By Dr. Brit Cooper-Jones
Many of us have been affected by dementia, either directly or indirectly. When a loved one is diagnosed with dementia — a general term that refers to the progressive impairment of various mental functions — it can be devastating. While the condition currently affects 46.8 million people worldwide, this number is only expected to increase as people continue to live longer, and it is projected to affect 74.7 million people by 2030.
In addition to impaired memory, patients with dementia may experience a range of other symptoms, such as difficulties with reasoning and judgment, speaking or writing coherently, recognizing familiar surroundings, planning and carrying out complex or multi-step tasks, caring for themselves, and/or managing their mood and behaviour.
Alzheimer disease is the most common cause of dementia, accounting for about 60 to 80 per cent of cases. However, other potential causes of dementia include a range of degenerative diseases and/or vascular (blood vessel) diseases. These can independently lead to dementia, or they may co-exist with Alzheimer disease as a person gets older and contribute to worsening symptoms.
Medications are available for treating dementia. However, while these have been shown to produce moderate benefits in the short term, they have also been associated with safety concerns. As a result, there has been interest in further exploring non-pharmacological treatment options (alternatives to medications) for patients with dementia.
One potential non-pharmacological treatment option is the use of a room equipped with a variety of sensory stimulation equipment, sometimes called Snoezelen therapy. In these rooms, patients’ senses of sound, sight, smell, and touch are stimulated using an array of equipment — for example, fibre optic lighting, aroma diffusers, projectors that generate changing colours and patterns, and water beds that gently vibrate and play music. Each form of sensory stimulation can be used independently, or in combination with other modalities, depending on what is most suited to each individual patient.
It has been suggested that Snoezelen therapy may be used to treat many conditions such as patients with learning disabilities, mental health challenges, autism, brain injuries, and more. Snoezelen therapy has also been explored as a potential therapeutic modality for elderly patients with dementia.
An interesting feature of Snoezelen therapy is that it can be used for different purposes depending upon a patient’s needs. For example, it can be used to calm a patient who is experiencing dementia-related agitation or behavioural disturbances (it has been suggested that sensory stimulation can improve mood and reduce behavioural problems). On the flip side, a sensory room may be used to provide a greater degree of stimulation and engagement with the world to a patient who is lacking such multi-sensory stimulation in their day-to-day life.
However, despite all of the proposed benefits of sensory rooms for patients with dementia, there remain key questions: Do they really work? Is there research out there to support their use? Are they a cost-effective use of health care dollars? Is there any guidance regarding how best to use them, and for which patients they might be most useful?
To help guide decisions about sensory rooms such as the Snoezelen environment, decision-makers and the health care community turned to CADTH — an independent agency that finds, assesses, and summarizes the research on drugs, medical devices, tests, and procedures — to find out what the evidence says.
A recent CADTH review of sensory rooms for patients with dementia in long-term care identified two systematic reviews, three randomized controlled studies, four non-randomized studies, and two evidence-based guidelines on this topic. CADTH’s review found that although sensory room therapy seems to improve symptoms of dementia, at least in the short term, it is unclear if these improvements are significantly different than those that can be achieved with other sensory therapies — including garden visits, massage, aromatherapy, individualized music therapy, animal-assisted therapy, toy therapy, and exercise therapy. Additionally, these therapies may be less expensive to implement than sensory rooms, which can cost from $10,000 to $30,000 or more depending on the complexity and quantity of equipment used.
CADTH also identified two evidence-based guidelines that recommend non-pharmacological treatments for dementia and include multi-sensory stimulation as a potential option. However, more research is still needed to further evaluate the benefits of sensory rooms in comparison to other similar treatment options in order to determine their most appropriate place in therapy.
To view CADTH’s full report, see: https://www.cadth.ca/sites/default/files/pdf/RC0999%20Sensory%20Rooms%20Final.pdf
And if you would like to learn more about CADTH, visit cadth.ca, follow us on Twitter @CADTH_ACMTS, or speak to a Liaison Officer in your region: cadth.ca/Liaison-Officers.
Dr. Brit Cooper-Jones MD is a Knowledge Mobilization Officer at CADTH.