***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES Dementia is the disease most frequently leading to admission in long-term care institutions , primarily because persons with this disease exhibit several behavioral problems . The objective of this study was to measure the efficacy of the sensory integration program developed by Ross and Burdick in improving the functioning of persons with dementia . METHOD Forty subjects with dementia ( 28 women , 12 men , mean age of 78.4 years ) in three different institutional setting s in Quebec City , Canada , were r and omly assigned to the study ( n = 22 ) or  control ( n = 18 ) group . Subjects in the study group participated in three 45-min sessions of a sensory integration program per week for 10 weeks . Outcomes were measured using the Revised Memory and Behavior Problems Checklist and the Psychogeriatric Scale of Basic Activities of Daily Living . RESULTS The sensory integration program had no significant effect on the behaviors of the study group . CONCLUSION Before this type of program is labeled inefficacious , other studies are necessary to determine whether modifying the frequency of sessions , the number of subjects , and the measuring instruments would lead to similar results Objectives : Agitation in nursing home residents with dementia leads to increase in psychotropic medication , decrease in quality of life , and to patient distress and caregiver burden .  Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been method ologically insufficient . The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes , and to explore its effect on psychotropic medication and quality of life . Method : In a crossover trial , 42 participants with dementia were r and omized to a sequence of six weeks of individual music therapy and six weeks of st and ard care . Outcome measures included agitation , quality of life and medication . Results : Agitation disruptiveness increased during st and ard care and decreased during music therapy . The difference at −6.77 ( 95 % CI ( confidence interval ) : −12.71 , −0.83 ) was significant ( p = 0.027 ) , with a medium effect size ( 0.50 ) . The prescription of psychotropic medication increased significantly more often during st and ard care than during music therapy ( p = 0.02 ) . Conclusion : This study shows that six weeks of music therapy  reduces agitation disruptiveness and prevents medication increases in people with dementia . The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample OBJECTIVE Preliminary data suggest that morning bright light might improve symptoms of agitation , a serious problem in patients with dementia . The authors exp and on an earlier pilot study by evaluating the effect of bright light therapy on agitated behavior in a large sample of patients with severe dementia . METHODS Ninety-two patients were r and omly assigned to morning bright light , morning dim red light , or evening bright light .  Agitation was rated by research staff who observed the patients every 15 minutes throughout the treatment period and by caregivers at one time-point before and one time-point after treatment . RESULTS Morning bright light delayed the acrophase of the agitation rhythm by over 1.5 hours . Bright light was associated with improved caregivers ' ratings but had little effect on observational ratings of agitation . CONCLUSION Although the result that light shifted the peak of the agitated behavior might be generalizable to patients with milder forms of AD , the fact that agitation was not ameliorated might not be . Because the suprachiasmatic nucleus ( SCN ) of patients with severe AD is likely to be more degenerated , and the circadian activity rhythms deteriorate as the disease progresses , it is still possible that patients with more intact SCNs , that is , patients with mild or moderate AD , might benefit from light treatment even more than those with severe AD Background Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care . Objective To examine whether modifying environmental stimuli by the use of calming music and h and massage affects agitated behavior in persons with dementia . Method A four group , repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music , h and massage , or calming music and h and massage simultaneously , or no intervention ( control ) on the frequency and type of agitated behaviors in nursing home residents with dementia ( N = 68 ) . A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors . Results Each of the experimental interventions reduced agitation more than no intervention . The benefit was sustained and increased up to one hour following the intervention ( F = 6.47 , p < .01 ) . The increase in benefit over time was similar for each intervention group . When types of agitated behaviors were examined separately , none of the interventions significantly reduced physically aggressive behaviors ( F = 1.93 , p = .09 ) , while physically nonaggressive behaviors decreased during each of the interventions ( F = 3.78 , p < 01 ) . No additive benefit result ed from simultaneous exposure to calming music and h and massage . At one hour following any intervention , verbally agitated behavior decreased more than no intervention . Conclusion Calming music and h and massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding , off setting disturbing stimuli , but no additive benefit was found by combining interventions simultaneously We undertook a r and omised controlled trial to assess whether a music therapy ( MT ) scheme of administration , including three working cycles of one month spaced out by one month of no treatment , is effective to reduce behavioural disturbances in severely demented patients . Sixty persons with severe dementia ( 30 in the experimental and 30 in the control group ) were enrolled . Baseline multidimensional assessment included demographics , Mini Mental State Examination ( MMSE ) , Barthel Index and Neuropsychiatry Inventory ( NPI ) for all patients . All the patients of the experimental and control groups received st and ard care ( educational and entertainment activities ) . In addition , the experimental group received three cycles of 12 active MT sessions each , three times a week . Each 30-min session included a group of three patients . Every cycle of treatment was followed by one month of wash-out . At the end of this study , MT treatment result ed to be more effective than st and ard care to reduce behavioural disorders . We observed a significant reduction over time in the NPI global scores in both groups ( F 7,357 = 9.06 , p < 0.001 ) and a significant difference between groups ( F 1,51 = 4.84 , p < 0.05 ) due to a higher reduction of behavioural disturbances in the experimental group at the end of the treatment ( Cohen 's d = 0.63 ) . The analysis of single NPI items shows that delusions , agitation and apathy significantly improved in the experimental , but not in the control group . This study suggests the effectiveness of MT approach with working cycles in reducing behavioural disorders of severely demented patients Although musical interventions have recently gained popularity as a non-pharmacological treatment in dementia , there is still insufficient evidence of their effectiveness . To investigate this issue , a single-center r and omized controlled trial was conducted with forty-eight patients with Alzheimer 's disease or mixed dementia to compare the effects of music versus cooking interventions in the emotional , cognitive , and behavioral domain , as well as on professional caregiver distress . Each intervention lasted four weeks ( two one-hour sessions a week ) . Multi-component evaluations ( with blind assessors ) were conducted before , during , and after the interventions to assess their short and long-term effects ( up to four weeks post interventions ) . Analyses revealed that both music and cooking interventions led to positive changes in the patients ' emotional state and decreased the severity of their behavioral disorders , as well as reduced caregiver distress . However , no benefit on the cognitive status of the patients was seen . While results did not demonstrate a specific benefit of music on any of the considered measures , the present study suggests the efficacy of two pleasant non-pharmacological treatments in patients with moderate to severe dementia . Our findings highlight the potential of such interventions in improving the well-being of patients living in residential care  , as well as reducing caregiver distress BACKGROUND Agitated behaviours are identified by caregivers as the most challenging in dementia care . Alternative approaches reducing occurrence of agitated behaviours and the need for chemical or physical restraints become valuable for institutionalized elders with dementia . OBJECTIVE AND SETTING This study was to evaluate the effects of group music with movement intervention on occurrence of agitated behaviours of institutionalized elders with dementia in Taiwan . METHODS A r and omized controlled trial was used . Thirty-six institutionalized elders with dementia completed the study , with 18 in the experimental group receiving group music with movement intervention twice a week for 4 weeks and 18 in the control group receiving usual care without intervention  . Modified Cohen-Mansfield Agitation Inventory was used to assess agitated behaviours at baseline , weeks 2 and 4 . RESULTS Agitated behaviours were significantly reduced in the experimental group following 4 weeks of group music with movement intervention compared to that of the control group ( p<0.001 ) . CONCLUSIONS Group music with movement intervention can be beneficial in managing agitated behaviours of those with dementia and should be incorporated into care routines in residential facilities OBJECTIVE This experimental study aim ed to evaluate the effects of a group music intervention on anxiety and agitation of institutionalized older adults with dementia . METHODS A total of 60 participants were r and omly assigned to an experimental or a control group . The experimental group received a 30-min music intervention using percussion instruments with familiar music in a group setting in mid afternoon twice weekly for 6 weeks , whereas the control group received usual care with no music intervention . The Rating of Anxiety in Dementia scale was used to assess anxiety , and Cohen-Mansfield Agitation Inventory was used to assess agitation at baseline , week 4 and week 6 . RESULTS Repeated measures analysis of covariance indicated that older adults who received a group music intervention had a significantly lower anxiety score than those in the control group while controlling for pre-test score and cognitive level ( F = 8.98 , p = 0.004 ) . However , the reduction of agitation between two groups was not significantly different . CONCLUSIONS Anxiety and agitation are common in older adults with dementia and have been reported by caregivers as challenging care problems . An innovative group music intervention using percussion instruments with familiar music as a cost-effective approach has the potential to reduce anxiety and improve psychological well-being of those with dementia Objectives : This study , as part of a larger programme of research , sought to investigate the effect that participation in a 40-min live group music programme , involving facilitated engagement with song-singing and listening , three times a week for eight weeks , had on agitation and anxiety in older people with dementia . Methods : A r and omized cross-over design , with music and reading control groups , was employed . Forty-seven participants with mild – moderate dementia , from two aged care facilities in Queensl and , Australia , were recruited . Participants were assessed three times on the Cohen-Mansfield Agitation Inventory – Short Form ( CMAI-SF ) and the Rating Anxiety in Dementia Scale ( RAID ) . Results : A sub- analysis of 24 participants attending ≥50 % of music sessions found a significant increase in the frequency of verbal aggression over time , regardless of group ( F(2,46 ) = 3.534 , p < 0.05 ) . A series of multiple regressions found cognitive impairment , length of time living in the facility and gender to be predictors of agitation overall and by subtype . Conclusion : Participation in the music programme did not significantly affect agitation and anxiety in older people with dementia . Both the music and reading group activities , however , gave some participants a ‘ voice ’ and increased their verbalization behaviour . Agitation was found to be predicted by a number of background factors ( namely level of cognitive impairment , length of time in the facility and gender ) . Future studies would benefit more from in-depth participant assessment prior to study commencement , helping to moderate the influence of low scores , and by undertaking interventions at times when assessed symptoms are most prevalent BACKGROUND Behavioral and psychological symptoms in dementia are frequent and are a major management problem , especially for patients with severe cognitive impairment . Preliminary reports have indicated positive effects of aromatherapy using select essential oils , but there are no adequately powered placebo-controlled trials . We conducted a placebo-controlled trial to determine the value of aromatherapy with essential oil of Melissa officinalis ( lemon balm ) for agitation in people with severe dementia . METHOD Seventy-two people residing in National Health Service ( U.K. ) care facilities who had clinical ly significant agitation in the context of severe dementia were r and omly assigned to aromatherapy with Melissa essential oil ( N = 36 ) or placebo ( sunflower oil ) ( N = 36 ) . The active treatment or placebo oil was combined with a base lotion and applied to patients ' faces and arms twice a day by caregiving staff . Changes in clinical ly significant agitation ( Cohen-Mansfield Agitation Inventory [ CMAI ] ) and quality of life indices ( percentage of time spent socially withdrawn and percentage of time engaged in constructive activities , measured with Dementia Care Mapping ) were compared between the 2 groups over a 4-week period of treatment . RESULTS Seventy-one patients completed the trial . No significant side effects were observed . Sixty percent ( 21/35 ) of the active treatment group and 14 % ( 5/36 ) of the placebo-treated group experienced a 30 % reduction of CMAI score , with an overall improvement in agitation ( mean reduction in CMAI score ) of 35 % in patients receiving Melissa balm essential oil and 11 % in those treated with placebo ( Mann-Whitney U 
    Output:
    
Based on these findings , stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia .