Treating Agitation in Patients with Dementia with a Therapy Dog in a Milieu Therapy Setting on a Geropsychiatric Ward

<b><i>Background:</i></b> Animal-assisted intervention has become a common therapeutic practice used for patients with dementia in home-dwelling and institutions. The most established procedure is a visiting service by specially trained dogs and their owners to improve social interactions and reduce symptoms of agitation. <b><i>Objectives:</i></b> The study aims to investigate the effects of a therapy dog on agitation of inpatients with dementia in a gerontopsychiatric ward. <b><i>Materials and Methods:</i></b> The severity of agitation was assessed by a rater blinded for the presence of the dog via the Overt Agitation Severity Scale (OASS). The scale was conducted on 1 day with the dog and his handler present (resident doctor on the ward) and on another day with only the handler present. Each patient was his/her own control. Heart rate variability (HRV) and serum level of brain-derived neurotrophic factor (BDNF) of the patients were measured on both days. 26 patients with the Mini-Mental Status Examination (MMSE) score &#x3c;21 and the diagnosis of dementia were included in the study. <b><i>Results:</i></b> A significant reduction of agitation in the OASS could be shown when the dog was present (<i>p</i> = 0.006). The data neither demonstrated a difference in the HRV for the parameters mean heart rate (<i>p</i> = 0.65), root mean square of successive differences (<i>p</i> = 0.63), and high frequencies (<i>p</i> = 0.27) nor in serum BDNF concentrations (<i>p</i> = 0.42). <b><i>Discussion:</i></b> Therapy dogs can be implemented as a therapeutic tool in a gerontopsychiatric ward to reduce symptoms of agitation in patients with dementia. The study was registered in the German Clinical Trials Register (DRKS00024093).

Animal-Assisted Interventions in Intensive Care Delirium: A Literature Review

Critical illness has lasting consequences on the mind and the body. Acute sequelae include a decline in cognitive function known as delirium. Increased interest in improving outcomes for intensive care unit survivors without a high incidence of delirium has initiated a focus on an array of nonpharmacologic interventions in many countries. One such intervention is animalassisted intervention. As the role of animals in human healing is being recognized by clinicians, need is increasing for formal and professionally directed therapies. This review ascertains the effect of interaction with animals on critically ill patients. Emerging evidence indicates that animal-assisted intervention improves the efficacy of critical care regarding primary symptoms and secondary factors of delirium.

A Stakeholder-Engaged Approach to Development of an Animal-Assisted Intervention for Obesity Prevention Among Youth With Autism Spectrum Disorder and Their Pet Dogs

Stakeholder involvement in research has been demonstrated to increase the effectiveness, validity, and quality of a study. This paper describes the engagement of a stakeholder panel in the development and implementation of an animal-assisted intervention (AAI) assessment and program for children diagnosed with Autism Spectrum Disorder (ASD). Canines for Autism Activity and Nutrition (CAAN) aims to promote physical activity and wellness among children diagnosed with ASD by integrating activities with their pet dog during the child's ongoing Applied Behavioral Analysis (ABA) in-home therapy sessions. Feedback from stakeholders guided program development at each stage of the research process, including this publication. Utilizing a stakeholder-informed approach was essential for the development of assessment tools, program materials, and program design. Methods that may assist others to effectively partner with stakeholders to implement an AAI among children diagnosed with ASD or related disorders are described.

Effects of Pet Therapy in Elderly Patients with Neurocognitive Disorders: A Brief Review

<b><i>Introduction:</i></b> Neurocognitive disorders (NCDs) are disturbances highly related to age. This means that, with the increasing trend in life expectancy, there is also an increase in this diagnosis, although NCDs are not exclusively found in the population over 65 years old. Likely, they will increase in the coming years together with improvements in diagnosis. In addition to the use of medicines and rehabilitative techniques, pet therapy is also used. Pet therapy makes use of animals with therapeutic, rehabilitative, educational, and recreational purposes for people affected by physical, neuromotor, and psychiatric disorders. Pet therapy seems to be functional for increasing social and communication competencies, facilitating verbal and body language, increasing self-esteem, improving quality of life, and reducing anxiety/stress. <b><i>Methods:</i></b> This study was based on scientific papers and publications obtained from the PubMed and Google Scholar databases. Moreover, other articles from further cross-references were included. Specific database research criteria were (a) articles published in 2018 or later, (b) samples containing only adults over 65 years old, (c) written in English or Italian, and (d) on the topic of animal-assisted intervention. <b><i>Results:</i></b> Uncertain results were obtained. Although a positive effect was found, the included articles were of insufficient methodological rigor. <b><i>Discussion/Conclusion:</i></b> Although many studies reported positive results, these could not be generalized because of the numerous biases present (e.g., small sample size, lack of methodological rigor, lack of protocol, etc.). Future studies, therefore, should seek to address the limitations found in the analyzed studies.

Neurological Mechanisms of Animal-Assisted Intervention in Alzheimer’s Disease: A Hypothetical Review

Alzheimer’s disease (AD) is an irreversible neurodegenerative brain disorder with aggregation of amyloid-beta (Aβ) and tau as the pathological hallmarks. AD is the most common form of dementia and is characterized by a progressive decline of cognition. The failure of pharmacological approaches to treat AD has resulted in an increased focus on non-pharmacological interventions that can mitigate cognitive decline and delay disease progression in patients with AD. Animal-assisted intervention (AAI), a non-pharmacological intervention, improves emotional, social, and cognitive dysfunction in patients with neurodegenerative diseases. In particular, AAI is reported to mitigate the effects of cognitive impairment in patients with AD. Despite the positive effects of AAI on cognitive dysfunction in patients with AD, there have been no studies on how AAI affects AD-related pathologies. This review postulates potential neurological mechanisms of emotional or social interaction through AAI in countering AD-related pathologies, such as Aβ deposition, tau hyperphosphorylation, neuroinflammation, and impaired adult hippocampal neurogenesis (AHN), and proposes insights for future research by organizing accumulated previous evidence.

Microbial Sharing between Pediatric Patients and Therapy Dogs during Hospital Animal-Assisted Intervention Programs

Microbial sharing between humans and animals has been demonstrated in a variety of settings. However, the extent of microbial sharing that occurs within the healthcare setting during animal-assisted intervention programs is unknown. Understanding microbial transmission between patients and therapy dogs can provide important insights into potential health benefits for patients, in addition to addressing concerns regarding potential pathogen transmission that limits program utilization. This study evaluated for potential microbial sharing between pediatric patients and therapy dogs and tested whether patient–dog contact level and a dog decolonization protocol modified this sharing. Patients, therapy dogs, and the hospital environment were sampled before and after every group therapy session and samples underwent 16S rRNA sequencing to characterize microbial communities. Both patients and dogs experienced changes in the relative abundance and overall diversity of their nasal microbiome, suggesting that the exchange of microorganisms had occurred. Increased contact was associated with greater sharing between patients and therapy dogs, as well as between patients. A topical chlorhexidine-based dog decolonization was associated with decreased microbial sharing between therapy dogs and patients but did not significantly affect sharing between patients. These data suggest that the therapy dog is both a potential source of and a vehicle for the transfer of microorganisms to patients but not necessarily the only source. The relative contribution of other potential sources (e.g., other patients, the hospital environment) should be further explored to determine their relative importance.