encouraging eating by staff has also produced mixed results and is a costly intervention in nursing homes due to the one on one attention it requires.

To address this issue, researchers from Purdue University studied whether individuals with dementia who observed aquariums increased food intake and maintained body weight. The study involved 70 residents in three extended care facilities in two states. A large aquarium (30 x 20 inch viewing area) was placed in the common dining area of both facilities. Each aquarium had 8 large colorful fish that were quick swimmers. The study found that aquarium placement was associated with a 25% increase in food intake over the 10-week study period. This amounted to an average 2.2 pound weight gain during the study. Eight of the 70 residents (11%) experienced weight loss during the study. A benefit of this intervention is that there are no side effects.

The authors stated that attraction to the natural environment (especially animals) is so innate that it survives dementia. Watching aquariums has been associated with decreased stress, less blood pressure, and increased satisfaction in other studies. It is possible that increased satisfaction and mental stimulation from observing the aquariums leads to increased food intake.

Suggested reading: The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss

Reference: Edwards NE, Beck AM. (2013). The Influence of Aquariums on Weight in Individuals With Dementia. Alzheimer Dis Assoc Disord, in press.

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