title: Study on the Effects of Individualized Learning Therapy on Cognitive Function and Behavioral and Psychological Symptoms of Dementia in the Institutionalized Older Adults.
abstract: BACKGROUND
  The increasing number of elderly people affected by dementia in Taiwan has made dementia care a crucial issue of concern. This issue is particularly important in terms of the proper management of behavioral symptoms and improvement of the cognitive functions of those affected by this disease.
  
  
  OBJECTIVE
  This study examined the effects of individualized learning therapy on cognition and neuropsychiatric symptoms among elderly people with dementia.
  
  
  METHODS
  A quasi-experimental, pretest-posttest research design was adopted. We recruited elderly people with dementia at the only two institutions for elderly patients with dementia in Central Taiwan. These institutions were assigned randomly as the experimental or control group, with totals of 23 and 21 participants, respectively. The participants in the experimental group received individualized learning therapy for 30 minutes twice weekly for 3 months. The comparison group received usual care only. The cognitive function and neuropsychiatric symptoms of all participants were measured using the Mini-Mental Status Examination (MMSE) before the start of and immediately after the 12-week intervention and the Chinese version of the Neuropsychiatric Inventory (CNPI), which was administered once per week during the intervention. Independent t tests (or Mann-Whitney U tests), chi-square tests (or Fisher's exact tests), paired t test, and generalized estimating equations were used for data analysis.
  
  
  RESULTS
  Participants in the experimental group had significantly higher MMSE scores (p < .01) and lower CNPI scores (p < .01) than their comparison group peers after the intervention. Furthermore, the neuropsychiatric symptoms in the experimental group such as hallucinations, bizarre behavior, depression, apathetic expression, irritability, and sleep disorder had significantly improved by the seventh week.
  
  
  CONCLUSIONS
  Individualized learning therapy may be an effective approach to improve cognitive function and reduce neuropsychiatric symptoms among older people with dementia. Therefore, future clinical application is warranted.
authors.affiliation: 1MS, RN, Doctoral Student, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, and Head Nurse, Department of Nursing, Cheng Ching Hospital, Taiwan, ROC 2MS, RN, Supervisor, Kuangten Hospital, Taiwan, ROC 3DNSc, RN, Professor, Department of Nursing, Hungkuang University, Taiwan, ROC 4PhD, RN, Professor, Hahn School of Nursing and Health Science, University of San Diego, USA.
authors.forename: Hsiao-Mei
authors.initials: HM
authors.lastname: Chen
authors.forename: Li-Jane
authors.initials: LJ
authors.lastname: Tsai
authors.forename: Shu-Yuan
authors.initials: SY
authors.lastname: Chao
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Clark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy; D003071:Cognition / Q000502:physiology*; D003704:Dementia / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007858:Learning; D008297:Male; D013624:Taiwan