The intervention reduced BPSD in severely demented nursing home residents and this effect was still present 3 months after the end of the programme.

Recent studies have suggested that memory circuits can be modulated by deep brain stimulation (DBS). This propriety might be used to slow down cognitive decline in patients suffering from Alzheimer's disease (AD). We conducted a prospective study to evaluate the feasibility and safety of DBS in AD patients with mild cognitive decline. Inclusion criteria were: patients (<70 years old) with AD diagnosed for less than 2 years, predominant impairment of episodic memory, and Mini-Mental Status Exam (MMSE) score between 20 and 24. The fornix was stimulated bilaterally by electrodes implanted stereotactically in the hypothalamus. Clinical, biological, neuropsychological, and imaging evaluations were conducted 3 months before surgery and 3, 6, and 12 months thereafter. During the one year-period of inclusion, 110 patients with recently diagnosed AD and predominant impairment of episodic memory were screened. Only 9 patients (8.2%) fulfilled all the inclusion criteria. Finally, just one patient accepted to be operated (acceptance rate 11.1%) and completed the study. No complications occurred and the stimulation was perfectly tolerated. After one year of stimulation, the memory scores (MMSE, ADAS-Cog, Free and Cued Selective Reminding Test) were stabilized compared to baseline, and mesial temporal lobes metabolism increased. This pilot study provides new data about the safety of fornix DBS in the hypothalamus. However, it suggests that only a small proportion of AD patients might be interested in this approach and that the acceptance of DBS by AD patients was low, raising questions about the relevance of this approach to meet the expectations of these patients.

This study examined the effectiveness of three different learning methods: trial and error learning (TE), errorless learning (EL) and learning by modeling with spaced retrieval (MR) on the relearning process of IADL in mild-to-moderately severe Alzheimer's Dementia (AD) patients (n=52), using a 6-weeks randomized controlled trial design. The participants had to relearn three IADLs. Repeated-measure analyses during pre-intervention, post-intervention and 1-month delayed sessions were performed. All three learning methods were found to have similar efficiency. However, the intervention produced greater improvements in the actual performance of the IADL tasks than on their explicit knowledge. This study confirms that the relearning of IADL is possible with AD patients through individualized interventions, and that the improvements can be maintained even after the intervention.

Apathy is rarely identified as a problem in NH. Emotional blunting was the only dimension sensitive to change. Failure to improve residents' level of interest could be explained by the difficulties encountered in accessing information regarding the subjects' personal interests. But it remains possible to modify residents' emotional reactivity and staff's perceptions of residents' behaviors and emotions.

Background. Apathy is the most frequent behavioural disturbance understanding how apathy drives engagement in resident's activities of interests is a milestone to better understanding and tailored challenging interventions targeting engagement enhancement. Method. Residents aged 60 and older with dementia according to the ICD 10 from four nursing homes in the south east of France. A set of 25 stimuli were used and categorized by participant into Work, Leisure, Family, or Personal categories, an additional “not interested” category was used for comparison of engagement. The participants stimuli allocation was randomized in guided and unguided situations over a two-week period with 15minute interaction for each stimulus (n = 2) of each category (5×(15 min×2)). Clinical trial identifier: NCT01314131. Results. The mean age, 95% confidence interval (CI) of the 40 participants was 85.4 (83.8–87) with a mean MMSE score, CI95% of 17.7 (16.5–19). Analyses revealed a significant superiority effect of guidance over unguided interaction in duration of engagement in all categories of interest except for the stimulus category “family” and all P < .05. Apathetic participants when guided had longer engagement duration in stimulus Leisure and Personal (all P < .01). Conclusion. Guidance and better activities of interest can lead to enhanced engagement time in participants with dementia.