# The Use of Equine-Assisted Therapy in Patients With Aggression and Agitation Behaviors due to Moderate-to-Severe Dementia: A Case Series

## TL;DR

This case series explores the potential of equine-assisted therapy to reduce aggression and agitation in patients with moderate-to-severe dementia.

## Contribution

The study presents real-world cases showing possible benefits of EAT for managing behavioral symptoms in advanced dementia.

## Key findings

- A discrete reduction in NPI-Q scores was observed after EAT sessions.
- Patients, families, and carers reported improvements not fully captured by the NPI-Q.
- Subjective experiences of EAT in dementia patients warrant further investigation.

## Abstract

Behavioral and psychological symptoms of dementia (BPSD) are very common, and their management remains challenging. In older people with dementia, equine-assisted therapy (EAT) may be a promising nonpharmacological intervention for the management of BPSD. Here, we present five cases of patients with agitation and aggression due to moderate-to-severe dementia. They had overall two to three sessions of EAT at a frequency of one session per week. We assessed the Neuropsychiatric Inventory Questionnaire (NPI-Q) score before and 1 day after the second EAT session. We observed a discrete reduction in the NPI-Q after the EAT sessions, although not all of the improvements experienced by patients, families, and carers were reflected in the NPI-Q. Future studies should be conducted to assess subjective lived experiences of EAT in patients with moderate-to-severe dementia.