Table 1.
Study Characteristics of Horticulture Interventions.a
| Author (Publication Year; Country) | Characteristic (Facility, Patients, Age) | Study Design | Duration of Follow-up | Intervention | Participants | Outcomes | Quality |
|---|---|---|---|---|---|---|---|
| Monney and Nicell (1992; Canada) | Special care units Alzheimer’s disease Mean age 83 |
Comparative, observational study | 4 month | Exterior space Garden |
25-31 | Violence (%): ↓, All incidents (%): ↓ | low |
| Mather et al (1997; Canada) | Care center Alzheimer’s disease Mean age 83 |
Comparative, observational study with pretest, midtest, posttest | 6 month | Walled garden | 10 | Disruptive behavior (%): NS | High |
| Jarrott et al (2002; United States) | Not clear Dementia Mean age 79 |
Comparative, observational study | 10-week | HT activities—3 time each week over a 10-week period. Activities lasted 30 to 45 min per session. |
9 | Time engagement (%): ↑, Doing nothing (%): ↓ | High |
| Cox et al (2004; Australia) | Care center (Rice Village) Alzheimer’s disease Mean age non |
pretest, posttest design | non | Multisensory Environments Living room Garden Snoezelen room |
24 | Snoezelen room was calming and appeared to be relaxing | High |
| Gigliotti et al (2004; United States) | Care institutional Dementia Mean age 83 |
Comparative study with pretest, posttest | 9-week | HT activities in 30 minutes, 3 times per week over 9 weeks in groups both indoors and outdoors three types of HT activities: cooking, crafts, and planting |
14 | Time engagement (%): NS, Doing nothing (%): ↓, Affect was more positive during HT than traditional activities. |
Medium |
| Gigliotti and Jarrott (2005; United States) | Veterus administration Dementia Mean age 80 |
Comparative study with pretest, posttest | 9-week | HT activities were facilitated half an hour per week over 9 weeks in addition to ordinary ADS activities | 48 | Time engagement (%): ↑, Doing nothing (%): ↓ Affect was more positive during HT than traditional activities. |
Medium |
| Detweiler et al (2008; United States) | Dementia facility Dementia Mean age 80.7 |
pretest, posttest design | 1 year | Open wander garden with free and direct access from the dementia unit | 34 | CMAI score: ↓, PRNs medications: ↓ Staff and family members felt that intervention improved mood and quality of life of the dementia residents. |
Medium |
| Lee and Kim (2008; Korea) | Nursing home Mild or severe dementia patients Mean age not clear |
pretest, posttest design (3 times measured) | 5-week | Indoor garden activities (4 weeks): dropwort and bean sprout | 23 | Sleep patterns: WASO: ↓, nap: ↓, TST: NS, NST: ↑ and NSE: ↑ CMAI scores: ↓, Cognition (HDS-R): ↑ |
Medium |
| Park et al (2008; Japan) | S-group home dementia patients Mean age 81.3 |
pretest, posttest design (3 times measured) | 8 or 9-month (Unclear) |
Horticulture activity program mixed individual activity and group activity was offered for a total of 20 sessions | 16 | ADL: ↑, Desire to participate: ↑, Facial expression: ↑, Cooperation levels: ↑ | Medium |
|
Thelander et al (2008; Sweden) |
Nursing home Moderate to serious dementia patients Mean age 86.8 |
pretest, posttest design | 6-week | The activities used were gardening activities (ie watering, weeding, raking, and planting), walks, and social activities. Every intervention session lasted between 40 and 70 min. | 8 | Cognitive capacity (MMSE): NS | Medium |
| Detweiler et al (2009; United States) | Dementia unit Dementia Mean age 80.5 |
Comparative study with pretest, posttest | 1 year | Open wander garden | 28 | The mean monthly fall severity score declined. The most significant changes in scheduled psychiatric medications were reductions in scheduled antipsychotics and an increase in residents requiring no antipsychotics. |
Medium |
| Jarrott and Gigliotti (2010; United States) | 5 Nursing home & 3 ADS Dementia Mean age 80.09 |
Comparative study with a cluster randomization | 6-week | Horticultural therapy-based programming was implemented twice weekly at 4 treatment sites for 6 weeks | 75 in HT group | Measure of engagement: Active (AE), Passive (PE), Self (SE), Other (OE) were found significant difference in 4 of the 5 engagement categories. Only Non (NE) was not. Apparent Affect Rating Scale (AARS): 3 affective coding categories, including pleasure: NS, anxiety: NS, interest: NS. |
high |
| 54 in TA group | |||||||
| Kang et al (2010; South Korea) | Senior welfare center Mild dementia Age range 65-79 |
quasi-experimental | 9-week | art and horticultural therapies in this intervention 3-hour sessions twice per week for 9 weeks | 20 in the experimental group | Significant differences were found post intervention between the 2 groups including, Cognition function (MMSE): ↑, Depression (GDS): ↓, Mental-emotional health: ↑ | high |
| 18 in control group | |||||||
| Murphy et al (2010; United States) | Dementia facility Dementia Mean age 80.71 |
pretest, posttest design | 1 year | Open wander garden | 34 | Agitation levels (CMAI): ↓, wander garden visits by month: ↑ | Medium |
| de Brunin et al (2012; Netherland) | Day care Dementia Mean age 77.7; 83.4 |
Observational cohort study | 6 month 1 year |
Green care farms (GCFs) | 47 | Medication use: NS, ADL: NS, IADL: NS | Medium |
| Regular day care facilities (RDCFs) | 41 | ||||||
| Edwards et al (2013; Australian) | Dementia-specific unit Alzheimer’s disease Age range: 79–90 |
pretest, posttest design | 3 month | Garden | 10 | QoI: ↑, CMAI: ↓, Depression (CSDD): ↓ | Medium |
| Hewitt et al (2013; UK) | Hospital Alzheimer’s disease Mean age 58.6 |
pretest, posttest design | 1 year | Structured Gardening program | 12 | QoI: ↑, Cognition function (MMSE): NS | Medium |
| Goto et al (2014; United States) | Nursing home Alzheimer’s disease Mean age 88 |
prospective | 1-month | A multimedia room and an interior garden | 18 | Behavioral assessment Assessment of pulse rate |
Medium |
| Chung et al (2016; United States) | Long-term nursing facility Dementia Mean age 61; 83 |
Qualitative study | 6 week | Media presentation on natural scenes | 23 | Agitation related of Behavior: NS | high |
| Hall et al (2016; UK) | Long-term care home Dementia Mean age 84.8 (range: 61-96) |
Mixed methods | 10 week | Horticultural activities | 14 | Well-being Neutral Ill-being |
Medium |
| Kim et al (2016; Korea) | Seongdong-gu center Alzheimer’s disease Mean age 78.48 |
Randomized control study | 6 month | Multidomain cognitive stimulation | 32 | Cognition function (MMSE): ↑, Qol: NS, Depression (GDS): ↓ | Medium |
| control | 21 | ||||||
| de Boer et al (2017; Netherland) | Nursing homes Dementia unclear |
Longitudinal observation study | 6 month | Green care farms | 5 | activate: ↑, social interaction: ↑ (compare with traditional nursing homes) | high |
| Traditional nursing homes | 4 | ||||||
| Regular small-scale living facilities | 9 | ||||||
| de Boer et al (2017; Netherland) | Nursing homes Dementia Mean age 83.8 |
Cross-sectional design | non | Green care farms | 34 | Qol: ↑, NPI: NS, CMAI: NS, Depression (CSDD): NS, (compare with traditional nursing homes) | high |
| Traditional nursing homes | 29 | ||||||
| Regular small-scale living facilities | 52 | ||||||
| Hsu et al (2017; Taiwan) | Veteran Home Dementia Mean age 86.4 |
Retrospective pretest, posttest design |
6 month | Multiple intervention | 141 | Cognition function (MMSE): NS, Depression (CSDD): ↓, ADL: ↑, IADL: NS, NPI: ↓, CMAI: ↓, NPI caregiver’s burden: ↓, | high |
Abbreviations: ADL, activities of daily living; ADS, adult day service; BMI, body mass index; CMAI, Cohen-Mansfield Agitation Inventory; HDS, Hasegawa Dementia Scale; HT, horticulture therapy; MMSE, Mini-Mental State Examination; NPI, neuropsychiatric inventory; NS, nonsignificant; NST, Nocturnal sleep; NSE, Nocturnal sleep efficacy; PRN, pro re nata; TA; traditional activities;TST, total sleep time; WASO, wake up after sleep onset.
a Dementia-related behavior disturbance was assessed with the Cohen-Mansfield Agitation Inventory (CMAI).