The impact of a novel multisensory environment on depression, agitation, stress, and sleep among older adults diagnosed with behavioral and psychological symptoms of dementia

Abstract

The current study explored the short-term effects of two cost-effective multisensory environments, Multisensory Stimulating Environment (MSSE) and Multisensory Relaxing Environment (MSRE), tested alone and in combination, on depression, agitation, sleep quality, and heart rate among older adults with behavioral and psychological symptoms of dementia (BPSD). Using a non-randomized repeated-measures crossover pilot trial design, eleven participants in a memory care facility were sequentially exposed to three intervention phases lasting five days each: MSSE (morning), MSRE (evening), and a combined MSSE + MSRE condition. Sleep metrics and heart rate were objectively assessed using a wearable device, Fitbit Sense 2, while depressive symptoms and agitation were caregiver-rated using validated scales. Linear Mixed Models with Sidak-adjusted pairwise comparisons were used to evaluate condition effects, and effect sizes (Cohen's d) were calculated for significant contrasts. Results showed that the combination of MSSE and MSRE significantly improved sleep efficiency and reduced both depressive symptoms and heart rate compared to baseline. Notably, evening depressive symptoms decreased most following MSRE and combined interventions. Although no significant reductions in overall agitation were found, MSSE was associated with reduced morning non-aggressive behaviors. These findings suggest that strategically timed, multisensory environmental interventions may offer a scalable, non-pharmacological approach to improving behavioral and physiological well-being in individuals with dementia. Further research with larger samples is warranted to confirm and expand upon these preliminary results.