• Anna Pedrinolla, Stefano Tamburin, Anna Brasioli, Alessio Sollima, Cristina Fonte, Ettore Muti, Nicola Smania, Federico Schena, and Massimo Venturelli.
• Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.
• J. Alzheimers Dis. 2019 Jan 1; 71 (3): 813-823.

BackgroundBehavioral and psychological symptoms of dementia (BPSD) affect 60-90% of patients with Alzheimer's disease (AD).ObjectiveTo determine if environmental therapy is an effective strategy to reduce BPSD, we tested 163 patients with AD with Neuropsychiatric Inventory (NPI) before and after 6 months of an indoor therapeutic garden (TG) or standard environment.MethodsA single-blind randomized controlled trial on AD patients with BPSD. Participants were randomized to an indoor TG (N = 82), or standard environment (control, N = 81) for 6 months.Primary Outcomechange in the NPI score from baseline (T0) to end of treatment (T1).Secondary Outcomeschange in use of quetiapine, cognition, activities of daily living, salivary cortisol, blood pressure from T0 to T1.ResultsNPI score significantly ameliorated (TG versus control: -31.8 points), quetiapine dosage (-150 mg), blood pressure (-2.6 mm Hg), and salivary cortisol (-6.4 to -2.1 Nmol/l) were significantly reduced, the Mini-Mental State Examination significantly improved (1.8 points) in the TG versus control arm at T1 (p < 0.001). No adverse events were reported.ConclusionThe indoor TG seems safe and may reduce BPSD, medication intake, and cortisol levels in AD.

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