Traditional Chinese medicine Jia Wei Gui Pi Tang improves behavioural and psychological symptoms of dementia and favourable positive emotions in patients

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Keywords

Jia Wei Gui Pi Tang; Kampo; anxiety; behavioural and psychological symptoms of dementia (BPSD); favourable positive emotions; traditional Chinese medicine.

Abstract

Background: Behavioural and psychological symptoms of dementia (BPSD) are challenging to manage, leading to caregiver burden and often to subsequent transfer of patients to a nursing home or psychiatric hospital for treatment. Eliciting favourable positive emotions should be an important goal in the treatment of negative emotions associated with BPSD. To date, no data have indicated that antipsychotic medications can improve positive emotions. BPSD are known to be associated with anxiety in patients with dementia. The traditional Chinese medicine Jia Wei Gui Pi Tang is officially indicated and approved for anxiety treatment in Japan. Methods: Here, we performed a multicentre, randomised, observer-blind control study of the effect of Jia Wei Gui Pi Tang on BPSD in Alzheimer's disease (AD) patients. Patients with AD or AD with cerebral vascular disease were randomly divided into the Jia Wei Gui Pi Tang treatment group and the control group that received no traditional Chinese medicine. BPSD were scored using the Neuropsychiatric Inventory Nursing Home Version (NPI-NH) and by favourable positive emotions using the Delightful Emotional Index (DEI). Results: A total of 63 participants (18 male and 45 female; mean age: 83.3 ± 6.0 years) were included in the study. Changes in NPI-NH scores differed significantly between the two groups (one-way analysis of variance, P < 0.001). Within the treatment group, there was a significant improvement in the NPI-NH score from 29.8 ± 17.3 at baseline to 13.2 ± 9.4 at the endpoint (paired t-test, P < 0.001), whereas there was no statistically significant change in the control group. Changes in DEI scores differed significantly between the two groups. Within the treatment group, there was a significant improvement in the DEI score from 24.3 ± 23.0 at baseline to 32.5 ± 21.2 at the endpoint (paired t-test, P = 0.001), whereas there was no statistically significant change in the control group. Conclusion: The traditional Chinese medicine Jia Wei Gui Pi Tang significantly improved both BPSD and positive emotions.

Citation

Nogami, T., Iwasaki, K., Kimura, H., Higashi, T., Arai, M., Butler, J. P., Fujii, M., & Sasaki, H. (2023). Traditional Chinese medicine Jia Wei Gui Pi Tang improves behavioural and psychological symptoms of dementia and favourable positive emotions in patients. Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society, 23(3), 503–511. https://doi.org/10.1111/psyg.12962

DOI

10.1111/psyg.12962

EWB Constructs:

(3) positive affect;

EWB Measures:

(1) favourable positive emotions: Delightful Emotional Index (DEI)

data availability:

data availability details:

N/A

brain imaging paradigm:

N/A

brain region/circuit:

Exclusion Criteria:

(1) experienced a major depressive or bipolar disorder episode within the previous year,
(2) had been on antidepressants or other herbal medicines, or had a malignant tumour or other life-threatening disease within the previous 2 years.
(3) All patients taking antidepressants were excluded

Inclusion Criteria

(1) age 65–100 years
(2) total NPI-NH score of >3
(3) positive NPI-NH subcategory scores for “anxiety” or “problems in night-time”
(4) MMSE score of <25

Non-EWB Behavioral
Measures:

(1) Neuropsychiatric Inventory Nursing Home Version (NPI-NH)
(2) Mini-Mental State Examination (MMSE)

First author:

Tatsuya Nogami

species:

Human

sample size:

study design:

(5) RCT

longitudinal data?

Yes

younger controls?

interventions:

Traditional Chinese medicine Jia Wei Gui Pi Tang

study population:

(2) patients with (pre)clinical dementia

sex (% female):

70.31%

ethnicity (%white)

not stated (Japan)

Age (mean, sd):

83.3, 6

biological/Physiological Measures:

N/A