Sensory Integration Therapy for the Treatment of Behavioral Symptoms of Dementia: A Case Report

Case Diagnosis: Late onset Alzheimer’s dementia with behavioral disturbance.

Case Description or Program Description: A 71-year-old male with behavioral disturbances and severe sensory processing dysfunction. The patient demonstrated poor self-regulation, poor environmental awareness, and increased assistance needed with activities of daily living (ADLs). Clinical presentation included agitation and withdrawal to ADLs, leading staff to deem him dependent in all aspects of care. Medical workup was negative, suggesting behaviors were sensory driven rather than psychiatric.

Setting: Skilled Nursing Facillity

Assessment/Results: A sensory diet, including a personalized plan of activities and strategies designed to meet the patient’s sensory needs, was implemented to assist the individual in self-regulating. Auditory input emerged as the most effective regulatory modality, as the patient demonstrated a consistent response to structured sound-based interventions. Given his background as a choir and music teacher, he retained processing abilities for rhythm and melody, which remain preserved in dementia. Therapeutic listening and modulated sound therapy led to immediate improvements in alertness, emotional regulation, and engagement.

Proprioceptive, vestibular, tactile, and olfactory inputs were embedded into daily routines. Interventions such as deep pressure, graded movement, controlled positioning, and scent-based orientation supported sensory modulation and participation in ADLs. Following intervention, feeding and upper-body dressing improved from dependent to moderate assistance, with increased initiation across all ADL tasks. The Cohen-Mansfield Agitation Inventory score decreased from 62 to 36, reflecting a 42% reduction in behavioral dysregulation.

Discussion (relevance): Sensory processing dysfunction in dementia is often misattributed to psychiatric symptoms or disease progression, leading to unnecessary pharmacological intervention. However, these behaviors frequently result from difficulty processing sensory input, contributing to agitation, withdrawal, and care resistance. By integrating structured sensory interventions into daily routines, the patient demonstrated improved self-regulation, engagement, and caregiver interactions.

Conclusions: Sensory integration therapy provides a viable, non-pharmacological approach to optimizing function, reducing caregiver burden, and improving quality of life in dementia care.