Methodological issues in the non pharmacological treatment of BPSD in nursing home--the TNM study.

Behavioural and psychological symptoms of dementia (BPSD) such as agitation, aggressiveness, oppositional behaviour and psychotic symptoms are often reported by caregivers and staff members in institutions for the elderly. Taking into account the limited efficacy and the importance of side effects observed with psychotropic agents, the majority of existing guideline underlines the importance of non-pharmacological strategies. The aim of this article is to describe the major methodological problems in non-pharmacological treatments studies and to present the design of the TNM study, a nursing home randomized controlled trial conducted in 16 French nursing homes.

Relearning of Activities of Daily Living: A Comparison of the Effectiveness of Three Learning Methods in Patients with Dementia of the Alzheimer Type.

This study examined the effectiveness of three different learning methods: trial and error learning (TE), errorless learning (EL) and learning by modeling with spaced retrieval (MR) on the relearning process of IADL in mild-to-moderately severe Alzheimer's Dementia (AD) patients (n=52), using a 6-weeks randomized controlled trial design. The participants had to relearn three IADLs. Repeated-measure analyses during pre-intervention, post-intervention and 1-month delayed sessions were performed. All three learning methods were found to have similar efficiency. However, the intervention produced greater improvements in the actual performance of the IADL tasks than on their explicit knowledge. This study confirms that the relearning of IADL is possible with AD patients through individualized interventions, and that the improvements can be maintained even after the intervention.