**1. Introduction**

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*Animal-Assisted Therapy (AAT)* or *Pet Therapy* is a supportive goal-oriented intervention which is mainly result from human and animal interaction. [1]- [6] In this treatment process, a health professional/patients' doctor have to determine which animal model should be accompanied with a specific clinical goal. This interventions can be followed by physical therapists, neurol‐ ogist, psychiatrist, veterinary public health specialists, psychologist, occupational therapists, provided that they have taken a certification in AAT. In addition, all therapy processes should be followed by patients' doctor according to the suggestions of AAT specialist.

Although there are so many approach about the effect mechanism of AAT, it is known that the human and animal interaction is the basis for all of them. The positive-constructive bond result from between human and animal interaction is the key point to initiate the effect mechanism of AAT. This curative effect starts to work four basic mechanism including psychological stimulation, emotional, playing, and physical according to the Ballarini. [4] However all of these mechanisms are different therapy ways, they can become interpenetrate with each others. The important point is that, it is supposed that the psychosomatic effects which give rise to curative features of AAT occurs when these mechanisms start to work. All of the mechanism together revealed that psychosomatic effects of human-animal bond and interaction in people taking an AAT and AAA. [5], [6]

Lafrance et al., reported that patients' social and verbal behaviors have been improved in a presence of a therapy dog. [7] Nathans et al., revealed that Animal Assisted Therapy can be used for improving anhedonia in patients with schizophrenia. In addition, they have found that AAT can be beneficial for rehabilitation of life quality and psycho-social behaviors. [8]

© 2013 Cevizci et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Different researchers have reported that AAT should be considered planning of the treatment of individual with dementia. [1], [9]- [12]

There are also studies indicating that keeping an animal has positive effects on the community health. [24] Heady et. al. reported that AAT caused decreasing national health costs. [25] Governments have been recently realized the significance of interaction between humans and animals as well as the contributions into human health, life quality and economy. Many countries have passed laws, which are a new understanding to allow keeping animals in apartments for rent, so as to support pet owners. Positive measures are taken in many European countries to keep pets in houses by laws. [26] AAT is to benefit from animal companionship during a targeted therapy in order to facilitate achievement of optimum results in patients, and to support the therapy. It provides very positive effects like providing adaptations of subjects to stressful situations and hospital environments; decreasing anxiety, stress, pain and blood pressure; increasing mobility and muscle activity. It has been shown that guiding animals increase physical activity, help in prevention of some moods like loneliness and depression, improve daily life activities and provide a social support by

Animal Assisted Therapy and Activities in Alzheimer´s Disease

http://dx.doi.org/10.5772/54504

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**2. Benefits of animal companionship for therapy from past to present**

showing the way to a blind man is drawn on armor in Pompeii historical ruins. [32]

Close relationships between humans and animals are way back to the prehistoric ages. By using DNA techniques, it has been demonstrated that dogs might have been domesticated 100,000 years ago. [30] Animals have been used to improve emotional and functional condi‐ tions of humans since ancient Greeks. Ancient Greeks have used dog drawings in their therapeutic temples, and they have provided melancholic people to ride on horses so as to get rid of their diseased souls. These applications have been used later also by Romans. [31] A dog

The first studies, which have shown animal assistance in therapy, were performed to recover behaviors of mentally ill people in 1792 in York Retreat in United Kingdom by using farm animals. [3] Florence Nightingale defined the significance of assisting animals for therapy as: "Especially during treatment of a patient with a chronic illness, a small pet is a perfect friend

Dogs were used in rehabilitation after the World War I, in the first half of the 20th century. To improve moods of American army officers, who experienced depression related to the war, dogs were given to them to keep in company. [33] In the same period, thousands of dogs were trained under a program to support blinded soldiers in Germany. In 1931, "Guiding Dogs Society" was established for blind people. Currently, dogs are being trained in order to support people with hearing problems; to alert people with seizures before the symptoms are started;

Similar applications have been widely spread all over the world, so they have helped thou‐ sands of people with disabilities to live freely. Lane et. al. have reported that this ability of dogs was very amazing, and this social support that they have provided for people they have

increasing the life quality. [27]- [29]

for the patient". [32]

and to support people with severe physical problems.

accompanied was very significant. [34]

The interaction between an animal and human result in an increase neurochemicals initiating a decrease in blood pressure and relaxation. This relationship may be beneficial for amelio‐ rating agitate behavior and psychological symptoms of dementia. In another study, it has been reported that aquarium assisted therapy may be beneficial for increasing eating behavior of aged people living in a nursing home. [10] Richeson revealed that AAT can be increase social interactions by initiating decrease the agitate behaviors of patients with dementia. [12] Kongable et al., observed that a therapy dog increased patients' some social behaviors such as smile, laugh, look, touch, verbalization. [13]

In aged people, AAT are used for ameliorating agitate behaviors, psychological, occupational, social and physical disorders especially in Alzheimer and Dementia. [14]- [20] People with Alzheimer may have an easier time decoding the simple repetitive, non-verbal actions of a dog. Animals can act as transitional objects, allowing people to first establish a bond with them and then extend this bond to people. Most of the study results revealed that AAT especially dog therapy had an "calming effect" on the patients with dementia and Alzheimer disease. [15]- [17], [20] This effect can be helpful as a communication link during therapy sessions and also decrease agitation behaviors. It is well known that incidence of aggression, agitation, social withdrawal, depression, and psychotic disorders are growing problems in Alzheimer disease for special care units, staff and family members of patients. Furthermore, environmental factors in nursing home or other health care units have been become increasingly forcible barrier for therapy of Alzheimer disease. In this conditions, AAT and other animal activities may be helpful to cope with these difficulties by presenting a different aspect.

AAT should be more commonly used in the world through increasing awareness of public health services about beneficials of companion animal and activities. Especially, AAT can be used for improving health disorders of aged people with physical-mental and social disabilities such as Alzheimer, dementia, aphasia, anxiety, depression, stres, schizophrenia, and feeling of loneliness, quality of life. An aquarium assisted therapy may be a good starting point to learn about benefits and facilities of AAT in developing countries like Turkey which have more lower the socio-economic groups than the developed countries.

Main principle of AAT is based on using psychosomatic effects, which appear as results of biological-physical-chemical changes during human and animal interactions. [4] Feeding animals or being together with animals cause these effects to appear, and play an important role in recovery of mental, social and physical health. [21] The strength of bonding between humans and animals has been revealed in a survey study, which is conducted on 14 veteri‐ narians and 117 patients in Ontario. In the study, patients, whose pets are died, have received a survey to define causes and effects of their worries by a phone call or e-mail. Of 30% of participants has been observed to have severe worries. [22] This strong bonding between humans and animals can also affect physical and mental health, and sometimes death or loss of an animal can be so effective that it can change a subject's life. [23] Dog, horse and dolphin are the most commonly preferred animal species in animal assisted therapy.

There are also studies indicating that keeping an animal has positive effects on the community health. [24] Heady et. al. reported that AAT caused decreasing national health costs. [25] Governments have been recently realized the significance of interaction between humans and animals as well as the contributions into human health, life quality and economy. Many countries have passed laws, which are a new understanding to allow keeping animals in apartments for rent, so as to support pet owners. Positive measures are taken in many European countries to keep pets in houses by laws. [26] AAT is to benefit from animal companionship during a targeted therapy in order to facilitate achievement of optimum results in patients, and to support the therapy. It provides very positive effects like providing adaptations of subjects to stressful situations and hospital environments; decreasing anxiety, stress, pain and blood pressure; increasing mobility and muscle activity. It has been shown that guiding animals increase physical activity, help in prevention of some moods like loneliness and depression, improve daily life activities and provide a social support by increasing the life quality. [27]- [29]

Different researchers have reported that AAT should be considered planning of the treatment

The interaction between an animal and human result in an increase neurochemicals initiating a decrease in blood pressure and relaxation. This relationship may be beneficial for amelio‐ rating agitate behavior and psychological symptoms of dementia. In another study, it has been reported that aquarium assisted therapy may be beneficial for increasing eating behavior of aged people living in a nursing home. [10] Richeson revealed that AAT can be increase social interactions by initiating decrease the agitate behaviors of patients with dementia. [12] Kongable et al., observed that a therapy dog increased patients' some social behaviors such as

In aged people, AAT are used for ameliorating agitate behaviors, psychological, occupational, social and physical disorders especially in Alzheimer and Dementia. [14]- [20] People with Alzheimer may have an easier time decoding the simple repetitive, non-verbal actions of a dog. Animals can act as transitional objects, allowing people to first establish a bond with them and then extend this bond to people. Most of the study results revealed that AAT especially dog therapy had an "calming effect" on the patients with dementia and Alzheimer disease. [15]- [17], [20] This effect can be helpful as a communication link during therapy sessions and also decrease agitation behaviors. It is well known that incidence of aggression, agitation, social withdrawal, depression, and psychotic disorders are growing problems in Alzheimer disease for special care units, staff and family members of patients. Furthermore, environmental factors in nursing home or other health care units have been become increasingly forcible barrier for therapy of Alzheimer disease. In this conditions, AAT and other animal activities

AAT should be more commonly used in the world through increasing awareness of public health services about beneficials of companion animal and activities. Especially, AAT can be used for improving health disorders of aged people with physical-mental and social disabilities such as Alzheimer, dementia, aphasia, anxiety, depression, stres, schizophrenia, and feeling of loneliness, quality of life. An aquarium assisted therapy may be a good starting point to learn about benefits and facilities of AAT in developing countries like Turkey which have more

Main principle of AAT is based on using psychosomatic effects, which appear as results of biological-physical-chemical changes during human and animal interactions. [4] Feeding animals or being together with animals cause these effects to appear, and play an important role in recovery of mental, social and physical health. [21] The strength of bonding between humans and animals has been revealed in a survey study, which is conducted on 14 veteri‐ narians and 117 patients in Ontario. In the study, patients, whose pets are died, have received a survey to define causes and effects of their worries by a phone call or e-mail. Of 30% of participants has been observed to have severe worries. [22] This strong bonding between humans and animals can also affect physical and mental health, and sometimes death or loss of an animal can be so effective that it can change a subject's life. [23] Dog, horse and dolphin

may be helpful to cope with these difficulties by presenting a different aspect.

are the most commonly preferred animal species in animal assisted therapy.

lower the socio-economic groups than the developed countries.

of individual with dementia. [1], [9]- [12]

304 Understanding Alzheimer's Disease

smile, laugh, look, touch, verbalization. [13]
