Skip to main content Accesibility Help

Animal-assisted activity and emotional status of patients with Alzheimer's disease in day care

  • Enrico Mossello (a1), Alessandro Ridolfi (a2), Anna Maria Mello (a1), Giulia Lorenzini (a3), Francesca Mugnai (a4), Carolina Piccini (a5), Domenico Barone (a1), Anna Peruzzi (a1), Giulio Masotti (a1) and Niccolò Marchionni (a1)...

Background: Preliminary studies suggest beneficial effects of animal-assisted activities (AAA) on behavioral and psychological symptoms of dementia (BPSD), but data are inconsistent. This study aimed to assess the effect of AAA with dogs on cognition, BPSD, emotional status and motor activity in severe Alzheimer's disease (AD).

Methods: Ten patients attending an Alzheimer Day Care Center (ADCC) participated in a repeated measures study, which included: two weeks' pre-intervention, three weeks' control activity with plush dogs (CA), and three weeks' AAA. Cognitive function (Severe Impairment Battery), mood (Cornell Scale for Depression in Dementia; CSDD), BPSD (Neuropsychiatric Inventory; NPI) and agitation (Cohen-Mansfield Agitation Inventory; CMAI) were assessed at baseline and after each period. Observed Emotion Rating Scale (OERS) for emotional status, Agitated Behavior Mapping Instrument (ABMI) and a checklist for motor activity were completed across the study periods, both during intervention sessions and after three hours.

Results: Cognition and NPI were unchanged across the study. Declines in the CMAI and CSDD scores after AAA were not significant, while the NPI anxiety item score decreased in comparison with CA (CA 3.1±2.3, AAA 1.5±2.7, p = 0.04). OERS “sadness” decreased (p = 0.002), while “pleasure” (p = 0.016) and “general alertness” (p = 0.003) increased during AAA compared with CA sessions, and observed sadness remained lower after three hours (p = 0.002). Motor activity increased significantly during AAA.

Conclusion: In this sample of severe AD patients in ADCC, AAA was associated with a decrease in anxiety and sadness and an increase in positive emotions and motor activity in comparison with a control activity.

Corresponding author
Correspondence should be addressed to: Dr. Enrico Mossello, Unit of Gerontology and Geriatric Medicine, Department of Critical Care Medicine and Surgery, University of Florence, Viale Pieraccini 6, 50139 Firenze, Italy. Phone: +39 0554271470, Fax: +39 0554271458. Email:
Hide All
Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271284.
Ballard, C. G. et al. (2008). Management of agitation and aggression associated with Alzheimer disease. Nature Reviews Neurology, 5, 245255.
Black, W. and Almeida, O. P. (2004). A systematic review of the association between the Behavioral and Psychological Symptoms of Dementia and burden of care. International Psychogeriatrics, 16, 295315.
Churchill, M., Safaoui, J., McCabe, B. W. and Baun, M. M. (1999). Using a therapy dog to alleviate the agitation and desocialization of people with Alzheimer's disease. Journal of Psychosocial Nursing and Mental Health Services, 37, 1622.
Cohen-Mansfield, J. (1986). Agitated behaviors in the elderly. II. Preliminary results in the cognitively deteriorated. Journal of the American Geriatrics Society, 34, 722727.
Cohen-Mansfield, J. and Libin, A. (2004). Assessment of agitation in elderly patients with dementia: correlations between informant rating and direct observation. International Journal of Geriatric Psychiatry, 19, 881891.
Cummings, J. L. and Back, C. (1998). The cholinergic hypothesis of neuropsychiatric symptoms in Alzheimer's disease. American Journal of Geriatric Psychiatry, 6, 6478.
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.
Edwards, N. E. and Beck, A. M. (2002). Animal-assisted therapy and nutrition in Alzheimer's disease. Western Journal of Nursing Research, 4, 697712.
Filan, S. L. and Llewellyn-Jones, R. H. (2006). Animal-assisted therapy for dementia: a review of the literature. International Psychogeriatrics, 18, 597611.
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Greer, K., Pustay, K. A., Zaun, T.C. and Coppens, P. (2001). A comparison of the effects of toys versus live animals on the communication of patients with dementia of the Alzheimer's type. Clinical Gerontologist, 24, 157182.
Kanamori, M. et al. (2001). A day care program and evaluation of animal-assisted therapy (AAT) for the elderly with senile dementia. American Journal of Alzheimer's Disease and Other Dementias, 16, 234239.
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychological function. JAMA, 185, 914919.
Kongable, L. G., Buckwalter, K. C. and Stolley, J. M. (1989). The effects of pet therapy on the social behavior of institutionalized Alzheimer's clients. Archives of Psychiatric Nursing, 3, 191198.
Lawton, M. P., van Haitsma, K. and Klapper, J. (1996). Observed affect in nursing home residents with Alzheimer's disease. Journals of Gerontology, series B: Psychological Sciences and Social Sciences, 51, 314.
Levinson, B. M. and Mallon, G. P. (1997). Historical background. In Levinson, B. M. (ed.), Pet Oriented Child Psychotherapy (pp. 325). Springfield, IL: Charles C. Thomas Publishers.
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA, 288, 14751483.
McCabe, B. W., Baun, M. M., Speich, D. and Agrawal, S. (2002). Resident dog in the Alzheimer's special care unit. Western Journal of Nursing Research, 24, 684696.
Motomura, N. Y. T. and Ohyama, H. (2004). Animal assisted therapy for people with dementia. Psychogeriatrics, 4, 4042.
O'Connor, D. W., Ames, D., Gardner, B. and King, M. (2009a). Psychosocial treatments of behavior symptoms in dementia: a systematic review of reports meeting quality standards. International Psychogeriatrics, 21, 225240.
O'Connor, D. W., Ames, D., Gardner, B. and King, M. (2009b). Psychosocial treatments of psychological symptoms in dementia: a systematic review of reports meeting quality standards. International Psychogeriatrics, 21, 241251.
Perkins, J., Bartlett, H., Travers, C. and Rand, J. (2008). Dog-assisted therapy for older people with dementia: a review. Australasian Journal on Ageing. 27, 177182.
Richeson, N. E. (2003). Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia. American Journal of Alzheimer's Disease and Other Dementias, 18, 353358.
Rolland, Y. et al. (2007). Exercise Program for nursing home residents with Alzheimer's disease: a one-year randomized, controlled trial. Journal of the American Geriatrics Society, 55, 158165.
Saxton, J., McGoingle-Gibson, K., Swihart, A., Miller, M. and Boller, F. (1990). Assessment of the severely impaired patient: description and validation of a new neuropsychological test battery. Psychological Assessment, 2, 298303.
Sellers, D. M. (2005). The evaluation of an animal assisted therapy intervention for elders with dementia in a long-term care. Activities Adaptation and Aging, 30, 6177.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed