Download PDF
Fortschr Neurol Psychiatr 2007; 75(12): 699-707
DOI: 10.1055/s-2006-944298
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Kreative Therapieansätze in der Behandlung von Demenzen - eine systematische Übersicht

Creative Therapy Options for Patients with Dementia - A Systematic ReviewB.  Schmitt1 , L.  Frölich1
  • 1Abteilung für Gerontopsychiatrie, Zentralinstitut für Seelische Gesundheit, Mannheim
Further Information

Publication History

Publication Date:
17 November 2006 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Das Spezifische kreativer Therapien liegt in der Aktivierung schöpferischer Potenziale des Patienten im Sinne der Krankheitsbewältigung, Neuorientierung und Förderung der Lebensqualität. Kreative Therapieansätze zur Behandlung der Demenzpatienten bieten den Vorteil, dass sie auf einer nonverbalen Ebene mit dem Patienten arbeiten können, dessen Kognition und häufig sprachliche Mitteilung beeinträchtigt ist. Der vorliegende Artikel gibt eine systematische Übersicht über Studien, die von der Anwendung der kreativen Therapien „Musik-, Kunst-, Drama- und Tanztherapie” in folgenden Datenbanken zu finden waren (Mai 2005): Medline, Psyndex Plus, PsychInfo und Cochrane. Als Suchbegriffe wurden eingegeben: „Creativ* and therapy and dementia and (stud*)”, „Dance therapy and dementia”, „Music therapy and dementia”, „Drama therapy and dementia” und „Art therapy and dementia”. Insgesamt wurden nach diesen Suchkriterien beginnend ab 1998 sieben quantitativ ausgewertete kontrollierte Studien, 3 prä-post-Vergleiche und drei qualitative Analysen beschrieben, die in Gruppen von mindestens 3 Teilnehmern durchgeführt wurden. Überblicksartikel werden im Text erwähnt. Die Übersicht der vorhandenen Studien zu kreativen Therapien bei Demenzen zeigt, dass die vorhandenen Daten den Einsatz kreativer Therapien zur Förderung der Interaktionsfähigkeit und der Lebendigkeit im Ausdruck unterstützen. Das Spannungsfeld zwischen Methodik der Erfassung der Therapieeffekte und der Therapieinhalte, die ihre Spezifität in der therapeutischen Anleitung zu aktiven und kreativen Prozessen der Patienten haben, führt zur Forderung nach Weiterentwicklung und Validierung von Instrumenten, mit denen Parameter wie z. B. Lebendigkeit und Interaktionsfähigkeit quantitativ abgebildet werden können.

Abstract

The specifics of creative therapies aim at activating the creative potential of the patients in the sense of acceptance, orientation and coping with their illness “dementia” and at improving their quality of life. Creative therapies in the treatment of dementia offer the advantage of working with these patients, whose cognition and often also verbal communication skills are affected in a nonverbal way. This article presents a systematic review of studies and case studies, which could be found on the subject of the implementation of active creative therapies “music-, art-, drama- and dance-therapy” within the following databases (05/05): Medline, Psyndex Plus, PsychInfo and Cochrane. The search terms used were: “Creativ* and therapy and dementia and (stud*)”, “Dance therapy and dementia”, “Music therapy and dementia”, “Drama therapy and dementia” and “Art therapy and dementia”. As a result of this search we found seven quantitative evaluated controlled studies, three prae-post comparisions and three qualitative evaluated studies which have been finished since 1998. All of these studies included groups of at least three participants. Further reviews are mentioned in this article. This survey of studies on creative therapies for patients with dementia shows positive effects like the improvement of interaction skills. The data supplied thus supports the approach of using creative therapies in order to help patients accept dementia as their illness and finally to cope with it. The methodical approach to the registration of the therapies’ effects and process-orientated contents of the therapy create a field of tension, leading to the request for a further development and validation of instruments, which allow the quantitative evaluation of parameters like liveliness, agility and interaction skills.

Schlüsselwörter

Demenzen - Kreative Therapien - Studienübersicht

Key words

dementia - creative therapies - review

Literatur

  • 1 Bickel H, Cooper B. Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study.  Psychol Med. 1994;  24 (1) 179-192
    CrossrefPubMedGoogle Scholar
  • 2 Gurka P, Marksteiner J. Die psychosoziale Therapie von Patienten mit Demenz.  WMW. 2002;  3/4 102-106
    PubMedGoogle Scholar
  • 3 Gunzelmann T, Reiser H. Gruppenarbeit mit Demenzkranken im frühen Krankheitsstadium: Überlegungen zu Zielen und Methoden. In: Fortschritte und Defizite im Problemfeld Demenz. Deutsche Alzheimer Gesellschaft e.V 1999: 65-80
    Google Scholar
  • 4 Sabe L, Jason L, Juejati M. et al . Dissociation between declarative and procedural learning in dementia and depression.  J Clin Exp Neuropsychol. 1995;  17 (6) 841-848
    PubMedGoogle Scholar
  • 5 Alexopoulos G S, Abrams R C, Young R C. et al . Cornell scale for Depression in Dementia.  Biological Psychiatry. 1988;  23 271-284
    CrossrefPubMedGoogle Scholar
  • 6 Folstein M F, Folstein S E, McHugh P R. Mini Mental State. A practical method for grading the cognitive state of patients for the clinician.  Journal of Psychiatric Research. 1975;  12 189-198
    CrossrefPubMedGoogle Scholar
  • 7 Erzigkeit H. SKT: Ein Kurztest zur Erfassung von Gedächtnis- und Aufmerksamkeitsstörungen. Manual. Weinheim: Beltz 4. Aufl 1989
    Google Scholar
  • 8 Reisberg B, Ferris S, de Leon M J. et al . The global deterioration scale for assessment of primary degenerative dementia.  American Journal of Psychiatry. 1982;  139 1136-1139
    CrossrefPubMedGoogle Scholar
  • 9 Reisberg B, Borenstein J, Salob S P. et al .Behave-AD. In: Burns A, Lawlor B, Craig S. Assessment scales in old age psychiatry. London: Martin Dunitz 1999
    Google Scholar
  • 10 Lawton M P, Brody E M. Assessment of older people: selfmaintaining and instrumental activities of daily living.  Gerontologist. 1969;  9 179-186
    CrossrefPubMedGoogle Scholar
  • 11 Spiegel R, Brunner C, Ermini-Fünfschilling D. et al . A new behavioral assessment scale for geriatric out- and in-patients: The NOSGER (Nurse's Observation Scale for Geriatric Patients).  Journal of the American Geriatric Society. 1991;  39 (4) 339-347
    PubMedGoogle Scholar
  • 12 Zarit S H, Todd P A, Zarit J M. Subjective burden of husbands and wives as caregiver: a longitudinal study.  The Gerontologist. 1986;  26 260-266
    PubMedGoogle Scholar
  • 13 Yesavage J, Brink T L, Rose T L. et al . Development and validation of a geriatric depression screening scale: a preliminary report.  Journal of Psychiatric Research. 1983;  17 37-49
    PubMedGoogle Scholar
  • 14 Beck A T, Ward C H, Mendelson M. et al . An inventory for measuring depression.  Archives of General Psychiatry. 1961;  4 561-571
    CrossrefPubMedGoogle Scholar
  • 15 Landsiedel-Anders S. Musiktherapie bei Demenzerkrankungen - eine klinisch-experimentelle Studie im Rahmen einer Gedächtnissprechstunde, Diplomarbeit Psychologie, FB 5. Universität Frankfurt am Main 2003
    Google Scholar
  • 16 Kertesz A. Western Aphasia Battery. Ontario, London, Canada: University of Western 1980
    Google Scholar
  • 17 Blessed G, Tomlison B C, Roth M. The association between quantitative measures of dementia and of senile changes in the cerebral grey matter of elderly subjects.  British Journal of psychiatry. 1968;  144 797-811
    PubMedGoogle Scholar
  • 18 Cummings J L, Mega M, Gray K. et al . The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia.  Neurology. 1994;  44 2308-2314
    CrossrefPubMedGoogle Scholar
  • 19 Cohen-Mansfield J, Marx M S, Rosenthal A S. A description of agitation in the nursing home.  Journal of Gerontology. 1989;  44 77-84
    PubMedGoogle Scholar
  • 20 Zarit S H, Zarit J M. Families under stress: Interventions for caregivers of senile dementia patients.  Psychotherapy Theory, Research and Practice. 1982;  19 462-471
    PubMedGoogle Scholar
  • 21 Spielberg C B, Gorsuch R L, Luschene R I. Cuestionario de ansiedad estado-rasgo. Madrid: TFA
    Google Scholar
  • 22 Mahony F I, Barthel D W. Functional Evaluation: The Barthel Index.  Maryland State Medical Journal. 1965;  14 61-65
    PubMedGoogle Scholar
  • 23 Kobayashi T, Hataguti Y, Nishimura K. A new clinical scale for rating of mental state.  J Clin Psychiatry. 1988;  17 1653-1688
    PubMedGoogle Scholar
  • 24 Helmes E, Csapo K, Short J. Standardization and validation of multidimensional observation scale for elderly subjects (MOSES).  J Gerontol. 1987;  42 395-405
    PubMedGoogle Scholar
  • 25 Nakane H, Asai O, Yamada Y. et al . Salivary chromogranin A as index of psychosomatic response.  Biomed Res. 1998;  19 401-406
    PubMedGoogle Scholar
  • 26 Watanabe K, Torikawa S, Kazuo S. et al . A study on the effects of music therapy for patients with dementia.  Seishin Igaku (Clinical Psychiatry). 2003;  Vol 45 (1) 49-54 (nur Abstrakt verwendet, Orginal in japanischer Sprache)
    PubMedGoogle Scholar
  • 27 Hughes C P, Berg L, Danzinger W L. et al . A new clinical scale for the staging of dementia.  Br J Psychiatry. 1982;  140 566-572
    CrossrefPubMedGoogle Scholar
  • 28 Hokoishi K, Ikeda M, Maki N. et al . Interrater reliability of the Physical Self-Maintenance Scale and the Instrumental Activities of Daily Living Scale in a variety of health professional representatives.  Aging Ment Health. 2001;  5 (1) 38-40
    CrossrefPubMedGoogle Scholar
  • 29 Clair A A. The effects of music therapy on engagement in family caregiver and care receiver couples with dementia.  Am J Alzheimers Dis Other Demen. 2002;  17 (5) 286-290
    PubMedGoogle Scholar
  • 30 Gardiner J C, Furois M, Tansley D. et al . Music therapy and reading as intervention strategies for disruptive behavior in dementia.  Clinical Gerontologist. 2000;  22 (1) 31-46
    CrossrefPubMedGoogle Scholar
  • 31 Hanson N, Gfeller K, Woodworth G. et al . A comparison of the effectiveness of differing types and difficulty of music activities in programming for older adults with Alzheimer's disease and related disorders.  Journal of Music Therapy. 1996;  33 93-123
    PubMedGoogle Scholar
  • 32 Hilliard R E. The use of music therapy in meeting the multidimensional needs of hospice patients and families.  Journal of Palliative Care. 2001;  17 (3) 161-166
    PubMedGoogle Scholar
  • 33 Brotons M, Koger S M. The impact of music therapy on language funcioning in dementia.  Journal of music therapy. 2000;  Band 37 (Heft 3) 183-195
    PubMedGoogle Scholar
  • 34 Sherratt K, Thornton A, Hatton C. Music interventions for people with dementia: a review of the literature.  Aging and Mental Health. 2004;  8 (1) 3-12
    CrossrefPubMedGoogle Scholar
  • 35 Koger S M, Chapin K, Brotons M. et al . Is music therapy an effective intervention for dementia: a meta- analytic review of literature.  Journal of Music Therapy. 1999;  36 (1) 2-15
    PubMedGoogle Scholar
  • 36 Koger S M, Brotons M. Music therapy for dementia symptoms.  Cochrane Database Syst Rev. 2000;  (3) CD001121
    PubMedGoogle Scholar
  • 37 Lou M F. The use of music to decrease agitated behaviour of the demented elderly: the state of the science.  Scandinavian Journal of Caring Sciences. 2001;  15 (2) 165-173
    CrossrefPubMedGoogle Scholar
  • 38 Vink A C, Birks J S, Bruinsma M S. et al . Music therapy for people with dementia.  The Cochrane Database of Systematic Reviews. 2003;  Issue 4 CD003477
    PubMedGoogle Scholar
  • 39 Ashida S. The effect of reminiscence music therapy sessions on changes in depressive symptoms in elderly persons with dementia.  Journal of music therapy. 2000;  Band 37 (Heft 3) 170-182
    PubMedGoogle Scholar
  • 40 Berger G, Bernhardt T, Schramm U. et al . No effects of a combination of caregivers support group and memory training/music therapy in dementia patients from a memory clinic population.  Int J Geriatr Psychiatry. 2004;  19 223-231
    CrossrefPubMedGoogle Scholar
  • 41 Brotons M, Koger S M. The impact of music therapy on language funcioning in dementia.  Journal of music therapy. 2000;  Band 37 (Heft 3) 183-195
    PubMedGoogle Scholar
  • 42 Brotons M, Marti P. Music therapy with Alzheimer's patients and their family caregivers: a pilot project.  Journal of music therapy. 2003;  2 138-150
    PubMedGoogle Scholar
  • 43 Suzuki M, Kanamori M, Watanabe M. et al . Behavioral and endocrinological evaluation of music therapy for patients with dementia.  Nursing and Health Sciences. 2004;  6 11-18
    CrossrefPubMedGoogle Scholar
  • 44 Clark M E. et al . Use of music to decrease agressive behaviors in people with dementia.  Journal of gerontological nursing. 1998;  24 (7) 10-17
    PubMedGoogle Scholar
  • 45 Gerdner L A. Effects of Individualized versus classical “relaxation” music on the frequency of agitation in elderly persons with Alzheimer's disease and related disorders.  International Psychogeriatrics. 2000;  12 (1) 49-65
    CrossrefPubMedGoogle Scholar
  • 46 Groene R W. Effectiveness of music therapy 1 : 1 intervention with individuals having Senile Dementia of the Alzheimer's Type.  Journal of music therapy. 1993;  Band 30 (Heft 3) 138-157
    PubMedGoogle Scholar
  • 47 Lord T R, Garner J E. Effects of music on Alzheimer patients.  Percept Mot Skills. 1993;  4 76 (2) 451-455
    PubMedGoogle Scholar
  • 48 Bach J. Urformen und endogene Bildmuster als Grundlage einer künstlerischen Therapie bei seniler Demenz.  Musik-, Tanz-, und Kunsttherapie. 2001;  12 (2) 77-86
    PubMedGoogle Scholar
  • 49 Hett A. Warum wollen Sie mit mir arbeiten? Ich bin alt und nicht mehr kreativ, war es nie! Kunsttherapeutische Arbeit auf einer Pflegestation. In: Noelke E, Willis M (Hrsg). Klientenzentrierte Kunsttherapie in institutionalisierten Praxisfeldern, 2002: 115-131
    Google Scholar
  • 50 Stewart E G. Art therapy and neuroscience blend: Working with patients who have dementia.  Art Therapy: Journal of the American Art Therapy Association. 2004;  21 (3) 148-155
    PubMedGoogle Scholar
  • 51 Wald J. Hospice in the home: A case study in art therapy. In: Art therapy with older adults: A sourcebook 2004: 244
    Google Scholar
  • 52 Wood M JM. Researching art therapy with people suffering from AIDS related dementia.  The Arts in Psychotherapy. 2002;  (29) 207-219
    CrossrefPubMedGoogle Scholar
  • 53 Lepp M, Ringsberg K C, Holm A-K. et al . Dementia - involving patients and their caregivers in a drama programme: the caregivers' experiences.  Journal of Clinical Nursing. 2003;  12 873-881
    CrossrefPubMedGoogle Scholar
  • 54 Wilkinson N, Srikumar S, Shaw K. et al . Drama and movement therapy in dementia: a pilot study.  The Arts in Psychotherapy. 1998;  25 (3) 195-201
    CrossrefPubMedGoogle Scholar
  • 55 Rosen W G, Mohs R C, Davis K L. A new rating scale for Alzheimer's disease.  American journal of Psychiatry. 1984;  141 1356-1364
    CrossrefPubMedGoogle Scholar
  • 56 Pattie A H, Gilleard C J. Manual for the Clifton Assessment Procedures for the Elderly (CAPE). Kent, UK: Hodder & Stoughton Educational 1979
    Google Scholar
  • 57 Goldberg D P. Manual of the General Health Questionnaire. Slough: NFER/Nelson 1978
    Google Scholar
  • 58 Smith A G. Exploring death anxiety with older adults through developmental transformations.  The Arts in Psychotherapy. 2000;  27 (5) 321-331
    CrossrefPubMedGoogle Scholar
  • 59 Hokkanen L, Rantala L, Remes A M. et al . Dance/movement therapeutic methods in management of dementia.  Journal of the American Geriatrics Society. 2003;  51 (4) 576-577
    CrossrefPubMedGoogle Scholar
  • 60 Tomoeda C K, Bayles K A, Trosset M W. et al . Cross sectional analysis of Alzheimer disease effects on oral discourse in a picture description task.  Alzheimer Dis Assoc Disorders. 1996;  10 204-215
    PubMedGoogle Scholar
  • 61 Palo-Bengtsson L, Winblad B, Ekman S-L. Social dancing: a way to support intellectual, emotional and motor functions in persons with dementia.  Journal of Psychiatric and Mental Health Nursing. 1998;  5 545-554
    CrossrefPubMedGoogle Scholar
  • 62 Palo-Bengtsson L, Ekman S-L. Emotional response to social dancing and walks in persons with dementia.  American Journal of Alzheimer's Disease and Other Dementias. 2002;  17 (3) 149-153
    PubMedGoogle Scholar
  • 63 Rösler A, Seifritz E, Kräuchi K. et al . Skill Learning in patients with moderate Alzheimer's disease: a prospective pilot-study of waltz-lessons.  International Journal of Geriatric Psychiatry. 2002;  17 1155-1156
    CrossrefPubMedGoogle Scholar
  • 64 Winckel A van de, Feys H, DeWeerdt W. Cognitive and behavioral effects of music-based exercises in patients with dementia.  Clinical Rehabilitation. 2004;  18 253-260
    CrossrefPubMedGoogle Scholar
  • 65 Kam P van der, Mol F, Wimmers M GHG. Beoordelingsschaal voor Oudere Patienten. Deventer: Van Loghum Slaterus 1971
    Google Scholar
  • 66 Lindeboom J, Jonker C. Amsterdamse Dementie Screeningstest (ADS6). Lisse: Swets & Zeitlinger 1988
    Google Scholar
  • 67 Krohne H W, Egloff B, Kohlmann C-W. et al . Untersuchungen mit einer deutschen Form der Positive and Negative Affect Schedule (PANAS).  Diagnostica. 1996;  42 139-156
    PubMedGoogle Scholar
  • 68 Deusinger I M. Die Frankfurter Körperkonzeptskalen. Göttingen: Hogrefe Verlag 1986
    Google Scholar
  • 69 Verhagen A P, de Vet H C, de Bie R A. et al . The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus.  Journal of Clinical Epidemiology. 1998;  51 (12) 1235-1241
    PubMedGoogle Scholar

Dr. Beate Schmitt

Schwindstr. 23

60325 Frankfurt/M

Email: beateschmitt@web.de