The Horse Physio - Delivering care with expertise since 1992

2.10.21 Sharing the Science

Animal-assisted therapy for dementia

In my work, I believe that the horses give me as much to me as I give to them. Since I don’t own my own horse at the moment, when I’m not at work I don’t get much equine interaction. After time off, I always notice the difference in my frame of mind once I’m back at work and spending my days with horses again.

Animal-assisted therapy is a growing trend, which I’m sure you’ve heard of. In terms of physical therapy, the correct term in relation to horses is ‘hippotherapy’ (with ‘hippo’ meaning ‘horse’). Riding for the Disabled is well established in the UK, and hippotherapy is popular in many countries. I spent a fascinating month in the USA during my university years working with two separate hippotherapy centres, and there’s no doubt that the work they do is excellent and beneficial.

The effect on the mind of time with animals is less easy to measure and therefore well recognised. Research in this area is limited. There are many difficulties in conducting good quality research into animal-assisted therapy, not least of which is that it’s impossible to ‘blind’ the study participants so that they don’t know which treatment they’re receiving. You’re either with an animal, or you’re not. If you’re given a stuffed toy instead, or a robotic animal, then clearly you’re going to recognise it as such.

The study cited below is a review of the current evidence into animal-assisted therapy for people with dementia. Most of the studies included in the review involved dogs, and one involved horses. The reviewers found low certainty evidence that animal-assisted therapy might slightly reduce depressive symptoms. The conclusion, as always, is that more research is needed. In particular, the authors concluded that future research would do well to focus on blinding the assessors (the people who measure the results), since the participants can’t be blinded. If you don’t know whether or not the person you’re assessing has worked with an animal or a soft toy, then you can’t be biased in your reporting of the results.

I’m impressed that they also noted that there is very little research into the effects of animal-assisted therapy on the animals, and that this should be addressed in future research.

Animal-assisted therapy for dementia

Background: Dementia is a chronic condition which progressively affects memory and other cognitive functions, social behaviour, and ability to carry out daily activities. To date, no treatment is clearly effective in preventing progression of the disease, and most treatments are symptomatic, often aiming to improve people's psychological symptoms or behaviours which are challenging for carers. A range of new therapeutic strategies has been evaluated in research, and the use of trained animals in therapy sessions, termed animal-assisted therapy (AAT), is receiving increasing attention.

Objectives: To evaluate the efficacy and safety of animal-assisted therapy for people with dementia.

Authors' conclusions: We found low-certainty evidence that AAT may slightly reduce depressive symptoms in people with dementia. We found no clear evidence that AAT affects other outcomes in this population, with our certainty in the evidence ranging from very-low to moderate depending on the outcome. We found no evidence on safety or effects on the animals. Therefore, clear conclusions cannot yet be drawn about the overall benefits and risks of AAT in people with dementia. Further well-conducted RCTs are needed to improve the certainty of the evidence. In view of the difficulty in achieving blinding of participants and personnel in such trials, future RCTs should work on blinding outcome assessors, document allocation methods clearly, and include major patient-important outcomes such as affect, emotional and social functioning, quality of life, adverse events, and outcomes for animals.

Lai NM, Chang SMW, Ng SS, Tan SL, Chaiyakunapruk N, Stanaway F. Animal-assisted therapy for dementia. Cochrane Database Syst Rev. 2019 Nov 25;2019(11):CD013243. doi: 10.1002/14651858.CD013243.pub2. PMID: 31763689; PMCID: PMC6953240.

https://pubmed.ncbi.nlm.nih.gov/31763689/

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