the last (30th) intervention after 6 weeks in 4 participants in the intervention group and 2 participants in the control group. The mean baseline score for salivary CgA rose slightly from 0.465 (+0.232) ng/mg protein at 16:00 hours to 0.497 (+0.248) ng/mg protein at 17:00 hours in the intervention group (P ¼ .478). After intervention, there was a significant decrease in protein for all participants from 0.580 (+0.290) ng/mg to 0.211 (+0.105) ng/mg (P ¼ .029). Measurements were also taken for the control group from 16:00 to 17:00 hours, at the same times as the intervention group’s baseline and postintervention measurements, and a slight increase was observed. Case Reports The following 2 participants, case A and case B, showed improvement in behavioral symptoms. Case A was an 84-year-old woman with Alzheimer’s disease. Her baseline characteristics were as follows: MMSE, 20 points; BPSD, delusion that people are stealing things, easily angered; and ADL, partial care, using wheelchair. Shortterm memory impairment was evident, but she was relatively competent in communicating and participated in occupational therapy. Table 2. Changes in Scores on Mini Mental State Examination (MMSE), Gottfries-Brane-Steen (GBS), and Behavior Pathology in Alzheimer’s Disease Rating Scale (Behave-AD) Evaluation Intervantion Group Control Group Baseline After Intervention test Baseline 6-Week Later test Mean SD Mean SD P Value Mean SD Mean SD P Value MMSE Behave16 Abbreviation: SD, standard deviation. Suzuki et al 683 Response to intervention. The participant enjoyed tactile massage and would come over in her wheelchair to ask, ‘‘Are you doing massage today?’’ From about the fourth week of intervention, she said, ‘‘The circulation in my hands is better, and it’s nice having warm hands. I always used to wake up in the night, but these days I’ve been sleeping right through till the morning, and it’s because of this massage.’’ Changes in evaluation measurements. The following changes were seen after 6 weeks of intervention. Mini Mental State Examination score decreased from 20 to 17 points. On the GBS, motor function increased from 13 to 14, and intellectual function decreased from 30 to 28. After the intervention, she was much calmer and better at communicating. Her GBS score for emotional function was 2, both before and after the intervention; similarly, she showed no changes in symptoms common in dementia (score, 10 before and after the intervention). In terms of the BEHAVE-AD, scores for (a) paranoid and delusional ideation decreased from 3 before the intervention, when she had strong delusions that people were stealing things from her, to 0 after the intervention, when this symptom disappeared. Her score for (c) activity disturbances decreased from 7 to 3, and she showed a decrease in wandering and aimless activity compared with before the intervention. Scores for (d) aggressive decreased from 2 to 0, and she went from being markedly easy to anger before the intervention to smiling more frequently after the intervention. Scores on (e) diurnal rhythm disturbances decreased from 1 to 0, and she started being able to sleep through the night after intervention. Finally, the score for (g) anxieties and phobias decreased from 3 to 0, and nurses noted a decrease in anxiety. Case B was a 92-year-old woman with Alzheimer’s disease. Symptoms of BPSD included hallucinations, talking to herself, refusal to eat, and resistance to care. She needed partial care for ADLs (meals, movement, toileting, bathing) and used a wheelchair. She was able to reply to simple questions to some extent but often talked to herself; it was frequently not possible to have a conversation with her. Symptoms tended to be relatively mild in the daytime, but marked appearance of hallucinations and talking to herself appeared in the evening. Response to intervention. When tactile massage was about to begin, she would sometimes proffer her hand voluntarily. Although she had hallucinations, her facial expression was Figure 2. Pre- to postintervention changes of the control group in salivary chromogranin A. 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 p=0.478 p=0.029 15 pm 16 pm pre post Baseline 30th (Last) intervenon ng/mg protein ng/mg protein Figure 1. Pre- to postintervention changes of the intervention group in salivary chromogranin A. 684 American Journal of Alzheimer’s Disease & Other Dementias® 25(8) relaxed, she would sometimes laugh out loud and, after the intervention, was observed to say, ‘‘You’re getting good at this.’’ Tactile behavior such as stroking the cheek of the nurse giving the massage was also observed Changes in evaluation measurements. Mini Mental State Examination scores did not change (0 at both assessments). On the GBS, (A) motor function decreased from 33 to 31, she started eating by herself, and frequency of incontinence decreased. (B) Intellectual function score decreased from 59 to 56, and it became possible to have a conversation with her as she answered questions. (C) Emotional function did not change (13 pre and post); similarly, there were no changes in different symptoms common in dementia (28 pre and post). On the BEHAVE-AD scale, (a) paranoid and delusional ideation scores decreased from 5 to 4, and her normal violence displayed during