Family caregivers often feel ill-equipped to handle bothersome behavioral and psychological symptoms of dementia, such as agitation, apathy, and sleep disturbances, leading to increased caregiver distress and nursing home placement for people with dementia. Therapies for such symptoms are currently limited and non-pharmacological options are preferred, given potential side effects of medications. Neurologic music therapy (NMT) could provide an additional treatment option for managing behavioral and psychological symptoms for community-dwelling people with dementia and their caregivers. This pilot study sought to evaluate the feasibility, acceptability, and effectiveness of home-based NMT for behavioral and psychological symptoms of dementia. Eighteen persons with dementia-caregiver dyads were enrolled to receive one-hour weekly sessions of home-based NMT for 6 weeks. Demographic, quality of life, neuropsychiatric symptom, and caregiver burden and self-efficacy information was collected at baseline, 6 weeks, and 12 weeks. Seven dyads (38.9%) withdrew from therapy before completing all sessions; these participants had higher Neuropsychiatric Inventory scores and were of older age at baseline. For those who completed therapy, neuropsychiatric symptom scores improved at 6 weeks, an effect that was sustained at 12 weeks. No other outcome measures changed significantly after therapy. Initiating NMT too late in the course of dementia, when behavioral symptoms are already present, may be impractical for people with dementia and increase caregiver stress, even when provided within the home. Introducing and incorporating the principles of NMT earlier in the course of dementia could allow for increased comfort and benefit for people with dementia and their caregivers.
OF the various anomalies of texture which may be found in the cranial bones of the insane. generalised thickening and sclerosis is perhaps the commonest, and is seen in its most typical form in the. dementias of epilepsy and chronic insanity. On the other hand, thickening of the cranial vault, limited to one particular area or bone, and accompanied in some cases by the formation of osteophytes, appears to be a rather rare condition. Usually it is the frontal bone which is affected in this way, and its precise appearance is subject to considerable variation. The construction of the calvaria may be fairly normal, the diploe being represented, but the two tables muich thicker than normal. c2 321 Protected by copyright.
To the student of mental deficiency the lower grades of oligophrenia offer endless opportunities for the exercise of his diagnostic acumen, and in this largely unexplored terrain there are doubtless many syndromes awaiting discovery.
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