Effect of Enriched environment on cognitive function and quality of life in patiënts with dementia

Animal studies show that an impoverished environment, ie minimal physical activity and social interaction, is associated with a faster cognitive decline. Early geriatric research shows dat impoverished environment (i.e. no physical activity, social interaction and cognitive stimulation) affects cognition, qualitiy of life, and mood and behavioral problems in patiënts with dementia. The nursing home can be a form of impoverished environment, because in a number of cases physical and cognitive activity are not stimulated.



the present study investigates whether a small-scale stay in an enriched green environment in a nursing home is related to a slower progression of cognitive functions, better mood, less behavioral problems, and a higher quality than if standard care is given. The enriched environment consist of small residental units where sensory stimulation (i.e. increasing daylight, green environment, animal-assisted therapy, music- and aromatherapy, social interaction) and physical activity will be stimulated.



174 patients with dementia who stay in Atlant Zorgcentrum in Apeldoorn, The Netherlands, will participate in the current study. 87 patiënt undergo the intervention (relocation) and 87 received no intervention (standard care). In both groups the cognition, mood, quality of life, behavior problems ad activities of daily lifes will be investigated by standard neuropsychological tests and behavioral observation methods rapported by blinded research assistents. There will be 3 measures: baseline measurement(T1) before the intervention, post measurment after 3 months (T2) and after 8 months (T3).

the present study investigates whether a small-scale stay in an enriched green environment in a care center is related to a slower progression of cognitive functions, better mood, less behavioral problems, and a higher quality than if standard care is given

T1 Baseline Measurement 2 weeks before start intervention:

MMSE, TESS-NH, SIB-II, MADRS, CMAI, NPI-NH Apathy scale, Katz-ADL, QUALIDEM, Actigraphy, GDS.



T2 Follow-up Measurement 3 months after start intervention:

TESS-NH, SIB-II, MADRS, CMAI, NPI-NH Apathy scale, Katz-ADL, QUALIDEM, Actigraphy, GDS.



T3 Follow-up Measurement 8 months after starts intervention:

TESS-NH, SIB-II, MADRS, CMAI, NPI-NH Apathy scale, Katz-ADL, QUALIDEM, Actigraphy, GDS.

The enriched environment consist of small residental units where sensory stimulation (i.e. increasing daylight, green environment, acces to a large safe garden, animal-assisted therapy, music- and aromatherapy, social interaction) and physical activity will be stimulated.



The intervention group will be compared with a control group of residents of other psychogeriatric wards from Atlant Zorggroep. These residents receive standard care (no intervention)