Table 3 Summary of key outcome data from the randomised studies
Theme Study ID | Outcome | Scale/Tool | Comparator groups and sample size Intervention(I), Control (C), Other (Oth) | Post Intervention scores or Change scores Mean (SD) | Interpretation and significance (as reported by authors) |
|---|---|---|---|---|---|
Psychological well-being | |||||
 Banks 2008 [55] | Loneliness | UCLA | AAT vs AIBO vs usual care (control) (I:13, Oth:12, C:13) | No data available | Control group statistically different from the AIBO (P < .05), and the AAT (P < .05) but no statistically significant difference between the AIBO and AAT groups |
 Banks 98/2002 [56] | Loneliness | UCLA-LS | AAT vs usual care (control) (I:30, C:15) | AAT1 40.56 vs AAT2 39.08 vs 48.7 | Both AAT groups differed significantly from the control group (p < .01) but not from each other |
 Colombo 2006 [59] | Depression | BSI | Resident pet vs plant vs usual care (nothing to care for – control) (I:48, P:43, C:53) | 0.79 (0.50) vs 1.10 (0.68) vs 1.40 (0.88) | Resident pet differed significantly to control and plant group (P < .001) |
|  | Anxiety | BSI |  | 0.78 (0.61) vs 0.71 (0.65) vs 0.92 (0.67) | Resident pet differed significantly to plant group (p < .05) but not to control |
|  | Depression and anxiety | LEIPAD-SV |  | 1.93 (1.94) vs 3.37 (2.13) vs 3.53 (3.08) | Resident pet differed significantly to plant group (p < .001) and control group (p < ..01) |
 Friedman 2015 [60] | Depression | CSDD | PAL vs reminisence (control) (I:32, C:28 | 5.21 (SE 0.77) vs 8.76 (SE 1.51) | No significant differences between groups (p = 0.07) |
 Johnson 1997 [62] | Depression | MAACL-R | PET vs toy vs human vs usual care (control) (I:17, toy: 16, Human:14, C:25) | 0.43 (0.35) vs 0.72 (1.21) vs 0.57 (0.94) vs 0.94 (1.36) | No significant differences between groups |
| Â | Anxiety | MAACL-R | Â | 0.25 (0.46) vs 0.44 (0.65) vs 0.71 (0.91) vs 0.96 (1.11) | No significant differences between groups |
| Â | Positive affect | MAACL-R | Â | 3.25 (2.82) vs 2.50 (2.26) vs 3.66 (3.33) vs 2.91 (2.27) | No significant differences between groups |
 Le Roux 2009 [63] | Depression | BDI | AAA vs usual care (no visits – control) (I:7, C:8) | 11.86 (8.75) vs 15.88 (10.18) | No significant differences between groups |
| Â | Anxiety | BAI | Â | 10.71 (7.61) vs 13.50 (10.73) | No significant differences between groups |
 Olsen 2016 [64] | Depression | CSDD | AAA vs usual care (control) (I:22, C:25) | 7.86 (4.42) vs 8.28 (5.62) | More participants in AAA improved than in control group (p = 0.03) |
 Panzer 2000 [65] | Depression | GDS (+ BDI) | AAT vs usual care (control) (I:16, C:19) | Mean difference -2.44 vs -1.21 | No significant differences between groups (p = 0.34) |
|  | Morale | PGC Morale Scale |  | Mean difference 1.06 vs 0.37 | No significant differences between groups (p = 0.44) |
 Thodberg 2016a [67] | Depression | GDS | AAT vs robot seal vs toy cat (I:35, Seal: 35, C: 30) | No data available | No significant differences between groups, but depression did improve over time for all groups |
 Travers 2013 [69] | Depression | GDS | AAT vs usual care (therapist only—control) (I:27, C:28) | 4.0 (2.9) vs 2.6 (2.1) | No significant differences between groups |
| Â | Irritability | MOSES | Â | 10.0 (3.6) vs 11.1 (3.9) | No significant differences between groups |
 Wall 1994 [71] | Depression | MS-E | AAT vs toy vs Human only vs no visits (control) (I:20, Toy:20, Human:20, C:20) | 1.38 (0.75) vs 1.38 (0.61) vs 1.65 (0.74) vs 1.91 (1.0) | No significant differences between groups |
| Â | Tense/irritable | MS-E | Â | 1.40 (0.56) vs 1.51 (0.69) vs 1.64 (0.56) vs 1.76 (0.66) | No significant differences between groups |
 Zulauf 1987 [72] | Depression | GDS | AAT vs Human only (control) (I:18, C:9) | AAT1 15.33, AAT2 7.39, C 12.39 | No significant differences between groups (p = .05) |
|  | Self-esteem | SES |  | No data available | No significant differences between groups (p = .05) |
| Â | Morale | PGC Morale Scale | Â | No data available | No significant differences between groups |
Behaviour | |||||
 Andrysco 1982 [54] | Behaviour | Direct and video observation | Pet therapy vs human only visit (control) (I:23, C:23) | No data available | Social interactions with other residents, activity involvement showed no significant differences between groups but dependency on staff did |
 Bumsted 1988 [57] | Selfcare | Self care agency tool | Pet therapy vs usual care (control) (I:10, C:10) | 22.10 (8.20) vs 22.90 (8.75) | No significant differences between groups |
| Â | Â | Physical self-maintenance scale | Â | 18.00 (7.82) vs 18.30 (6.65) | No significant differences between groups |
 Colombo 2006 [59] | Self care | LEIPAD-SV | Resident pet vs plant vs usual care (nothing to care for – control) (I:48, P:43, C:53) | 5.45 (3.78) vs 3.25 (2.45) vs 7.36 (3.74) | Resident pet differed significantly to plant group (p < .01) and control group (p < .05) |
|  | Social functioning | LEIPAD-SV |  | 3.06 (1.52) vs 4.15 (1.95) vs 4.15 (1.95) | Resident pet differed significantly to plant group and control group (p < .01) |
 Friedman 2015 [60] | Apathy | Apathy evaluation scale | PAL vs reminisence (control) (I:32, C:28) | 17.53 (SE 0.90) vs 15,72 (SE 0.82) | No significant difference between groups |
| Â | Agitation | CMAI | Â | 15.53 (SE 0.68) vs 20.00 (SE 1.69) | No significant difference between groups |
 Olsen 2016 [64] | Agitation | BARS | AAA vs usual care (control) (I:24, C:26) | 23.75 (7.13) vs 24.65 (13.95) | No significant difference between groups |
 Pope 2016 [66] | Agitation | CMAI | AAT vs usual care (human only visit—control) (I:44, C:44 -crossover) | 34.0 (12.8) vs 36.6 (13.4) | No significant difference between groups |
|  | Social behaviour | Social behaviour checklist |  | 157.08 vs 111.09 | Significant difference between groups (p < .001) |
 Travers 2013 [69] | Self care | MOSES | AAT vs usual care (therapist only—control) (I:27, C:28) | 17.5 (6.5) vs 17.4 (6.1) | No significant differences between groups |
 Thodberg 2016a [67] | Sleep | Acti-watch | AAT vs robot seal vs toy cat (I:35, Seal: 35, C: 30) | No data available | No significant differences between groups |
 Valenti Soler 2015 [70] | Behaviour | NPI | AAT vs usual care (control) (I:36, C:32) | 22.33 (14.67) vs 28.66 (19.08) | No significant differences between groups (p = 0.65) |
| Â | Apathy | APADEM-NH | Â | No data available | No significant differences between groups |
 Zulauf [72] | Behaviour | NOSIE (3) | AAT vs Human only (control) (I:18, C:9) | AAT1 87.17, AAT2 100.57, C 85.78 | Significant differences between AAT2 compared with AAT1 and control (p < .05) |
Quality Of Life (QoL) | |||||
 Briones 2021 [58] | Quality of life | QOL-AD | AAT vs usual care (control) (I:16, C:18) | 32.46(1.27) vs 31.5(1.41) | Both groups improved from baseline, no significant difference between AAT and control |
 Olsen 2016 [64] | Quality of life | QUALID | AAA vs usual care (control) (I:24, C:26) | 24.8 (5.79) vs 25.3 (10.26) | No effect of AAA on QoL at Post intervention p = 0.344 (or at follow-up p = 0.136 at 3 months) |
 Travers 2013 [69] | Quality of life | QOL-AD | AAT vs usual care (therapist only—control) (I:27, C:28) | A 34.0 (7.2) vs 38.9 (5.9) B 38.1 (4.4) vs 33.2 (5.3) C 34.7 (4.9) vs 39.6 (6.1) | Mean QOL-AD score in AAT was significantly higher (better) than in the control group (p = 0.02) in Facility B but was significantly lower (p = 0.02) in Facility C however an outbreak of Gastroenteritis during the final week of intervention in this facility may have influenced this |
 Valenti Soler 2015 [70] | Quality of life | QUALID | AAT vs usual care (control) (I:36, C:32) | 24.33 (6.68) vs 24.72 (6.68) | No effect of AAT on QoL at Post intervention p = 0.101 |
Engagement/Interaction | |||||
 Andrysco 1982 [54] | Smiles | Direct and video observation | Pet therapy vs human only visit (control) (I:23, C:23) | No data available | Paired t-test showed no significant difference between the two groups though residents smiled more in the AAT group |
| Â | Verbalisation | Direct Observation | Â | Â | Overall improvement in verbalisation in intervention group but no significant differences between groups |
| Â | Eye contact | Direct Observation | Â | Â | Eye contact with researcher decreased during AAT as resident watched the animal. Differences not significant |
|  | Tactile | Direct Observation |  |  | Residents did not touch researcher but wee touching animal 40–70% of the time |
| Â | Number of questions | Direct Observation | Â | Â | Residents asked significantly more questions about all topics during pet interactions |
 Greer 2002 [61] | Words spoken | Video observation | AAA vs toy cat (I:6, C:6 ABACA design) | 24.8 words/min vs 19.3 words/min | Average total words were greater during the live cat intervention than in the toy cat intervention. Words/min continued to increase even after withdrawal in the live cat condition |
| Â | Meaningful information units | Video observation | Â | 6.2MIU/min vs 4.7MIU/min | The groups reacted differently in the withdrawal period |
| Â | Initiations | Video observation | Â | 2.5/min vs 2.1/min | Average initiations were greater during the live cat intervention than in the toy cat intervention |
 Johnson 1997 [62] | Smiles | Observation checklist | PET vs usual care (control) (I:25, C:25) | 7 (3.25) vs 4.27 (3.47) | Significant difference between groups p < 0.02 |
|  | Verbalisation | Audio-recording |  | No data available | No difference between groups p = 0.67 |
| Â | Eye contact | Observation checklist | Â | 7.65 vs 7.86 | No significant difference between groups |
 Pope 2016 [66] | Engagement | Menorah Park Engagement Scale | AAT vs usual care (human only visit—control) (I:44, C:44 -crossover) | Mixed results across not engaged, self, passive and constructive engagement | No significant difference between groups p = 0.26 |
 Thodberg 2016b [68] | Interaction | Direct observation (bespoke tool) | AAT vs robot seal vs toy cat (I:35, Seal: 35, C: 30) | Conversation (various) Physical contact (various) Eye contact (various) | Physical contact more likely with animal (p < .001) or seal (p = 0.01) than toy cat. Conversation more likely with animal or seal (both p < .05) than toy cat but there were several moderators. Eye contact more likely with animal than seal or toy cat over time |
 Wall 1994 [71] | Speech | Audio observation | AAT vs toy vs Human only vs no visits (control) (I:20, Toy:20, Human:20, C:20) | 84.45 (35.07) vs 77.63 (38.05) vs 83.82 (39.05) (no data for control) | No significant differences between groups |
 Zulauf 1987[72] | Activity participation | Direct observation | AAT vs Human only (control) (I:18, C:9) | 68.11 vs 59.00 | Mixed results as AAT1 and 2 differed. No significant differences between groups p = 0.08 |