園藝療法中嗅覺刺激對輕度失智症之介入研究

According to the statistics of the Ministry of Internal Affairs, aging population in Taiwan broke through 14% in 2018 which assumed that presumably the advanced aging society coming in 8 years. Based on the aging population structure, it is estimated that there will be 2 dementia patients per 100 people in 2031 (Taiwan Dementia Association, 2018). In order to obey the World Health organization's Global Plan of Action on Dementia, the Taiwan Ministry of Health and Welfare also extent the age limit in the policy of “National Ten-year Long-term Care Plan 2.0” in 2016, involving over 50-years-old patients with dementia and increasing service projects of dementia cures prevention programs in the attention of relevant government authorities. In the 1980s, scholars discovered that the loss of olfactory and gustatory sense in cranial nerves is a precursor to dementia. Doctors also confirmed the pathological cause of neurodegenerative diseases through brain anatomy by the nerve tangles or knots from hippocampal gyrus neurons (short-term memory, long-term memory and spatial localization function). The scholars in 90s proposed that the development of mild cognitive impairment in the pre-dementia is related to the neuronal cytopathology associated with the hippocampal olfactory sensation. After 2000, the community-based study found that the degree of olfactory loss can be regarded as mild cognitive loss. Thus, olfactory function might play an important role to make progress of the dementia degeneration. The aim of this study is to examine the effect of the olfactory stimulation intervention on the people with mild to moderate dementia. We recruit 29 participants who has been diagnosed with mild to moderate dementia from 2 day care centers in Taipei. They are randomly assigned to three groups, including the olfactory intervention group, game comparison group, and control group. Beside the control group, the participant with two other groups were required to attend twelve weeks intervention (twice a week, thirty minutes for one section). Every participants completed the olfactory test, both paper-pencil and computer-based examination for cognition, blood test and psychological measurement before and after the intervention. The results showed that the participant in olfactory intervention group significant improved score in the LOTCA-G examination, and the Aβ1-42 concentration of the blood test significant increase in the control group; furthermore, the olfactory intervention group is lowest concentration among three groups in the Tau concentration of the blood test via ANCOVA analysis. Therefore, the olfactory intervention might has potential effect on the alleviation of the dementia progression. However, further research with bigger sample size is needed in order to gain more scientific evidence.