Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not horticultural therapy is a safe and effective treatment in reducing agitation for dementia patients in nursing homes.

STUDY DESIGN: Review of three English language primary studies published between 2008 and 2010.

DATA SOURCES: Two randomized control trials and a case series, which compare horticultural therapy to the use of traditional therapy methods.

OUTCOMES MEASURED: The primary outcome measured in all three studies focus on the level of agitation in dementia patients. Secondary outcomes also included efficacy of sleep as well as level of cognition.

RESULTS: In the case series study by Lee et al, horticultural therapy was found to significantly improve level of agitation, cognition and certain aspects of sleep such as wake after sleep onset, nap duration, and nocturnal sleep time and efficiency. There was no improvement in sleep onset, wake-up time, or total sleep time. The two randomized control trials, indicated that no significant improvement in agitation after horticultural therapy based on corresponding p-values. In Jarrot et al, anxiety/agitation was not significantly decreased (p = 0.932) after the AARS was converted with the Mann-Whitney test. Luk at el demonstrated lack of significant improvement in the CMAI score for control and therapy groups post-intervention; p = 0.115 and p = 0.249, respectively.

CONCLUSIONS: The results of two randomized control trials demonstrated that horticultural therapy was not effective at reducing agitation in dementia patients, while the case series study indicated a possible decrease in agitation for the therapy group. Overall consistency was not provided and the data was inconclusive. All trials were limited due to small sample size and lack of follow-up studies.