title: Evaluation of the efficacy of animal-assisted therapy based on the reality orientation therapy protocol in Alzheimer's disease patients: a pilot study.
abstract: BACKGROUND
  The aim of this study was to evaluate the efficacy of animal-assisted therapy (AAT) in elderly patients affected by Alzheimer's disease based on the formal reality orientation therapy (ROT) protocol.
  
  
  METHODS
  Our study was carried out at an Alzheimer's centre for 6 months. A homogeneous sample (age, Mini-Mental State Examination (MMSE), 15-item Geriatric Depression Scale (GDS)) of 50 patients was selected at random and successively. Patients were divided into three groups: (i) 20 patients received a course of AAT (AAT group) based on the ROT protocol; (ii) 20 patients were engaged exclusively in activities based on the ROT group; and (iii) 10 patients (control group) participated in no stimulations. MMSE and GDS were administered at time 0 (T0 ) and time 1 (T1 ) to all three groups. Differences within groups between T0 and T1 for GDS and MMSE scores were analyzed by Student's t-test. Differences between group means were analyzed using an anova test with the Bonferroni-Dunn test for post-hoc comparisons.
  
  
  RESULTS
  Both the AAT group and ROT group had improved GDS scores and showed a slight improvement in terms of mood. On the GDS, the AAT group improved from 11.5 (T0 ) to 9.5 (T1 ), and the ROT group improved from 11.6 (T0 ) to 10.5 (T1 ). At the same time, a slight improvement in cognitive function, as measured by the MMSE, was observed. In the AAT group, mean MMSE was 20.2 at T0 and 21.5 at T1 , and in the ROT group, it was 19.9 at T0 and 20.0 at T1 . In the control group, the average values of both the GDS and MMSE remained unchanged. The Bonferroni-Dunn results showed statistically significant differences between groups, particularly between the AAT group and the other two (P < 0.001).
  
  
  CONCLUSIONS
  Pet therapy interventions based on the formal ROT protocol were effective and, compared to the ROT, provided encouraging and statistically significant results.
authors.affiliation: Department of Veterinary Medicine and Animal Productions, University of Studies of Naples Federico II, Naples, Italy.
authors.forename: Lucia Francesca
authors.initials: LF
authors.lastname: Menna
authors.affiliation: Department of Veterinary Medicine and Animal Productions, University of Studies of Naples Federico II, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Santaniello
authors.affiliation: Department of Veterinary Medicine and Animal Productions, University of Studies of Naples Federico II, Naples, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Gerardi
authors.affiliation: Department of Fragility, ASL Napoli 1 Centro-CRIUV, Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Di Maggio
authors.affiliation: Department of Fragility, Geriatrician Center Frullone ASL Naples1 Centre, Naples, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Milan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology / Q000628:therapy*; D056447:Animal Assisted Therapy; D000818:Animals; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
keywords: AAT; Alzheimer' disease; ROT; non-pharmacological therapies; public health