Efficacy of animal-assisted therapy adapted to reality orientation therapy: measurement of salivary cortisol

Stress-related hormones represent relevant factors contributing to the progression of neurodegenerative disorders. This study was aimed to verify whether Animal-Assisted Therapy (AAT) adapted to Reality Orientation Therapy (ROT) could modify salivary cortisol levels in Alzheimer’s patients. Our study was carried out at the Alzheimer’s Daycare Centre in Naples. A sample, homogeneous in age, sex, cultural level, MMSE of 22 patients were divided into two groups: the AAT group, made up of 11 patients that received a cycle of AAT (with dog) adapted to ROT, and the control group (CTRL group), with 11 patients participating in ROT-based activities without the dog. The ROT cycle consisted of 12 meetings, each of which was 45-minutes long. Before and after each meeting, salivary samples were collected for all patients in the respective groups. Cortisol levels were measured by chemiluminescence-based procedures. The MMSE and GDS tests were administered at the start (T0) and the end (T1) of the entire cycle of 12 meetings. The variation of cortisol was evaluated through the General Linear Logistic Model with Mixed Effects (GLLM-ME). Differences in MMSE and GDS were evaluated using the non-parametric Wilcoxon test for paired data. The GLM-ME prediction reported the proportion of subjects from the two groups that showed a reduction in cortisol level. An increasing trend was observed for the AAT group while the CTRL group remains confined around the 0.5 value. The Wilcoxon test was significant (P<0.05) only for the last two meetings in the AAT group. MMSE and GDS tests were significantly different for the AAT group before and after the cycle of therapy. Through the Wilcoxon test, the CTRL group showed opposite behavior compared to the AAT-ROT group, while differences in GDS were not significant. Determination of salivary cortisol may be useful to verify the effectiveness of AAT adapted to ROT as a non-pharmacological therapy in Alzheimer's disease patients.