[The long-term effect of day care rehabilitation on individuals with dementia]

In the treatment of senile dementia, rehabilitation rather than drugs, could result in more positive long-term effects. A Day Care program designed for individuals with Senile Dementia of the Alzheimer type (SDAT) and Vascular Dementia (VD:MID and BD), activates the brain through memory training, creative arts therapy, physical activity, and social interaction. The objective of this study is to determine if Day Care can modify the patients intellectual decline or even alter the natural course of the dementing illness. 135 SDAT and 213 VD patients were studied over three years. ADL (Activities of Daily Living) measurements were evaluated by the Barthel Index and cognitive measurements by the NM-scale. The Wilcoxon test and the Sign test were carried out using the BI and NM-scale scores. These results indicated a decline or arrest in the progression of SDAT and VD as determined by the multiple logistical models. The 8 variables (risk factors, medication, age at onset, self-rehabilitation, family support, sex, grade of dementia and Day Care) influence on the survival curves was calculated using the Kaplan-Meire Life table method. The Cox proportional hazard analysis was then used to examine the relationship between the 8 variables and dementia. The significantly positive results from these four analyses of the ADL and cognitive measurements indicate that Day Care programs clearly retards the progression of intellectual decline in dementia patients and improves the quality of life (QOL) in all cases. In VD patients the mortality rate was notably decreased through Day Care. These results make one consider the benefits of introducing such programs into society as a strong treatment against the onset of dementia developing into severe, dehabilitating dementia. However a healthy diet, a physically and mentally active life, as well as early diagnosis, are the best preventions against dementia.