Art Therapy for Alzheimer's Disease and Other Dementias
Journal of Alzheimer's Disease
Patients with dementias commonly experience neuropsychiatric symptoms that diminish their quality of life. Pharmacologic treatments for these symptoms are limited in their efficacy. In the absence of near-future prospects for a cure for degenerative dementias, treatments that improve neuropsychiatric symptoms and quality of life are needed. We explore the hypothesis that art therapy is useful in dementia by reviewing the extant literature. With appropriate structure, patients with dementia can
... with dementia can produce and appreciate visual art. Case studies and several small trials suggest that art therapy engages attention, provides pleasure, and improves neuropsychiatric symptoms, social behavior, and self-esteem. Whether these benefits generalize beyond the studio remains unknown. We offer a theoretical framework that motivates the use of art therapy and propose that clinical enquiry to establish methods, assess efficacy, and define optimal conditions for the use of art therapy in Alzheimer's and other dementing disorders is timely. Keywords: Alzheimer's disease, art therapy, behavioral neurology, flow theory, frontotemporal dementia, neuropsychiatry With an estimated prevalence of ∼5.4 M in the US and 36 M people globally, dementia has a major impact on healthcare. Global prevalence of dementia is expected to double by 2030 to 66 M and more than triple by 2050 to 115 M . Unfortunately, options to treat dementia are limited and their efficacy is marginal. Without treatments to arrest or reverse degenerative dementias, interventions to improve the quality of life of patients and their caregivers remain of prime importance. In this paper, we examine the potential of one such intervention, art therapy. Neuropsychiatric symptoms are among the most distressing clinical features experienced by people with dementia and their caregivers. Apathy, depression, delusions, hallucinations, aggression, psychomotor agitation, inappropriate sexual behavior, and sleep impairment [2, 3] are common and tend to increase over time  . These symptoms impair activities of daily living , worsen quality of life , lengthen hospital stay  , and are associated with more rapid cognitive decline  . Caring for people with dementia imposes its own burden on caregivers' emotional and physical health. The severity of neuropsychiatric symptoms strongly predicts caregiver distress  , which includes depression, anxiety, and increased mortality  . Medications such as cholinesterase inhibitors, memantine, antipsychotics, and antidepressants do not substantially improve neuropsychiatric symptoms or relieve caregiver burden  . Cholinesterase inhibitors have limited efficacy in treating neuropsychiatric symptoms  . Atypical antipsychotics like risperidone and olanzapine can provide modest short-term improvement  but are associated with non-trivial side effects  .