A randomized controlled trial of the effects of multi‐sensory stimulation (MSS) for people with dementia
Abstract
Objectives. To investigate short‐term effects of Multi‐Sensory Stimulation (MSS) on behaviour, mood and cognition of older adults with dementia, the generalization of effects to day hospital and home environments and the endurance of any effects over time. Design. A randomized controlled trial comparing MSS with a credible control of one‐to‐one activities. Methods. Fifty patients with diagnoses of moderate to severe dementia were randomized to either MSS or Activity groups. Patients participated in eight 30‐minute sessions over a 4‐week period. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre, mid, post‐trial, and follow‐up assessments were taken to investigate any generalization of effects on cognition, behaviour at the day hospital and behaviour and mood at home and endurance of effects once sessions had ceased. Results. Immediately after MSS and Activity sessions patients talked more spontaneously, related better to others, did more from their own initiative, were less bored/inactive, and were more happy, active or alert. Both groups were more attentive to their environment than before, with a significantly greater improvement from the MSS group. At the day hospital, patients in the Activity group improved on their ‘speech skills’ (amount of speech; initiation of speech), whereas the MSS group remained unchanged during the trial. The MSS group showed a significant improvement in mood and behaviour at home compared to the Activity group whose behaviour deteriorated. No longer‐term benefits were shown; indeed, behaviour declined sharply during the month follow‐up period. Conclusions. Both MSS and Activity sessions appear to be effective and appropriate therapies for people with dementia.
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Sensory stimulation interventions have been found to reduce passive behaviors, provide more constructive engagement and pleasure, and improve behaviors.
“Sensory stimulation interventions have been found to reduce passive behaviors, 45 provide more constructive engagement and pleasure, 42,46 and improve behaviors. 47-49”
From Therapeutic recreation interventions for need-driven dementia-compromised (2002) · cites this paper as [46]
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“and Marshall-Baker, A. (1995). The effects of visual barriers on exiting behavior”
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“The first included study on the effects of Multi Sensory Stimulation/Snoezelen was conducted by Baker et al. (2001) among people living at home with their primary caregiver and attending a hospital day centre in the United Kingdom.”
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“The video recordings were observed using the measuring device INTERACT, which was specifically designed to measure the effects of snoezelen on demented elderly.(13,14,37,38) The scale includes 22 items about mood (4 items), speech (5 items), relating to other people (4 items), relating to the environment (4 items), ne…”
MethodEffects of multi‐sensory stimulation for people with dementia
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“Related research also indicates that sensory stimulation may effect short-term benefits for people with dementia (Baker et al., 2001) on measures of mood, behaviour and speech skills during and after sessions (both in day centre units and at home).”
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“Multi-sensory stimulation (MSS) or Snoezelen is visual, auditory, tactile and olfactory stimulation offered to people in a specially designed room or environment (Baker et al., 2001).”
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“In contrast to previous findings [29, 30], no significant effects on mood and behavior during MSSE sessions in comparison to other activity sessions were found.”
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“stimulation—may be helpful for patients with initiation difficulty (Baker et al., 2001).”
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“For apathy specifically, several interventions involving environmental stimulation have been shown to reduce apathy in patients with dementia, including multisensory stimulation (Baker et al., 2001), social interaction (Dettmore, Kolanowski, & Boustani, 2009), and music therapy (Holmes, Knights, Dean, Hodkinson, & Hop…”
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“Many of these interventions are aimed to provide sensory stimulation to older people with dementia who are either deprived of adequate sensory stimulation (under-stimulation) or experience difficulty processing excessive and/or unstructured incoming information (over-stimulation) because of their deteriorated cognitiv…”
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“Given that previous research has provided some support for the use of multisensory stimulation using MSEs and sensory spaces (Baker et al., 2001; Collier et al., 2010; Sanchez et al., 2013; van Weert et al., 2005), the findings from this study suggest that most sensory rooms and MSEs in care home…”
ResultMUSEUM EXPERIENCE DESIGN BASED ON MULTI-SENSORY TRANSFORMATION APPROACH
Harada, T., YANAGISAWA, H., Gressier‐Soudan, E., et al. (2018) · Proceedings of the ... International Design Conference/Design ... · doi:10.21278/idc.2018.0150 · Cited by 30 · see citing works
Neurobehavioral Initiation and Motivation Problems After Acquired Brain Injury
Palmisano, S., Fasotti, L., & Bertens, D. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00023 · Cited by 28 · see citing works
“Examples of behavioral therapies are activity therapy (63), multi-sensory stimulation (64), and music therapy (65).”
BackgroundO’Connor, N., Fox, S., Kernohan, G. W., Drennan, J., Guérin, S., Murphy, A., & Timmons, S. (2022) · BMC Palliative Care · doi:10.1186/s12904-022-00922-7 · Cited by 30 · see citing works
“Only one RCT addressed this, with positive outcomes for multisensory stimulation in terms of mood and ‘behaviour’ [35].”
BackgroundSensory Stimulation in Dementia Care
Vozzella, S. (2007) · Topics in Geriatric Rehabilitation · doi:10.1097/01.tgr.0000270179.23952.23 · Cited by 29 · see citing works
da Silva, R. C. G., Abrunheiro, S. F. S., Cardoso, D., Santos‐Costa, P., Couto, F. C., Agrenha, C., & Apóstolo, J. (2018) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003483 · Cited by 28 · see citing works
“Unauthorize to institutionalization, formal and informal caregiver overload, and decreased quality of life.(4,5,15,21,23) Healthcare professionals should be trained and provided with the best available scientific evidence to promote patient safety and high quality care.”
BackgroundInfluentialUse of Multisensory Environments in the Home for People with Dementia
Riley-Doucet, C. K. (2009) · Journal of Gerontological Nursing · doi:10.3928/00989134-20090331-01 · Cited by 28 · see citing works
Variability in Response of Older People with Dementia to Both Snoezelen and Reminiscence
Baillon, S. F., van Diepen, E., Prettyman, R. J., Rooke, N., Redman, J., & Campbell, R. (2005) · British Journal of Occupational Therapy · doi:10.1177/030802260506800805 · Cited by 26 · see citing works
Garzotto, F., Gelsomini, M., Gianotti, M., & Riccardi, F. (2018) · Internet of things · doi:10.1007/978-3-319-94659-7_9 · Cited by 27 · see citing works
“Several authors [2, 11, 21] therefore call for exploring new materials and solutions for MSEs.”
BackgroundGoodall, G., André, L., Taraldsen, K., & Serrano, J. A. (2021) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2021.1920349 · Cited by 24 · see citing works
Helbling, M., Grandjean, M., & Srinivasan, M. (2023) · Special Care in Dentistry · doi:10.1111/scd.12906 · Cited by 24 · see citing works
A scoping review: Sensory interventions for older adults living with dementia
Hayden, L., Passarelli, C., Shepley, S., & Tigno, W. (2022) · Dementia · doi:10.1177/14713012211067027 · Cited by 22 · see citing works
“, 2004; 2005a; 2005b; Woodrow, 1998) Multisensory (Baker et al., 2001; 2003; Bakshi, 2004; Bauer et al., 2012; Bunn et al., 2018; Burns et al., 2002; Chang et al., 2019; Charlesworth, 2001; Chung et al., 2016; Cui et al., 2017; Duffin, 2012; Eggert et al., 2015; Fitzsimmons et al., 2014; Forbes, 2004; Fu et al., 2013;…”
BackgroundInfluentialLin, L.-J., & Li, K. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1003325 · Cited by 22 · see citing works
Using Multi-Sensory Environments (MSEs) with People with Dementia
Hope, K. W., & Waterman, H. A. (2004) · Dementia · doi:10.1177/1471301204039324 · Cited by 22 · see citing works
“For example, Pinkney and Barker (1994) offer information and advice specific to using MSEs with older people. They argue that the environment is age appropriate, enjoyable and failure free and that the fact that no intellectual reasoning or verbal response is required makes them particularly appropriate for older peop…”
BackgroundInfluentialPalliative Care for Patients With Dementia in Long-Term Care
Fulton, A. T., Rhodes‐Kropf, J., Corcoran, A. M., Chau, D., & Castillo, E. H. (2011) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2011.01.002 · Cited by 22 · see citing works
Letts, L. J., Minezes, J., Edwards, M., et al. (2011) · American Journal of Occupational Therapy · doi:10.5014/ajot.2011.002592 · Cited by 22 · see citing works
Wholistic Design in Dementia Care
Chalfont, G. E. (2007) · Journal of Housing for the Elderly · doi:10.1300/j081v21n01_08 · Cited by 21 · see citing works
“Sensory stimulation studies lack evidence of positive lasting effect for people with dementia in terms of reduced agitation, aggression or other symptoms, although short term benefits occur (Baker et al., 2001; Ballard, O’Brien, Reichelt, & Perry, 2002).”
BackgroundBoersma, P., van Weert, J. C. M., Lissenberg-Witte, B. I., et al. (2017) · The Gerontologist · doi:10.1093/geront/gnx200 · Cited by 19 · see citing works
Hearing loss and dementia: an exploratory study of the views of audiologists
Wright, N., Stickley, T., Mulla, I., et al. (2014) · Quality in Ageing and Older Adults · doi:10.1108/qaoa-08-2014-0014 · Cited by 18 · see citing works
Use of multisensory stimulation in institutionalized older adults with moderate or severe dementia
Machado, B. M., & Santana, C. D. S. (2022) · Dementia & Neuropsychologia · doi:10.1590/1980-5764-dn-2021-0022 · Cited by 18 · see citing works
Psychosocial interventions for people with moderate to severe dementia: A systematic review
Boote, J. D., Lewin, V., Beverley, C., & Bates, J. (2006) · Clinical Effectiveness in Nursing · doi:10.1016/j.cein.2006.06.002 · Cited by 18 · see citing works
“Behaviour and mood Clifton Assessment Procedures for the Elderly (Pattie and Gilleard, 1979) Baker et al. (2003)”
BackgroundMethodInfluentialCollier, L., & Truman, J. L. (2008) · Neurorehabilitation · doi:10.3233/nre-2008-23410 · Cited by 19 · see citing works
“MSEs are also reported to influence the interpersonal interactions and levels of engagement amongst this group [5,50] and staff feel that these improvements directly impact on the quality of their relationship with the individual [27].”
A therapeutic cooking program for older adults with dementia: Effects on agitation and apathy
Buettner, L. L. (2011) · NC Digital Online Collection of Knowledge and Scholarship (The University of North Carolina at Greensboro) · Cited by 18 · see citing works
Multisensory Stimulation in Rehabilitation of Dementia: A Systematic Review
Calderone, A., Marra, A., Luca, R. D., Latella, D., Corallo, F., Quartarone, A., Tomaiuolo, F., & Calabrò, R. S. (2025) · Biomedicines · doi:10.3390/biomedicines13010149 · Cited by 19 · see citing works
“This finding suggests that integrating MSS with physical activity and technology can be a promising avenue for enhancing functional cognition [59,60].”
Snoezelen in people with intellectual disability or dementia: A systematic review
Testerink, G., ten Brug, A., Douma, J. G., & van der Putten, A. A. J. (2023) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2023.100152 · Cited by 17 · see citing works
“For people with dementia, there was often no difference in effects between snoezelen and recreational activity sessions (for example, Baker et al., 2001; Maseda et al., 2014).”
Snoezelen: Children with Intellectual Disability and Working with the Whole Family
Nasser, K., Cahana, C., Kandel, I., et al. (2004) · The Scientific World JOURNAL · doi:10.1100/tsw.2004.105 · Cited by 17 · see citing works
- Authors
- Baker, R., Bell, S., Baker, E., Holloway, J., Pearce, R., Dowling, Z., Thomas, P., Assey, J., & Wareing, L.
- Affiliations
- Poole Hospital (GB)
- Corresponding author
- Pearce, Rebecca
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2001-03
- Volume
- 40
- Issue
- 1
- Pages
- 81-96
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W2092893498
- Cited by
- 200
- References
- 0
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 8 · 2023: 7 · 2022: 9 · 2021: 10 · 2020: 8 · 2019: 7 · 2018: 9 · 2017: 8 · 2016: 15 · 2015: 11 · 2014: 15 · 2013: 3 · 2012: 8
- FWCI
- 4.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Arts and Humanities › Conservation › Art Therapy and Mental Health
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- multisensory stimulation, dementia, mood, cognition, day hospital, family environment, treatment effects over time, speaking skills, older adults
- MeSH terms
- Acoustic Stimulation, Affect, Aged, Alzheimer Disease, Mental Disorders, Communication, Environment, Female, Generalization, Psychological, Humans, Male, Photic Stimulation, Relaxation Therapy, Cognitive Behavioral Therapy
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