Enriched gardens improve cognition and independence of nursing home residents with dementia: a pilot controlled trial

Background Dementia is a major issue worldwide, and considerable efforts were made to design therapeutic mediation tools and evaluate their benefits on the health of patients. Methods Design: Multi-center cluster-controlled pilot trial. Settings and participants: Four nursing homes that offered separated access to one conventional sensory garden (CSG) and one enriched garden (EG). The participants were residents with dementia, independent for walking and with no severe dementia or behavioural troubles. Eligible residents were divided into three groups according to the proximity of their room: close to the CSG or EG gardens for the first two groups and further from the gardens for the third (control) group. Interventions: We asked staff members to frequently invite residents to visit the EG or the CSG depending on their group allocation. No invitation to gardens was made to the control group. We installed 12 enrichment modules in the EG that stimulated cognitive, independence and walking/balance functions. Measures: Cognitive function (MMSE), independence for activities of daily living (ADL) and risk of falls (unipodal stance and timed up and go - (TUG)) were assessed at baseline and after 6 months. Results The 120 participants were 81 center dot 0 +/- 3 center dot 5 years old and comprised of 83 women. Their MMSE score was 17 center dot 5 +/- 2 center dot 9. Patients' characteristics were not significantly different between the three groups. Among the participants invited to visit the EG group, 6-month changes in MMSE showed improvement compared to other groups (+ 0 center dot 93 +/- 0 center dot 65 vs -0 center dot 25 +/- 0 center dot 71 and -0 center dot 24 +/- 0 center dot 73 in the EG vs CSG and control groups, respectively, P < 0 center dot 0001). Changes in ADL, TUG and unipodal stance were significantly improved in the group visiting the EG as compared to other groups, which indicates better functioning. Conclusions EGs offer a new approach to therapeutic mediation for residents of nursing homes with dementia.