Laughter Might Be Good Medicine for Alzheimer's
FRIDAY, Sept. 30 (HealthDay News) -- Exposing Alzheimer's
patients to "humor therapy" appears as effective as psychiatric
drugs in reducing the agitation that often plagues those struggling
with dementia, new Australian research suggests.
In a three-month period, nursing home residents who actively
participated in a weekly two-hour clowning session involving music,
mime and humorous props showed a significant reduction in both
physically and verbally aggressive behavior.
What's more, the 20-percent plunge in overall agitation, which
the team attributed to humor therapy, lasted for at least 14 weeks
beyond the conclusion of the clowning program, the investigation
"Normally, nursing homes are a little like being stuck on a bad cruise where you can't get off," said study co-author Jean-Paul Bell, creative director at the Arts Health Institute in Avalon Beach, New South Wales, and co-founder of the Australia-wide hospital-based "Clown Doctor" program. "You are getting the creature comforts but no stimulating conversation or playful contact."
Bell and his colleagues sought to implement what he called a
"person-centered" therapeutic approach, coupling visual sight-gags
-- such as mimicking a conversation through two tin cans --
alongside provocative and irreverent verbal humor to encourage
active patient participation and reactions.
The result: "The humor intervention worked well for pretty much
everyone," Bell noted, particularly for the "highest-care" patients
deemed most debilitated by dementia. As an added bonus, the impact
was achieved without running any of the risk for serious side
effects, including falling and premature death, that have been
previously associated with prescription antipsychotic drugs.
Bell and Australian colleagues (at the Dementia Collaborative
Research Centre, the University of New South Wales and Prince of
Wales Hospital, among others) recently presented the findings at
the National Dementia Research Forum, in Sydney.
The study authors noted that between 70 percent and 80 percent
of dementia patients experience some form of agitation and
distress, which can include bouts of wandering, screaming and
To explore whether and how much humor might help, the authors
focused on 399 nursing home residents with dementia or other
"age-associated conditions" living in one of 35 facilities in the
All the patients had lived in their respective facilities for at
least three months. However, none was considered to be in an
end-of-life situation or suffering from severe psychosis.
An "ElderClown," trained to engage in humor-based therapy in a
medical setting, performed the weekly humor sessions.
To a large degree, the sessions relied on humorous improvisation
skills, similar to those used by "clown doctors" performing for
sick children. The goal: to lift the mood of the patients, while
engaging them in both conversation and physical interaction.
In addition, regular facility staff was partnered with these
clowns, to continue to promote humor therapy between sessions.
Depression, quality-of-life, social engagement and agitation
behaviors were all assessed before therapy, at the end of the
three-month program, and 26 weeks after therapy began.
While humor therapy did not appear to affect mood or quality of
life, it had a clinically significant impact on patient agitation,
on par with what might be expected following administration of
standard antipsychotic medications.
However, while agitation itself remained lower 26 weeks
following therapy launch, the boost in both happiness and positive
behaviors seen during the program faded once the program ended.
Nevertheless, the team suggested that humor therapy should
become a first-line treatment choice for dementia patients
suffering from agitation.
Sam Fazio, Chicago-based director of medical and scientific
relations at the Alzheimer's Association, described the study as
"very well-done" and "important."
"I think that the point about it being a good alternative to pharmacological treatment is really something to consider," Fazio said. "We need more of this type of research to show that there are other ways to work with people than simply medication."
Fazio added that humor therapy is just one non-pharmacological
approach among a range of viable options, including both art
therapy and pet therapy. He said that while all such interventions
show promise, they do not replace the overall need to better
understand the physiological roots of agitation.
"Reducing agitation is of great benefit," he said. "And I'm not discounting this therapy at all, because it can work for a lot of folks. But we need to also look at what's causing the agitation, what the triggers are. And then decide exactly how we're going to approach it."
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