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Liu KPY, Conroy M, Clark A, Lim D. What clinicians could consider in providing group interventions for people with cognitive impairments: a scoping review. Psychogeriatrics 2024. [PMID: 39228149 DOI: 10.1111/psyg.13171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 07/10/2024] [Accepted: 07/22/2024] [Indexed: 09/05/2024]
Abstract
This study identified evidence and considerations for allied health clinicians in providing group interventions for people with cognitive impairment. A scoping review was conducted by searching the MEDLINE (Ovid), CINHAL (EBSCOhost), Scopus (Elsevier), Embase (Ovid) and TROVE databases from 2016. Articles of any study design in which group interventions were performed by an allied health professional with participants with cognitive impairment were included. Data on physical, cognitive, psychological, and quality of life measures were extracted from the selected articles. Standardised mean changes (SMC) were calculated. Ten articles were included in the study. No article directly compared group interventions versus one-to-one interventions. The results of the meta-analysis showed significant improvements after the intervention in the physical (SMC = 0.42, P = 0.013), cognitive (SMC = 0.43, P = 0.005), psychological (SMC = 0.14, P = 0.005), and quality of life domains (SMC = 0.28, P = 0.002). This review identified considerations for clinicians when developing group interventions for people with cognitive impairments, including specific participant criteria, increasing support, modifications to intervention difficulty, and environmental considerations. Group intervention for people with cognitive impairments demonstrated moderate effectiveness in improving physical and cognitive domains and a small effect in improving psychological and quality of life domains. Specific considerations are recommended when clinicians provide group interventions for people with cognitive impairments.
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Affiliation(s)
- Karen P Y Liu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
- South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Mannix Conroy
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Annemieke Clark
- Mount Wilga Private Hospital, Ramsay Health Care, Sydney, New South Wales, Australia
| | - David Lim
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Research Institute for Innovative Solutions for Well-being and Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Layne D, Logan A, Lindell K. Palliative Care Coordination Interventions for Caregivers of Community-Dwelling Individuals with Dementia: An Integrative Review. NURSING REPORTS 2024; 14:1750-1768. [PMID: 39051366 PMCID: PMC11270266 DOI: 10.3390/nursrep14030130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024] Open
Abstract
Alzheimer's disease is a serious illness with a protracted caregiving experience; however, care coordination interventions often lack the inclusion of palliative care. The purpose of this integrative review is to identify and synthesize existing care coordination interventions that include palliative care for individuals with dementia and their caregivers living in community settings. The Whittemore and Knafl framework guided the review, with data analysis guided by the SELFIE framework domains. Study quality was assessed using the Mixed Methods Appraisal Tool, while the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines informed reporting results. Nine care coordination interventions involving family caregivers across eighteen publications were identified. Only a single intervention explicitly mentioned palliative care, while the remaining interventions included traditional palliative care components such as advance care planning, symptom management, and emotional support. Many of the identified interventions lacked theoretical grounding and were studied in non-representative, homogeneous samples. Further research is needed to understand the lived experiences of people with dementia and their caregivers to alleviate care coordination burden.
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Affiliation(s)
- Diana Layne
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Ayaba Logan
- Academic Affairs, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Kathleen Lindell
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA;
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Huang CK, Lee PL, Lee HH. Effects of a Taiwanese Adaptation of the Group Cognitive Stimulation Therapy Program on Mild-To-Moderate Dementia: A Quasi-Experimental Trial. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-15. [PMID: 38943515 DOI: 10.1080/01634372.2024.2372103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
Cognitive stimulation therapy (CST) was found to significantly improve cognitive function and quality of life (QOL) in patients with mild-to-moderate dementia in the UK. However, indigenous research on older adults with dementia in Taiwan is scarce. Therefore, this study developed and investigated the effects of a Taiwan version of group CST (CST-T) through a quasi-experimental trial. Excluding the dropouts, there were 13 experimental participants (M = 78.9 ± 9.0) and 13 control participants (77.9 ± 5.6). The results indicated significant improvements in cognitive function, QOL, and daily life functioning in the experimental group compared with the control group, and these effects remained evident at a 3-month follow-up.
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Affiliation(s)
- Chih-Kun Huang
- Department of Social Work, National Quemoy University, Kinmen, Taiwan
| | - Pai-Lin Lee
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Hsiao-Han Lee
- Southern Region Senior's Citizens' Home, Ministry of Health and Welfare, Pingtung, Taiwan
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Siddiqui S, Mehta D, Coles A, Selby P, Solmi M, Castle D. Psychosocial Interventions for Individuals With Comorbid Psychosis and Substance Use Disorders: Systematic Review and Meta-analysis of Randomized Studies. Schizophr Bull 2024:sbae101. [PMID: 38938221 DOI: 10.1093/schbul/sbae101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
BACKGROUND AND HYPOTHESIS Substance use is highly prevalent among people with schizophrenia (SCZ) and related disorders, however, there is no broad-spectrum pharmacotherapy that concurrently addresses both addiction and psychotic symptoms. Psychosocial (PS) interventions, which have yielded promising results in treating psychosis and substance dependence separately, demonstrate potential but have not been systematically evaluated when combined. STUDY DESIGN Systematic review and random-effects meta-analyses of randomized controlled trials (RCTs) investigating PS interventions for individuals with comorbid substance use and psychotic disorders, encompassing SCZ and schizophrenia spectrum disorders (SSD). We included relevant studies published from MEDLINE, PsycINFO, and Google Scholar through May 2023. STUDY RESULTS We included 35 RCTs (5176 participants total; approximately 2840 with SSD). Intervention durations ranged from 30 min to 3 years. Meta-analysis did not identify a statistically significant pooled PS intervention effect on the main primary outcome, substance use (18 studies; 803 intervention, 733 control participants; standardized mean difference, -0.05 standard deviation [SD]; 95% CI, -0.16, 0.07 SD; I2 = 18%). PS intervention effects on other outcomes were also not statistically significant. Overall GRADE certainty of evidence was low. CONCLUSIONS At present, the literature lacks sufficient evidence supporting the use of PS interventions as opposed to alternative therapeutic approaches for significantly improving substance use, symptomatology, or functioning in people with SCZ and related disorders. However, firm conclusions were precluded by low certainty of evidence. Further RCTs are needed to determine the efficacy of PS treatments for people with dual-diagnoses (DD), either alone or in combination with pharmacotherapy.
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Affiliation(s)
- Salsabil Siddiqui
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Dhvani Mehta
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | | | - Peter Selby
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, Toronto, Canada
- Institute of Mental Health Policy Research, Campbell Family Research Institute, CAMH, Toronto, Canada
- Institute of Mental Health Policy and Research, Addictions Division, Integrated Nicotine and Tobacco Research, Education, Programming, Implementation and Digital Health (INTREPID) Lab, CAMH, Toronto, Canada
| | - Marco Solmi
- SCIENCES Lab, Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - David Castle
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Tasmania, Hobart, Australia
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Autschbach D, Hagedorn A, Halek M. Addressing loneliness and social isolation through the involvement of primary and secondary informal caregivers in nursing homes: a scoping review. BMC Geriatr 2024; 24:552. [PMID: 38918689 PMCID: PMC11197341 DOI: 10.1186/s12877-024-05156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES To clarify the mechanisms of interventions addressing loneliness and social isolation in older adults living in nursing homes through the involvement of primary and secondary informal caregivers. METHODS This scoping review was performed by two independent reviewers, covering the period between 2011 and 2022 and the databases MEDLINE, CINAHL, PsycINFO and Scopus. It included terms related to (A) informal caregivers, (B) nursing homes, (C) psychosocial interventions, (D) involvement and (E) social isolation or loneliness. RESULTS Thirty-three studies met the inclusion criteria. Although there were various definitions and assessment tools related to social isolation and loneliness, the studies referred to three dimensions of these concepts in nursing home residents: the quantity of social interactions, the perception of these encounters and biographical changes in social relationships. Most studies did not explicate the mechanisms of these interventions. The review uncovered the following aspects of intervention mechanisms: increasing opportunities for social contact, creating meaningful encounters, maintaining existing relationships with primary informal caregivers and establishing new ones with secondary informal caregivers. CONCLUSION Studies reporting on interventions addressing loneliness and social isolation in nursing home residents need to clarify and detail their intervention mechanisms in order to foster more targeted interventions. In addition, there is a need for further research on large-scale programs or care philosophies in this field and the development of intervention designs, which allow for tailored intervention formats in order to respond to the individual perception of social relationships.
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Affiliation(s)
- Dominique Autschbach
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany.
| | - Anika Hagedorn
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - Margareta Halek
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
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Odano I, Maeyatsu F, Hosoya T, Asari M, Oba K, Taki Y. Diagnostic approach with Z-score mapping to reduce artifacts caused by cerebral atrophy in regional CBF assessment of mild cognitive impairment (MCI) and Alzheimer's disease by [ 99mTc]-ECD and SPECT. Jpn J Radiol 2024; 42:508-518. [PMID: 38351252 PMCID: PMC11056337 DOI: 10.1007/s11604-023-01526-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/21/2023] [Indexed: 04/30/2024]
Abstract
PURPOSE The aim of this study was to develop a novel approach that enhanced diagnostic accuracy in the diagnosis of mild cognitive impairment (MCI) and early Alzheimer's disease (AD) using cerebral perfusion SPECT by minimizing artifacts caused by cerebral atrophy. MATERIALS AND METHODS [99mTc]-ECD and SPECT studies were performed on 15 cognitively normal patients, 40 patients with MCI, and 16 patients with AD. SPECT images were compared using SPM. The atrophy correction method was incorporated to reduce artifacts through the MRI masking procedure. Regional Z-score, percent extent, and atrophy correction rate were obtained and compared. The Z-score mapping program was structured as a single package that ran semi-automatically. RESULTS The method significantly reduced regional Z-score in most regions, leading to improved estimates. The mean atrophy correction rate ranged from 10.4 to 12.0%. In MCI and AD, the convexities of the frontal and parietal lobes and the posterior medial cerebrum were particularly sensitive to cerebral atrophy, and the Z-scores were overestimated, whereas the posterior cingulate cortex and the cerebellum were less sensitive. The diagnostic accuracy for MCI increased from 67 to 69% and for AD from 78 to 82%. CONCLUSION The proposed approach provided more precise Z-scores with less over- or underestimation, artifacts, and improved diagnostic accuracy, being recommended for clinical studies.
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Affiliation(s)
- Ikuo Odano
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
- Department of Neurology and Radiology, Miyagi Kosei Association, Izumi Hospital, Sendai, Japan.
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan.
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan.
| | - Fumio Maeyatsu
- Department of Neurology and Radiology, Miyagi Kosei Association, Izumi Hospital, Sendai, Japan
| | - Tetsuo Hosoya
- Department of Software Development. Division of Quality, Safety Management and Regulatory Affairs, PDRadiopharma. Inc., Tokyo, Japan
| | - Mami Asari
- Department of Neurology and Radiology, Miyagi Kosei Association, Izumi Hospital, Sendai, Japan
| | - Kentaro Oba
- Department of Human Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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van de Beek SH, Erdal A, Husebø BS, Vislapuu M, Achterberg WP, Caljouw MAA. Impact of Pain and Neuropsychiatric Symptoms on Activities in Nursing Home Residents (COSMOS Trial). J Am Med Dir Assoc 2024; 25:847-852.e3. [PMID: 38403273 DOI: 10.1016/j.jamda.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/20/2023] [Accepted: 01/10/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE This study aims to identify whether pain and dementia-related behavior are associated with different types of activities in nursing home residents, controlled for dementia severity. DESIGN Cross-sectional baseline data from the multicomponent cluster randomized controlled COSMOS trial (acronym for Communication, Systematic pain treatment, Medication review, Organization of activities, and Safety). SETTING AND PARTICIPANTS A total of 723 patients from 33 Norwegian nursing homes with 67 units (clusters). Participants aged ≥65 years, with a life expectancy of >6 months, and with valid data on activity were eligible for inclusion. METHODS Activity was operationalized in time (hours per week) and type (cognitive, social, physical, and no activity). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), pain with the Mobilization-Observation-Behavior-Intensity-Dementia-2 Pain Scale (MOBID-2), and behavior with the Neuropsychiatric Inventory Nursing Home version (NPI-NH). Analyses were performed using linear and logistic regression. Sensitivity analyses for dementia severity were performed to account for effect modification. RESULTS A total of 289 participants were included (mean age 86.2 [SD 7.6]; 74% female). A higher pain score was associated with less time spent on activity in participants with severe dementia (estimate 0.897, P = .043). A higher score for the NPI-NH mood cluster (depression and anxiety) was associated with a higher likelihood of participation in cognitive activities (odds ratio [OR], 1.073; P = .039). Apathy (OR, 0.884; P = .041) and lack of inhibition (OR, 0.904; P = .042) were associated with a lower likelihood of participation in social activities as well as no engagement in activities (apathy OR, 0.880; P = .042; lack of inhibition OR, 0.894; P = .034). CONCLUSION AND IMPLICATIONS Pain and dementia-related behavior may influence the participation in activities in the nursing home. There is an urgent need to investigate what type of activity stimulates people in different stages of dementia.
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Affiliation(s)
- Sifra H van de Beek
- Department of Internal Medicine, Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands; Department of Ethics and Law, Leiden University Medical Center, Leiden, the Netherlands; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Ane Erdal
- Department of Global Public Health and Primary Care, Center for Elderly and Nursing Home Medicine (SEFAS), Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Bettina S Husebø
- Department of Global Public Health and Primary Care, Center for Elderly and Nursing Home Medicine (SEFAS), Faculty of Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Maarja Vislapuu
- Department of Global Public Health and Primary Care, Center for Elderly and Nursing Home Medicine (SEFAS), Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
| | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
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Cummings J, Sano M, Auer S, Bergh S, Fischer CE, Gerritsen D, Grossberg G, Ismail Z, Lanctôt K, Lapid MI, Mintzer J, Palm R, Rosenberg PB, Splaine M, Zhong K, Zhu CW. Reduction and prevention of agitation in persons with neurocognitive disorders: an international psychogeriatric association consensus algorithm. Int Psychogeriatr 2024; 36:251-262. [PMID: 36876335 PMCID: PMC10480345 DOI: 10.1017/s104161022200103x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVES To develop an agitation reduction and prevention algorithm is intended to guide implementation of the definition of agitation developed by the International Psychogeriatric Association (IPA). DESIGN Review of literature on treatment guidelines and recommended algorithms; algorithm development through reiterative integration of research information and expert opinion. SETTING IPA Agitation Workgroup. PARTICIPANTS IPA panel of international experts on agitation. INTERVENTION Integration of available information into a comprehensive algorithm. MEASUREMENTS None. RESULTS The IPA Agitation Work Group recommends the Investigate, Plan, and Act (IPA) approach to agitation reduction and prevention. A thorough investigation of the behavior is followed by planning and acting with an emphasis on shared decision-making; the success of the plan is evaluated and adjusted as needed. The process is repeated until agitation is reduced to an acceptable level and prevention of recurrence is optimized. Psychosocial interventions are part of every plan and are continued throughout the process. Pharmacologic interventions are organized into panels of choices for nocturnal/circadian agitation; mild-moderate agitation or agitation with prominent mood features; moderate-severe agitation; and severe agitation with threatened harm to the patient or others. Therapeutic alternatives are presented for each panel. The occurrence of agitation in a variety of venues-home, nursing home, emergency department, hospice-and adjustments to the therapeutic approach are presented. CONCLUSIONS The IPA definition of agitation is operationalized into an agitation management algorithm that emphasizes the integration of psychosocial and pharmacologic interventions, reiterative assessment of response to treatment, adjustment of therapeutic approaches to reflect the clinical situation, and shared decision-making.
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Affiliation(s)
- Jeffrey Cummings
- Joy Chambers-Grundy Professor of Brain Science, Director, Chambers-Grundy Center for Transformative Neuroscience, Co-Director, Pam Quirk Brain Health and Biomarker Laboratory, Department of Brain Health, School of Integrated Health Sciences. University of Nevada Las Vegas (UNLV)
| | - Mary Sano
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NYC NY and James J. Peters VAMC, Bronx NY
| | - Stefanie Auer
- Centre for Dementia Studies, University for Continuing Education Krems, Austria
| | - Sverre Bergh
- The research centre for age-related functional decline and disease, Innlandet hospital trust, Ottestad, Norway
| | - Corinne E. Fischer
- Faculty of Medicine, Department of Psychiatry, University of Toronto, Canada
| | - Debby Gerritsen
- Department of Primary and Community Care, Radboud university medical center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, the Netherlands
| | - George Grossberg
- Department of Psychiatry & Behavioral Neuroscience, Division of Geriatric Psychiatry St Louis University School of Medicine
| | - Zahinoor Ismail
- Departments Psychiatry, Neurology, Epidemiology, and Pathology, Hotchkiss Brain Institute & O’Brien Institute for Public Health University of Calgary
| | - Krista Lanctôt
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute; and Departments of Psychiatry and Pharmacology/Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Maria I Lapid
- Mayo Clinic Department of Psychiatry and Psychology, Rochester, MN, USA
| | - Jacobo Mintzer
- Psychiatrist, Ralph. H. Johnson VA Medical Center, Charleston, SC and Professor, College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Rebecca Palm
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Paul B. Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Michael Splaine
- Owner Splaine Consulting, Managing Partner, Recruitment Partners LLC
| | - Kate Zhong
- Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas
| | - Carolyn W. Zhu
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, NYC, NY and James J. Peters VAMC, Bronx NY
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Vega-Mendoza M, Norval RS, Blankinship B, Bak TH. Language Learning for People Living with Dementia and Their Caregivers: Feasibility and the Quality of Experience. Healthcare (Basel) 2024; 12:717. [PMID: 38610141 PMCID: PMC11011596 DOI: 10.3390/healthcare12070717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/04/2024] [Accepted: 03/17/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND A body of research from around the world has reported positive effects of bilingualism on cognitive ageing and dementia. However, little is known about whether foreign language learning could be applied as an intervention for people already living with dementia. Yet, before it is possible to determine the efficacy of language courses as an intervention for people living with dementia (PLWD), it is necessary to establish whether such an intervention is feasible. Our study explored this possibility. METHODS We conducted an exploratory study to examine the feasibility and tolerability of 2-week Italian beginner courses for PLWD in early stages and their family carers in two Scottish Dementia Resource Centres (DRCs). The courses were delivered by trained tutors from Lingo Flamingo, a social enterprise specialising in language teaching for older learners and learners with dementia. Twelve PLWD and seven carers participated in the study. Focus groups preceded and followed the courses. Additional post-course open interviews with the DRC managers were conducted, with a follow-up via telephone approximately one year later. RESULTS Qualitative content analysis resulted in 12 themes, 5 reflected in the interview schedule and 7 arising from the focus groups and interviews. Overall, the courses were perceived positively by PLWD, carers, and DRC managers, although a few logistically and linguistically challenging aspects were also mentioned. The courses were found to positively impact both the individual by increasing self-esteem and producing a sense of accomplishment as well as the group by creating a sense of community. Notably, no adverse effects (in particular no confusion or frustration) were reported. CONCLUSION The positive outcomes of our study open a novel avenue for future research to explore foreign language training in dementia as an intervention and its implications.
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Affiliation(s)
- Mariana Vega-Mendoza
- Psychology, Department of Health, Education and Technology, Luleå University of Technology, 971 87 Luleå, Sweden
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh EH8 9JZ, UK; (B.B.); (T.H.B.)
| | | | - Brittany Blankinship
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh EH8 9JZ, UK; (B.B.); (T.H.B.)
- Usher Institute, The University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Thomas H. Bak
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, Edinburgh EH8 9JZ, UK; (B.B.); (T.H.B.)
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10
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AbdElsalam RMM, ElKholy SEAE. Pilot testing cognitive stimulation intervention on older adults' cognitive function, cognitive self-efficacy, and sense of happiness. Geriatr Nurs 2024; 56:191-203. [PMID: 38359739 DOI: 10.1016/j.gerinurse.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND With the ageing population increasing worldwide, identifying effective approaches to counteract cognitive decline becomes significant for maintaining cognitive health and quality of life in older adults. The lack of cognitive activity accelerates age cognitive decline. Cognitive stimulation interventions can maintain older adults' cognitive reserve, enhance their feelings of happiness, and potentially improve their psychosocial wellbeing. AIM This study aimed to determine the impact of Cognitive Stimulation Intervention on older adults' cognitive function, cognitive self-efficacy, and sense of happiness. METHOD A quasi-experimental methodological approach was applied. Two seniors' clubs were the sites for recruitment in this study as part of the Alexandria Governorate's Ministry of Social Solidarity, Egypt. Eighty older adults (aged 60 and above), randomly assigned into two equal groups. The study group received the study intervention, and the control group received regular seniors' club services. RESULTS Cognitive function, cognitive self-efficacy, and sense of happiness scores among the study group, were significantly increased from (22.40 ± 0.67, 54.51 ± 8.63 and 27.68 ± 14.0 respectively) to (24.30 ± 1.07, 87.84 ± 4.96 and 65.98 ± 8.90 respectively) (P < 0.001) following the interventions, and were significantly higher than the control group's post-test percent scores (22.08 ± 0.98, 54.35 ± 6.97, and 28.75 ± 9.60 respectively) (P < 0.001). CONCLUSIONS Cognitive Stimulation Intervention effectively fostered the older adults' cognitive function, cognitive self-efficacy, and sense of happiness. Consequently, seniors' clubs, care homes, and other contexts seeking to apply Cognitive Stimulation Intervention to improve older adults' cognitive function, and general wellbeing must embed this intervention as part of their routine care and social activities programs.
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Rose T, Spencer-Davies C. The power of a cup of tea: psychosocial interventions in dementia. Br J Community Nurs 2024; 29:68-75. [PMID: 38300238 DOI: 10.12968/bjcn.2024.29.2.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Dementia is a condition that affects the psychological and emotional wellbeing of not only the person with the diagnosis but also those around them. Therefore, providing holistic support and care to the entire family is essential. Psychosocial interventions have a significant impact on families living with dementia. They are a broad category of strategies and approaches that support the whole person by recognising their inherent strengths, and acknowledging and addressing the challenges they face. These interventions can range from a simple conversation over a cup of tea to more structured forms of psychotherapy.
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Affiliation(s)
- Tom Rose
- Admiral Nurse Clinical Lead, St Barnabas Hospice, Lincolnshire
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Yaron G, Bakker F, de Bruin S. In constant search of the good: a qualitative study into insiders' perspectives on living well with dementia. Front Psychiatry 2024; 15:1285843. [PMID: 38362025 PMCID: PMC10867197 DOI: 10.3389/fpsyt.2024.1285843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction The new concept of 'living well with dementia' is currently gaining traction in practice, policy, and research. However, people with dementia and their carers' own understanding of this concept has not received much scholarly attention. This is because empirical studies into living well with dementia are predominantly quantitative; there are only a few qualitative studies on this topic. This study therefore sets out to investigate what living well means for 'insiders' in an everyday context. Methods To explore insiders' own perspectives on living well with dementia, we conducted interviews and focus group discussions with 21 dementia stakeholders. The study included ten individuals with mild-to-moderate dementia living at home, five family carers who are or have been involved in the care for a person with dementia, and six health and social care professionals. Results Living well with dementia, for our study participants, revolves around shaping their daily lives according to their values. In this sense, living well with dementia is no different than without. As it involves the values of the person with dementia and those of their social network, living well is both an individual and a collective concern. Having dementia undermines people with dementia's ability to substantiate their values, but it is still possible to live well. As they attempt to shape living well with dementia, respondents encounter tensions within the social network and within the person with dementia. To handle these tensions, they work for mutual attunement by using sensitivity and switching between leading and following in social interactions. Discussion Living well with dementia in a daily context is a dynamic process in which people with dementia, family carers, and professionals constantly seek the good together. This insight contributes to a better understanding of stakeholders' ongoing, invisible efforts to mutually attune. It may also help bypass dichotomizing approaches to dementia. Finally, it opens up new venues for research into reciprocity in the care collective. The article closes with recommendations to improve dementia care and support in light of these findings.
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Affiliation(s)
- Gili Yaron
- Research Group ‘Living Well With Dementia’, Windesheim University of Applied Sciences, Department of Health and Well-being, Zwolle, Netherlands
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13
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Marques MJ. The quality of family relationships in dementia: Mixed methods to unravel mixed feelings. DEMENTIA 2024; 23:210-233. [PMID: 38100191 PMCID: PMC10807244 DOI: 10.1177/14713012231220759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Objective: Close relationships influence health and quality of life outcomes for people with dementia and their families. Yet, we know little on the role of different relationship domains with quantitative methods having proved to have limitations in this research field. We aimed to study these relationship domains over time, contrasting the views of people with dementia and their family carers, making use of both quantitative and qualitative approaches.Methods: A convergent mixed methods design was adopted, analysing longitudinal data (four time points over three years) from 66 dyads of Portuguese community-dwelling people with dementia and their primary carers, from the EU-Actifcare project sample. Quantitative assessments used sociodemographic and clinical variables, and Positive Affect Index scores, with descriptive and inferential analyses. Qualitative data, collected through individual and joint semi-structured interviews, were explored using thematic analysis.Results: Both quantitative and qualitative findings demonstrated that some domains of relationship quality are affected in different ways, with changes occurring at different stages. Some (e.g., 'communication') may even improve after initial decline. 'Closeness' was consistently altered over time, from carers' perspectives, and played an important protective role regarding institutionalisation. Overall, changes in the relationship quality were perceived differently by people with dementia and their carers, and these divergent perspectives often led to tension. Qualitative data revealed that 'mixed feelings' (ambivalence) involve complex experiences, arguably more difficult to manage than negative feelings alone. Furthermore, perceived informal support, particularly from the extended family, and receiving formal services' assistance, seemed to facilitate positive (re)appraisals of the relationship.Conclusions: A deeper understanding of relationship quality and its domains as dementia progresses may help tailoring interventions to tackle modifiable aspects of relationships, meeting the needs and cherishing the resources of dyads and families. Timely assessments could identify relationships at risk and need for support, including for alternative caring arrangements.
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Affiliation(s)
- Maria J. Marques
- Maria J. Marques, CHRC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 130, Lisbon 1169-056, Portugal.
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Naylor R, Spector A, Fisher E, Fucci F, Bertrand E, Marinho V, Bomilcar I, Coutinho B, Laks J, Mograbi DC. Experiences of cognitive stimulation therapy (CST) in Brazil: a qualitative study of people with dementia and their caregivers. Aging Ment Health 2024; 28:238-243. [PMID: 37458268 DOI: 10.1080/13607863.2023.2231376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/17/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVES There is a lack of investment in psychosocial treatments for people with dementia in Brazil. Cognitive Stimulation Therapy (CST) is a group-based intervention that has shown to have benefits on activities of daily living and mood for people with dementia in Brazil. This study aims to explore the experiences and perceived changes following CST groups. METHODS Individual interviews were conducted with the participants of the group (n = 12) and their caregivers (n = 11). Framework analysis was used to inspect the data. RESULTS Two main themes have emerged: 'Personal benefits of being part of the group', containing two subthemes: 'Benefits for caregivers' and 'Benefits for person with dementia' and 'Day-to-day changes', containing seven subthemes; 'Memory', Sociability', 'Language', 'Mood', 'Orientation', 'Everyday activities' and 'Behavioural and psychological symptoms'. CONCLUSION Results suggest that CST groups led to perceived personal benefits for the people with dementia and caregivers and that there are perceived changes for the participants of the groups.
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Affiliation(s)
- Renata Naylor
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aimee Spector
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Emily Fisher
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Fernanda Fucci
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Valeska Marinho
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Iris Bomilcar
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Coutinho
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jerson Laks
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Translational Biomedicine Postgraduate Programme, Universidade do Grande Rio (Unigranrio), Duque de Caxias, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Parlak MM, Köse A, Güç M, Munis ÖB. Development of mobile compatible software for cognitive-communication disorder in individuals with Alzheimer's disease. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:234-254. [PMID: 37528064 DOI: 10.1111/1460-6984.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive neurodegenerative disease. Cognitive functions and communication skills worsen as the disease progresses, thereby reducing patients' independence levels. Therefore, recommending software that can be used at home may be a useful means of slowing down the cognitive and communicative decline in AD. AIMS To develop software that can be used at home to slow down the cognitive and communicative decline and increase independence in individuals with AD; and to examine the effect of this software on the cognitive communication skills of individuals with AD. METHODS & PROCEDURES The study was completed in four stages: the development of the application; the evaluation of the participants and their training for the application; their use of the application at home; and the re-evaluation of the participants. A total of 32 individuals who met the inclusion criteria were included in the study. These individuals were randomly divided into study and control groups, each consisting of a total of 16 participants, including six in the mild stage, six in the moderate stage, and four in the severe stages. The developed software was loaded on tablets and given to the participants in the study group. The participants in the control group only received their pharmacological treatment, while those in the study group received both their pharmacological treatment and used the developed application. All participants were evaluated with the Mini-Mental State Examination (MMSE) and Language Assessment Test for Aphasia (LATA) before and after application use. A survey was administered to the caregivers of the participants in the study group after the use of the application. OUTCOMES & RESULTS The results revealed a positive change in the cognitive-communication skills of the individuals in the study group, even if they were in the severe stage, according to the LATA and MMSE, as well as the survey. The application led to the greatest improvements in grammar on the LATA and orientation on the MMSE. No rapid cognitive decline was seen in individuals at all stages in the control group. CONCLUSIONS & IMPLICATIONS In this study, software was developed in Turkish that can be used in every stage of AD as part of a holistic cognitive-communication intervention programme offering alternative and supportive communication for individuals with AD, even those in the severe stage. Results prove the effectiveness of the developed software on the cognitive-communication skills of individuals with AD. WHAT THIS PAPER ADDS What is already known on the subject There are a few (as far as is known, three) applications developed in English for cognitive-communication disorders due to dementia. What this study adds to the existing literature In this study, for the first time in Turkish, mobile-compatible software has been developed for both cognitive and communication disorders that is specific to individuals with AD and can be used by individuals at all stages of the disease. The effects of the application we developed on the cognitive-communication skills of individuals with AD were shown in a randomised controlled trial. What are the potential or actual clinical implications of this work? Using the app can help people with all stages of AD keep their cognitive and communication skills and have a better prognosis in terms of cognitive-communication skills, especially grammar and orientation.
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Affiliation(s)
- Mümüne Merve Parlak
- Department of Speech and Language Therapy, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Murat Güç
- Computer Engineering and Software Development, D-Market Electronic Services and Trade Joint Stock Company (hepsiburada.com), Istanbul, Turkey
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Tuohy D, Kingston L, Carey E, Graham M, Dore L, Doody O. A scoping review on the psychosocial interventions used in day care service for people living with dementia. PLoS One 2023; 18:e0295507. [PMID: 38079409 PMCID: PMC10712883 DOI: 10.1371/journal.pone.0295507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Adult Day care centres provide an important aspect of care provision through all phases of the dementia illness from diagnosis to the end of life (Dabelko HI 2008) supporting the well-being of both older people living with dementia and their care partners. Services within adult day care settings are designed to provide biopsychosocial health benefits to participants as well as care partner respite. OBJECTIVE To examine research studies, literature reviews and grey literature and identify and map the literature on psychosocial interventions used in day care services for older people living with dementia and chart their use, evaluation and outcomes. The research review question is "what are the psychosocial interventions used in day care service for older people living with dementia?" Psychosocial interventions are important non-pharmacological interventions which support people's wellbeing. METHODS Inclusion/Exclusion criteria were identified and guided the search strategy. Participants were people aged 60 years and over living with dementia attending day care services. The use of psychosocial interventions for this cohort was the focus of the review. Databases were searched (Cochrane Reviews, CINAHL, Embase, Medline EBSCO, Medline Ovid, Medline PubMed, PsycINFO, Scopus, Open Grey, Lenus and WHO Global Index Medicus databases) using keywords/terms with Boolean operators from 2011 to 2023. Rayyan was used to extract and manage the data. RESULTS The findings present a narrative and charting of the data from the 45 papers that met the review criteria, and this data is mapped onto the five objectives. Within this review, interventions were grouped into five broad types: nature (n = 6 papers), memory/cognitive (n = 11 papers), social (n = 17 papers), animal (n = 4 papers), or physical/sensory (n = 7 papers) based interventions. CONCLUSIONS This review has illustrated the wide variety in the types, range and facilitation of psychosocial interventions within adult day care services. This review highlights the potential benefits of these interventions. However, findings must be considered in the context that many were provided as brief intervention studies with little evidence of continuation after the study and further research is required given the complex and diverse range of interventions. Results will be of interest to practitioners planning to implement or evaluate psychosocial interventions used in day care services for older people living with dementia.
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Affiliation(s)
- Dympna Tuohy
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liz Kingston
- Department of Nursing and Midwifery, Health Research Institute, Health Implementation Science and Technology Cluster, University of Limerick, Limerick, Ireland
| | - Eileen Carey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Margaret Graham
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Liz Dore
- Research Services Department, Glucksman Library, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
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Hwang JJ, Donnelly TT, Raffin Bouchal S, Davidson S. Factors influencing access to nonpharmacological interventions for community-dwelling seniors with mild-to-moderate dementia: An integrative review. J Psychiatr Ment Health Nurs 2023; 30:1054-1081. [PMID: 37203563 DOI: 10.1111/jpm.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/06/2023] [Accepted: 04/23/2023] [Indexed: 05/20/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT Research has shown effectiveness of nonpharmacological interventions in improving or maintaining cognition, mood, functioning, self-efficacy and quality of life for persons with mild-to-moderate dementia (PWDs). These interventions are critical during the earlier stages of dementia. However, Canadian and international literature report underutilization of and difficulty accessing the interventions. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE To our knowledge, this is the first review that explored factors influencing seniors' utilization of nonpharmacological interventions in the earlier stages of dementia. This review contributed to the discovery of unique factors such as PWDs' beliefs, fears, perceptions, and acceptability of nonpharmacological interventions and environmental influences on intervention provision. PWDs' intervention uptake may appear as a matter of personal choices related to individuals' knowledge, beliefs and perceptions. However, the analysis of the research evidence suggests that PWDs' choices are shaped by environmental factors such as formal and informal caregiver support, acceptability and accessibility of nonpharmacological interventions, dementia care workforce, community's attitudes towards dementia and funding. The complex interplay among factors highlights the importance of targeting health promotion strategies at both individuals and their environments. WHAT ARE THE IMPLICATIONS FOR PRACTICE The review findings feature opportunities for healthcare practitioners, including mental health nurses, in advocating for PWDs' evidence-informed decision-making and access to desired nonpharmacological treatments. Involvement of patients and families in care-planning through ongoing assessment of health and learning needs, as well as enablers and barriers to using interventions, continuing information provision, and personalized referrals to appropriate services can promote PWDs' rights to healthcare. ABSTRACT INTRODUCTION: Despite the significance of nonpharmacological interventions in optimal management of mild-to-moderate dementia, it remains unclear in the literature how persons with mild-to-moderate dementia (PWDs) view, understand and access nonpharmacological interventions. AIM The purpose of this review was to explore the extent and nature of evidence concerning factors that influence the use of nonpharmacological interventions for community-dwelling seniors with mild-to-moderate dementia. METHOD An integrative review was undertaken following Toronto and Remington (A step-by-step guide to conducting an integrative review, 2020)'s instruction which expanded Torraco (Human Resource Development Review, 2016, 15, 404)'s and Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546)'s guidance. RESULTS The review of 16 studies suggests that PWDs' use of nonpharmacological interventions is shaped by a complex interplay of various personal, interpersonal, organizational, community and political influences. DISCUSSION The findings highlight the complex, interrelated relationships among multiple factors and subsequent limitations of behaviour-oriented health promotion strategies. To assist PWDs in making healthier choices, health promotion strategies need to direct attention to both individuals' behaviours and environmental conditions impacting the behaviours. IMPLICATIONS FOR PRACTICE The findings of this review can inform multidisciplinary health practitioners' (including mental health nurses) practice with seniors living with mild-to-moderate dementia. We recommend actionable ways in which they can empower patients and their families in dementia management.
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Affiliation(s)
| | | | | | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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18
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Sousa L, Moura B, McDermott O, Fernandes L. A Preliminary Psychometric Case Study of the Music in Dementia Assessment Scales: European Portuguese Version (Midas-PT). ACTA MEDICA PORT 2023; 36:731-739. [PMID: 36640266 DOI: 10.20344/amp.18763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/07/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Music in Dementia Assessment Scales (MiDAS) is a standardized outcome measure aiming to capture the effects of music-based interventions in patients with dementia. It is a unique instrument regarding its specificity, with the potential to enhance research in the field of music in dementia care. The aim of this study was to report a preliminary psychometric study of the translated and adapted instrument to European Portuguese (MiDAS-PT). MATERIAL AND METHODS Care home residents with dementia attended bi-weekly group music-based interventions, for five weeks. Intervention coordinators and care home staff completed MiDAS ratings at every session and the Quality-of-Life Scale (QoL-AD) at three time-points. Inter-rater reliability, test-retest reliability, internal consistency, concurrent validity (QoL-AD) and construct validity were evaluated. RESULTS A total of 529 forms were completed (staff = 235, therapist = 294). Low therapist inter-rater and test-retest reliability, good internal consistency, low concurrent validity, and good construct validity were found. There were high factor loadings between the five MiDAS items (Interest, Response, Initiation, Involvement, and Enjoyment). CONCLUSION This preliminary investigation indicated acceptable psychometric properties on a range of attributes, but more research is needed in order to definitely establish the psychometric value of the scale.
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Affiliation(s)
- Lídia Sousa
- Department of Clinical Neurosciences and Mental Health. Faculty of Medicine. Porto University. Porto; Center for Health Technologies and Services Research. Porto; Psychiatry Department. Centro Hospitalar de Vila Nova de Gaia-Espinho. Vila Nova de Gaia. Portugal
| | - Bárbara Moura
- Psychiatry Department. Centro Hospitalar de Vila Nova de Gaia-Espinho. Vila Nova de Gaia. Portugal
| | - Orii McDermott
- Faculty of Medicine & Health Sciences. University of Nottingham. Nottingham. Portugal
| | - Lia Fernandes
- Department of Clinical Neurosciences and Mental Health. Faculty of Medicine. Porto University. Porto; Center for Health Technologies and Services Research. Porto; Psychiatry Department. Centro Hospitalar Universitário de S. João. Porto. Portugal
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Gerritzen EV, McDermott O, Orrell M. Online peer support: views and experiences of people with young onset dementia (YOD). Aging Ment Health 2023; 27:2386-2394. [PMID: 37162440 DOI: 10.1080/13607863.2023.2205833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/09/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES This study explores (1) which platforms people with YOD use for online peer support, (2) reasons for using or not using online peer support, and (3) how to optimise potential benefits and accessibility. METHODS A mixed-methods online survey was conducted including fixed-choice and open questions. Participants were people with YOD recruited through dementia organisations, Join Dementia Research and the NHS using convenience sampling. Fixed-choice questions were analysed with Chi-square test of significance and free-text responses with thematic analysis. RESULTS A total of 69 completed surveys were analysed. Zoom was most popular for online peer support, followed by Facebook and Twitter. Positives included sharing social support, joining from home, and the option to choose a preferred platform. However, it can be difficult to follow the conversation or understand others. Many were unaware about online peer support and some felt uncomfortable talking to strangers online. To improve access and benefits of online peer support organisations and healthcare professionals should advertise and signpost more and groups should have a clear description. CONCLUSION Online platforms facilitate social support and make peer support accessible to those who do not have access to in-person options. Future research and practice should focus on raising awareness about online peer support.
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Affiliation(s)
- E V Gerritzen
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - O McDermott
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - M Orrell
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Reschke-Hernández AE, Gfeller K, Oleson J, Tranel D. Music Therapy Increases Social and Emotional Well-Being in Persons With Dementia: A Randomized Clinical Crossover Trial Comparing Singing to Verbal Discussion. J Music Ther 2023; 60:314-342. [PMID: 37220880 PMCID: PMC10560009 DOI: 10.1093/jmt/thad015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The number of people living with Alzheimer's disease and related dementias (ADRD) is growing proportional to our aging population. Although music-based interventions may offer meaningful support to these individuals, most music therapy research lacks well-matched comparison conditions and specific intervention focus, which limits evaluation of intervention effectiveness and possible mechanisms. Here, we report a randomized clinical crossover trial in which we examined the impact of a singing-based music therapy intervention on feelings, emotions, and social engagement in 32 care facility residents with ADRD (aged 65-97 years), relative to an analogous nonmusic condition (verbal discussion). Both conditions were informed by the Clinical Practice Model for Persons with Dementia and occurred in a small group format, three times per week for two weeks (six 25-minute sessions), with a two-week washout at crossover. We followed National Institutes of Health Behavior Change Consortium strategies to enhance methodological rigor. We predicted that music therapy would improve feelings, positive emotions, and social engagement, significantly more so than the comparison condition. We used a linear mixed model approach to analysis. In support of our hypotheses, the music therapy intervention yielded significant positive effects on feelings, emotions, and social engagement, particularly for those with moderate dementia. Our study contributes empirical support for the use of music therapy to improve psychosocial well-being in this population. Results also highlight the importance of considering patient characteristics in intervention design and offer practical implications for music selection and implementation within interventions for persons with ADRD.
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Atee M, Burley CV, Ojo VA, Adigun AJ, Lee H, Hoyle DJ, Elugbadebo O, Leon T. Physical restraint in older people: a statement from the Early Career Network of the International Psychogeriatric Association. Int Psychogeriatr 2023:1-12. [PMID: 37782041 DOI: 10.1017/s1041610223000728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The International Psychogeriatric Association (IPA) has expressed significant concerns over the use of physical restraints in older people across diverse aged care settings. Following an extensive analysis of the available literature, the IPA's Early Career Network (ECN) has formulated a collection of evidence-based recommendations aimed at guiding the use of physical restraints within various care contexts and demographic groups. Physical restraints not only infringe upon human rights but also raise significant safety concerns that adversely impact the physical, psychological, social, and functional well-being of older adults. Furthermore, their effectiveness in geriatric settings remains inadequate. Given these considerations, the IPA and its ECN firmly assert that the use of physical restraints should only be considered as a final recourse in the care of older people.
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Affiliation(s)
- Mustafa Atee
- The Dementia Centre, HammondCare, Osborne Park, WA, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Claire V Burley
- UNSW Medicine and Health Lifestyle Clinic, School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, NSW, Australia
| | - Victor Adekola Ojo
- Royal Perth and Bentley Group, Bentley, WA, Australia
- Nissi Healthcare Telehealth, Clyde, VIC, Australia
- Vita Healthcare, Mount Eliza, VIC, Australia
| | | | - Hayoung Lee
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Daniel Jake Hoyle
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS, Australia
| | - Olufisayo Elugbadebo
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tomas Leon
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Global Brain Health Institute, Trinity College, Dublin, Ireland
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Samtani S, Meka A, Siette J. Beyond memory: exploring the value of social cognition for older adults with neurocognitive disorders. Front Psychiatry 2023; 14:1209745. [PMID: 37840782 PMCID: PMC10575711 DOI: 10.3389/fpsyt.2023.1209745] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Neurocognitive disorders involves progressive decline in cognition, function, behavior and needs. Recent developments have identified the need to characterize social cognition in individuals with neurocognitive impairments to support uncertainty in clinical decision making, treatment plans and monitoring individual change. Routine social cognition assessments have thus been more recently used and adopted in persons with dementia or mild cognitive impairment. This work serves to summarize current assessments and provide a discourse on the practicality of available social cognition tools, its implication in clinical practice and key future directions. We highlight advantages in establishing validated, multicomponent measures of social cognition for people with neurocognitive disorders.
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Affiliation(s)
- Suraj Samtani
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Anjani Meka
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia
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Roberts JR, MacLeod CA, Hoare Z, Sullivan MP, Brotherhood E, Stott J, Windle G. Development of an item pool for a patient reported outcome measure of resilience for people living with dementia. J Patient Rep Outcomes 2023; 7:96. [PMID: 37755535 PMCID: PMC10533765 DOI: 10.1186/s41687-023-00638-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Policies to support people living with dementia increasingly focus on strengths-based approaches, highlighting the importance of building resilience. This research responds to the lack of a suitable resilience measure for people with dementia. It develops a pool of items to inform a new measure of resilience for this population. METHODS A conceptual model and associated data informed the item generation of the draft resilience measure. Regular meetings with professionals (n = 7) discussed response-scale formatting, content and face validity, leading to refinement and item reduction. Cognitive interviews with people living with dementia (n = 11) then examined the face and content validity of items and the suitability of response-scale formatting. These two phases informed subsequent revision and further item reduction of the resilience measure. RESULTS The first item generation exercise led to 140 items. These were independently assessed by the professionals and this refinement reduced the measure to 63 items across 7 domains of the conceptual model (psychological strengths; practical approaches for adapting to life with dementia; continuing with hobbies, interests and activities; strong relationships with family and friends; peer support and education; participating in community activities; the role of professional support services). Cognitive interviews explored the 63 items with people living with dementia. Detailed feedback led to items removed due to difficulty with (a) understanding (N = 7); (b) answering (n = 11); (c) low preference for that item (n = 6); and (d) presence of a preferred item within a cluster of similar questions (n = 4). Items were amended to enhance clarity/conciseness (n = 19) leading to a final 37-item pool. CONCLUSION Established methods for measurement development included the expertise of people with dementia and led to the generation of a set of items for a new resilience measure that were understandable and acceptable to this target population. This 37-item pool reflects the conceptual understanding of resilience in dementia as being derived across individual, community and societal level resources.
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Affiliation(s)
| | | | - Zoe Hoare
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Mary Pat Sullivan
- Faculty of Education and Professional Studies, School of Social Work, Nipissing University, North Bay, ON, Canada
| | - Emilie Brotherhood
- Dementia Research Centre, Queen Square Institute of Neurology, University College London (UCL), London, UK
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Gill Windle
- School of Medical and Health Sciences, Bangor University, Bangor, UK
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O'Connell B, Ghosh M, Dunham M, Smyth A. Evaluation of an educational program for people with dementia and their caregivers. Australas J Ageing 2023; 42:517-526. [PMID: 36734521 DOI: 10.1111/ajag.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/10/2022] [Accepted: 12/15/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study evaluated the impact of a 5-week educational and supportive program for people newly diagnosed with dementia and their caregivers. METHODS The study involved a pretest-posttest survey followed by interviews. Wilcoxon signed-rank test was conducted to determine postprogram changes. Kruskal-Wallis tests measured variation in responses between the people with dementia and their caregivers. Interviews were analysed using the NVivo software identifying themes against the program objectives of improving knowledge on dementia, coping strategies, communication and support services for people with dementia and their caregivers. RESULTS Fifty-three dyads (n = 106) completed the survey. There were significant improvements in participants' level of understanding of dementia (z = -8.04, p < 0.001), knowledge of local services (z = -8.11, p < 0.001) and coping with life with dementia (z = -6.93, p < 0.001). These findings were consistent with interview data from 16 dyads. CONCLUSIONS The increasing number of people with dementia and their caregivers living in the community present health challenges. Programs that assist this group to function well in the community are important. Evaluation of this program indicated improved outcomes in relation to adjusting to life with dementia, enhancing knowledge, fostering communication and reducing feelings of isolation. Areas of improvement included lengthening the program with ongoing contact sessions with program facilitators and other participants. Given the positive effects of the program on this vulnerable group of people, it maybe useful for health-care agencies involved in dementia care to conduct this type of program as a matter of routine treatment and care for people newly diagnosed with dementia.
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Affiliation(s)
- Beverly O'Connell
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Manonita Ghosh
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Melissa Dunham
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Aisling Smyth
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
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Lühnen J, Richter T, Calo S, Meyer G, Köpke S, Möhler R. Psychosocial interventions for reducing antipsychotic medication in care home residents. Cochrane Database Syst Rev 2023; 8:CD008634. [PMID: 37650479 PMCID: PMC10471006 DOI: 10.1002/14651858.cd008634.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Antipsychotic medications are regularly prescribed in care home residents for the management of behavioural and psychological symptoms of dementia (BPSD) despite questionable efficacy, important adverse effects, and available non-pharmacological interventions. Prescription rates are related to organisational factors, staff training and job satisfaction, patient characteristics, and specific interventions. Psychosocial intervention programmes aimed at reducing the prescription of antipsychotic drugs are available. These programmes may target care home residents (e.g. improving communication and interpersonal relationships) or target staff (e.g. by providing skills for caring for people with BPSD). Therefore, this review aimed to assess the effectiveness of these interventions, updating our earlier review published in 2012. OBJECTIVES To evaluate the benefits and harms of psychosocial interventions to reduce antipsychotic medication use in care home residents compared to regular care, optimised regular care, or a different psychosocial intervention. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 14 July 2022. SELECTION CRITERIA We included individual or cluster-randomised controlled trials comparing a psychosocial intervention aimed primarily at reducing the use of antipsychotic medication with regular care, optimised regular care, or a different psychosocial intervention. Psychosocial interventions were defined as non-pharmacological intervention with psychosocial components. We excluded medication withdrawal or substitution interventions, interventions without direct interpersonal contact and communication, and interventions solely addressing policy changes or structural interventions. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Critical appraisal of studies addressed risks of selection, performance, attrition and detection bias, as well as criteria related to cluster randomisation. We retrieved data on the complex interventions on the basis of the TIDieR (Template for Intervention Description and Replication) checklist. Our primary outcomes were 1. use of regularly prescribed antipsychotic medication and 2. ADVERSE EVENTS Our secondary outcomes were 3. mortality; 4. BPSD; 5. quality of life; 6. prescribing of regularly psychotropic medication; 7. regimen of regularly prescribed antipsychotic medication; 8. antipsychotic medication administered 'as needed'; 9. physical restraints; 10. cognitive status; 11. depression; 12. activities of daily living; and 13. COSTS We used GRADE to assess certainty of evidence. MAIN RESULTS We included five cluster-randomised controlled studies (120 clusters, 8342 participants). We found pronounced clinical heterogeneity and therefore decided to present study results narratively. All studies investigated complex interventions comprising, among other components, educational approaches. Because of the heterogeneity of the results, including the direction of effects, we are uncertain about the effects of psychosocial interventions on the prescription of antipsychotic medication. One study investigating an educational intervention for care home staff assessed the use of antipsychotic medication in days of use per 100 resident-days, and found this to be lower in the intervention group (mean difference 6.30 days, 95% confidence interval (CI) 6.05 to 6.66; 1152 participants). The other four studies reported the proportion of participants with a regular antipsychotic prescription. Of two studies implementing an intervention to promote person-centred care, one found a difference in favour of the intervention group (between-group difference 19.1%, 95% CI 0.5% to 37.7%; 338 participants), while the other found a difference in favour of the control group (between-group difference 11.4%, 95% CI 0.9% to 21.9%; 862 participants). One study investigating an educational programme described as "academic detailing" found no difference between groups (odds ratio 1.06, 95% CI 0.93 to 1.20; 5363 participants). The fifth study used a factorial design to compare different combinations of interventions to supplement person-centred care. Results showed a positive effect of medication review, and no clear effect of social interaction or exercise. We considered that, overall, the evidence about this outcome was of low certainty. We found high-certainty evidence that psychosocial interventions intended primarily to reduce antipsychotic use resulted in little to no difference in the number of falls, non-elective hospitalisations, or unplanned emergency department visits. Psychosocial interventions intended primarily to reduce antipsychotic use also resulted in little to no difference in quality of life (moderate-certainty evidence), and BPSD, regular prescribing of psychotropic medication, use of physical restraints, depression, or activities of daily living (all low-certainty evidence). We also found low-certainty evidence that, in the context of these interventions, social interaction and medication review may reduce mortality, but exercise does not. AUTHORS' CONCLUSIONS All included interventions were complex and the components of the interventions differed considerably between studies. Interventions and intervention components were mostly not described in sufficient detail. Two studies found evidence that the complex psychosocial interventions may reduce antipsychotic medication use. In addition, one study showed that medication review might have some impact on antipsychotic prescribing rates. There were no important adverse events. Overall, the available evidence does not allow for clear generalisable recommendations.
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Affiliation(s)
- Julia Lühnen
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Institute of Clinical Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Tanja Richter
- Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany
| | - Stella Calo
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Gabriele Meyer
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sascha Köpke
- Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany
- Institute of Nursing Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ralph Möhler
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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Huizenga J, Scheffelaar A, Bleijenberg N, Wilken JP, Keady J, Van Regenmortel T. What matters most: Exploring the everyday lives of people with dementia. Int J Geriatr Psychiatry 2023; 38:e5983. [PMID: 37565538 DOI: 10.1002/gps.5983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES Research on what matters most to people with dementia is crucial for developing tailored interventions and support. This study explored how people with dementia experience their everyday lives, providing insight into what is important to them to live the best they can at home. METHODS Inspired by a phenomenological approach, open interviews were conducted with 15 people with dementia, supplemented by home tours and walking interviews. Data collection included one to three sessions per participant. Data were analysed using descriptive content analysis and followed the phases of open, axial, and selective coding. A co-researcher group of seven people with dementia was consulted during the analysis to help interpret the emergent findings. FINDINGS Six dimensions of what matters most in everyday life were identified: 1) Engaging in meaningful activities, which included routines, household chores, leisure, day activities, and volunteering or work; 2) Keeping a sense of connection, in relationships within the home, with family, friends, groups, and the neighbourhood; 3) Having a sense of belonging, which included attachments inside and outside the home, and to cherished objects; 4) Connecting to self, which included the ability to reflect on past experiences, live in the present moment and anticipate the future; 5) Adjusting to ongoing changes, which included alterations in sensory perceptions, perceptions of the physical environment, and navigating shifts in interpersonal dynamics; 6) Being open to help and support, from professionals, community and society. CONCLUSIONS For people with dementia, everyday life is a continuous balancing act between what matters most and what can be achieved daily. This is not only related to dementia but is also embedded in the wider perspective of life history, relational networks, and the physical environment. This study highlights the importance of identifying what matters most to people with dementia to provide person-centred support.
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Affiliation(s)
- Jacoba Huizenga
- Institute of Social Work, HU University of Applied Sciences, Utrecht, The Netherlands
- Research Center Social Innovation, HU University of Applied Sciences, Utrecht, The Netherlands
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Aukelien Scheffelaar
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Nienke Bleijenberg
- Research Center Healthy & Sustainable Living, HU University of Applied Sciences, Utrecht, The Netherlands
- Department Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jean Pierre Wilken
- Research Center Social Innovation, HU University of Applied Sciences, Utrecht, The Netherlands
| | - John Keady
- Division of Nursing, Midwifery and Social Work/Greater Manchester Mental Health NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Tine Van Regenmortel
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- HIVA-Research Institute for Work and Society, Faculty of Social Sciences, University of Leuven, Leuven, Belgium
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Beyene DA, Berha AB. Management Practice and Clinical Outcomes of Dementia in Sub-Saharan Africa: A Systematic Review. Behav Neurol 2023; 2023:2307443. [PMID: 37533682 PMCID: PMC10393511 DOI: 10.1155/2023/2307443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 06/03/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dementia is a severe neurodegenerative disorder and it is a group of acquired symptoms associated with impaired cognitive functions. In low-income settings particularly in Sub-Saharan Africa (SSA), it is often seen as part of normal aging. Environmental, behavioral, and lifestyle interventions have the potential to alter the disease course of dementia. Objective This study is aimed to synthesize the literature/evidence(s) on the management practice and treatment outcomes of dementia in SSA. Method Comprehensive literature was searched in PubMed database, Cochrane Library, and Google Scholar. Eligibility has been set, and based on the criteria, initially, a total of 442 results were obtained, and from those around 183 articles were duplicated. After examining titles and abstracts of records 26 articles were identified. Finally, five randomized clinical trials (RCT) and three prospective cohort studies that were reported on the management practice and treatment outcome of dementia in SSA were eligible for analysis. RCT and prospective cohort studies were used to strengthen the quality of evidence. The quality of the included RCT studies was assessed by using the Cochrane Risk of Bias Tool. Result A total of 2781 patient data were included in the final analysis. Of these, 2354 patients were obtained from 5 RCTs and 427 patients from 3 prospective cohort studies, which were conducted in SSA countries. RCT studies were done on the feasibility and clinical effectiveness of cognitive stimulation therapy (CST) showed improvements in language memory domains and physical health. In addition, studies that focus on the management of human immunodeficiency virus-associated dementia (HIVAD) were reported to improve neurocognitively. Conclusion CST is applicable in low-resource settings and it shows improvements in cognitive function and quality of life. Early initiation of combination antiretroviral therapy in resource-limited settings has been associated with improvement in the cognitive function of HIVAD.
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Affiliation(s)
- Dessale Abate Beyene
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemseged Beyene Berha
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Zhu X, Dong Z, Wu Y, Xu DW. A review of different types of volunteer programs for older adults with and without cognitive impairment. Front Public Health 2023; 11:1164952. [PMID: 37397711 PMCID: PMC10311508 DOI: 10.3389/fpubh.2023.1164952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Theoretical models and empirical evidence suggest an association between volunteering and health outcomes in older adults. However, less is known about existing programs that involve older adults engaging in formal volunteering, especially programs for older volunteers with cognitive impairment. In this review, we summarized and evaluated different types of volunteering-based programs involving older volunteers with and without cognitive impairment. After a non-systematic literature search, we presented eight example volunteer programs. Older volunteers participate in the programs in person or remotely. In five of the programs, older volunteers without cognitive impairment participate in intergenerational engagement, support and referral, home visiting, and dementia care services. The other three programs specifically recruit older volunteers with cognitive impairment and provide intergenerational engagement and individualized volunteer activities. Both strengths and challenges identified in the programs were discussed. Different types of volunteering-based programs are available for engaging older volunteers. For volunteers to remain active during the pandemic or for volunteers who live with cognitive impairment, remote programs can be a valuable alternative. Program effects on older volunteers need to be tested in more rigorously designed studies.
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Affiliation(s)
- Xianghe Zhu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, China
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhiwei Dong
- College of Management, Weifang Medical University, Weifang, China
| | - Yili Wu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, China
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dong-Wu Xu
- Department of Psychology, School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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Borella E, Melendugno A, Meneghetti C, Murroni V, Carbone E, Goldin G, Cavalli R, Basso A, Pazzaglia F. Effects of an outdoor horticultural activities program on cognitive and behavioral functioning, mood, and perceived quality of life in people with dementia: a pilot study. Front Psychol 2023; 14:1182136. [PMID: 37529310 PMCID: PMC10390226 DOI: 10.3389/fpsyg.2023.1182136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/12/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction One of various non-pharmacological treatments for people with dementia (PwD) is horticultural therapy. The aim of this double-blind, pre- and post-test, pilot study was to examine the effects of horticultural activities (HA) for PwD at a residential and daytime care facility. Whether combining HA with elements drawn from other psychosocial interventions (cognitive stimulation) would maximize any benefits was also newly examined. Materials and methods Twenty-four PwD were involved either in HA, alone (TG1, N = 7) or combined with some cognitive stimulation (TG2, N = 8), or in indoor treatment-as-usual activities (CG, N = 9). Benefits were assessed in terms of general cognitive functioning (for participants with mild-to-moderate dementia), mood, behavioral and psychological symptoms, and quality of life. Results No differences emerged between TG1 and TG2 in any outcome measure, so the two groups were combined (N = 15). Compared with the CG, the TG involved in HA exhibited less frequent and severe behavioral and psychological symptoms and an improved mood after the intervention. Caregivers also reported less distress in the TG after the intervention than in the CG. Considering only PwD with mild-to-moderate dementia, the TG also showed benefits in a measure of general cognitive functioning, and self-reported quality of life, compared with the CG. Discussion Our results further confirm that engaging PwD in participatory HA in contact with natural elements can decrease their dementia symptoms and their caregivers' distress, but also increase PwD's quality of life. Our findings also suggest the need to consider dementia severity when assessing the benefits of horticultural therapy.
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Affiliation(s)
- Erika Borella
- Department of General Psychology, University of Padova, Padova, Italy
- Inter-University Research Center in Environmental Psychology (CIRPA), Rome, Italy
| | | | - Chiara Meneghetti
- Department of General Psychology, University of Padova, Padova, Italy
- Inter-University Research Center in Environmental Psychology (CIRPA), Rome, Italy
| | - Veronica Murroni
- Department of General Psychology, University of Padova, Padova, Italy
| | - Elena Carbone
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giulia Goldin
- Department of General Psychology, University of Padova, Padova, Italy
| | - Raffaele Cavalli
- Department of Land Environment, Agriculture and Forestry, University of Padova, Padova, Italy
| | | | - Francesca Pazzaglia
- Department of General Psychology, University of Padova, Padova, Italy
- Inter-University Research Center in Environmental Psychology (CIRPA), Rome, Italy
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El Baou C, Desai R, Cooper C, Marchant NL, Pilling S, Richards M, Saunders R, Buckman JEJ, Aguirre E, John A, Stott J. Psychological therapies for depression and cardiovascular risk: evidence from national healthcare records in England. Eur Heart J 2023; 44:1650-1662. [PMID: 37072130 PMCID: PMC10163979 DOI: 10.1093/eurheartj/ehad188] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 04/20/2023] Open
Abstract
AIMS People with depression are up to 72% more at risk to develop cardiovascular disease (CVD) in their lifetime. Evidence-based psychotherapies are first-line interventions for the treatment of depression and are delivered nationally in England through the National Health Service via the Improving Access to Psychological Therapy (IAPT) primary care programme. It is currently unknown whether positive therapy outcomes may be associated with cardiovascular risk reduction. This study aimed to examine the association between psychotherapy outcomes for depression and incident CVD. METHODS AND RESULTS A cohort of 636 955 individuals who have completed a course of psychotherapy was built from linked electronic healthcare record databases of national coverage in England: the national IAPT database, the Hospital Episode Statistics (HES) database, and the HES-ONS (Office of National Statistics) mortality database. Multivariable Cox models adjusting for clinical and demographic covariates were run to estimate the association between reliable improvement from depression and the risk of subsequent incidence of cardiovascular events. After a median follow-up of 3.1 years, reliable improvement from depression symptoms was associated with a lower risk of new onset of any CVD [hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.86, 0.89], coronary heart disease (HR: 0.89, 95% CI: 0.86, 0.92), stroke (HR: 0.88, 95% CI: 0.83, 0.94), and all-cause mortality (HR: 0.81, 95% CI: 0.78, 0.84). This association was stronger in the under 60 compared with the over 60 for all outcomes. Results were confirmed in sensitivity analyses. CONCLUSION Management of depression through psychological interventions may be associated with reduced risk of CVD. More research is needed to understand the causality of these associations.
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Affiliation(s)
- Céline El Baou
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
| | - Roopal Desai
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Tower Hamlets Memory Service, East London NHS Foundation Trust, London, UK
| | | | - Steve Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
| | - Rob Saunders
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Joshua E J Buckman
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
- iCope—Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Elisa Aguirre
- North East London NHS Foundation Trust (NELFT), London, UK
| | - Amber John
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
| | - Joshua Stott
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
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Huynh K, Nategh L, Jamadar S, Stout J, Georgiou-Karistianis N, Lampit A. Cognition-oriented treatments and physical exercise on cognitive function in Huntington's disease: a systematic review. J Neurol 2023; 270:1857-1879. [PMID: 36513779 DOI: 10.1007/s00415-022-11516-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022]
Abstract
Cognitive impairment is prevalent in Huntington's disease (HD), with no treatments currently available. While cognition-oriented treatments and physical exercise have shown efficacy in improving cognition in other populations, they have not been systematically reviewed in HD. This systematic review aims to examine the effects of cognitive and exercise interventions on cognition in HD, along with effects on psychosocial function, functional independence, and neuroimaging outcomes. Seventeen studies (three cognitive, seven exercise, seven combining cognitive and physical exercise) were included. While there was generally low certainty of evidence, interventions that included cognitive training appeared to have larger effect sizes on cognition, while physical exercise (alone or combined with cognitive rehabilitation or stimulation) showed negligible effect sizes. On the other hand, combined interventions had larger effects on psychosocial function. Finally, effects on functional independence appeared negligible following exercise and combined interventions, and effects on neuroimaging outcomes were inconclusive. Larger studies should seek to confirm the benefits of cognitive and physical interventions, and further explore changes in functional independence and neural outcomes.
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Affiliation(s)
- Katharine Huynh
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton, Victoria, 3800, Australia
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Grattan St, Parkville, Victoria, 3010, Australia
| | - Leila Nategh
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Grattan St, Parkville, Victoria, 3010, Australia
| | - Sharna Jamadar
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton, Victoria, 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Clayton, Victoria, 3800, Australia
| | - Julie Stout
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton, Victoria, 3800, Australia
| | - Nellie Georgiou-Karistianis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton, Victoria, 3800, Australia.
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Grattan St, Parkville, Victoria, 3010, Australia
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Brown P, Harrison Dening K. Assessing and managing agitation as a symptom of dementia. Nurs Older People 2023; 35:e1433. [PMID: 36883890 DOI: 10.7748/nop.2023.e1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 03/09/2023]
Abstract
Behavioural and psychological symptoms of dementia (BPSD) affect more than one third of people with dementia at some point during the course of their condition. Agitation is the third most common BPSD but is the least well understood in terms of identification and management. Furthermore, agitation as a symptom of dementia is often confused with agitation as a way of expressing an emotion or unmet need. Psychosocial interventions are recommended to support the person with dementia and their family carers to manage agitation as a symptom of dementia, as well as other BPSD, in a person-centred manner. Some psychosocial interventions for managing agitation as a symptom of dementia have shown benefits, but further investigation of the usefulness of a range of interventions is needed. This article discusses the assessment and management of agitation as a symptom of dementia and illustrates their application through a case study.
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Affiliation(s)
- Pat Brown
- Dementia UK, London, England and PhD student, University College London, London, England
| | - Karen Harrison Dening
- Dementia UK, London, England and honorary professor of dementia nursing, De Montfort University, Leicester, England
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Luo G, Zhang J, Song Z, Wang Y, Wang X, Qu H, Wang F, Liu C, Gao F. Effectiveness of non-pharmacological therapies on cognitive function in patients with dementia-A network meta-analysis of randomized controlled trials. Front Aging Neurosci 2023; 15:1131744. [PMID: 36967820 PMCID: PMC10035791 DOI: 10.3389/fnagi.2023.1131744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Objective Non-pharmacological therapies (NPTs) have received increasing attention from researchers as a category of treatment to improve cognitive impairment in patients with dementia because of their fewer side effects. In this study, photobiomodulation (PBM), enriched environment (EE), exercise therapy (ET), computerized cognitive training (CCT), and cognitive stimulation therapy (CST) were selected to compare the effects of NPTs that improve dementia by quantifying information from randomized controlled trials (RCTs). Methods We did a systematic review and network meta-analysis. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure Database, Wan Fang Database, Chinese Biomedical Literature Database, Web of Science, and VIP Database from the time of database creation to 1 August 2022. Two investigators independently screened the literature, extracted information, and assessed the RCTs' quality with the Cochrane Collaboration Network Risk of Bias 2.0. Network meta-analysis was performed using R language (X64 version 4.1.3) and STATA 17.0. Results We identified 1,268 citations and of these included 38 trials comprising 3,412 participants. For improving dementia, the results of the network meta-analysis showed that compared with the control group (CON), PBM (SMD = 0.90, 95% CI: 0.43-1.37), EE (SMD = 0.71, 95% CI: 0.02-1.41), ET (SMD = 0.42, 95% CI: 0.16-0.68), and CST (SMD = 0.36, 95% CI: 0.11-0.62) were significantly different (P < 0.05); There was no significant difference in CCT (SMD = 0.41, 95% CI: -0.07-0.88) (P > 0.05). The ranked results showed that PBM has more potential to be the best intervention (P = 0.90). In addition, there was a significant difference between PBM and CST in improving cognitive function (SMD = 0.54, 95% CI: 0.00; 1.08, P < 0.05). Conclusion In this study, NPTs have excellent potential to improve cognition in people with dementia, and PBM may have more significant benefits in improving cognition than the other four NPTs. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022363746.
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Affiliation(s)
- Guangxin Luo
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Junqiu Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Zeyi Song
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, China
| | - Ying Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xiaojing Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Haifeng Qu
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, China
| | - Fang Wang
- Department of Psychology, The Fourth People’s Hospital of Wuhu, Wuhu, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, China
| | - Fujia Gao
- School of Public Health, North China University of Science and Technology, Tangshan, China
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, School of Public Health, North China University of Science and Technology, Tangshan, China
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Mossello E, Baccini M, Caramelli F, Biagini CA, Cester A, De Vreese LP, Darvo G, Vampini C, Gotti M, Fabbo A, Marengoni A, Cavallini MC, Gori G, Chattat R, Marini M, Ceron D, Lanzoni A, Pizziolo P, Mati A, Zilli I, Cantini C, Caleri V, Tonon E, Simoni D, Mecocci P, Ungar A, Masotti G. Italian guidance on Dementia Day Care Centres: A position paper. Aging Clin Exp Res 2023; 35:729-744. [PMID: 36795236 PMCID: PMC9933825 DOI: 10.1007/s40520-023-02356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023]
Abstract
Dementia Day Care Centres (DDCCs) are defined as services providing care and rehabilitation to people with dementia associated with behavioural and psychological symptoms (BPSD) in a semi-residential setting. According to available evidence, DDCCs may decrease BPSD, depressive symptoms and caregiver burden. The present position paper reports a consensus of Italian experts of different disciplines regarding DDCCs and includes recommendations about architectural features, requirements of personnel, psychosocial interventions, management of psychoactive drug treatment, prevention and care of geriatric syndromes, and support to family caregivers. DDCCs architectural features should follow specific criteria and address specific needs of people with dementia, supporting independence, safety, and comfort. Staffing should be adequate in size and competence and should be able to implement psychosocial interventions, especially focused on BPSD. Individualized care plan should include prevention and treatment of geriatric syndromes, a targeted vaccination plan for infectious diseases including COVID-19, and adjustment of psychotropic drug treatment, all in cooperation with the general practitioner. Informal caregivers should be involved in the focus of intervention, with the aim of reducing assistance burden and promoting the adaptation to the ever-changing relationship with the patient.
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Affiliation(s)
- Enrico Mossello
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy.
| | | | - Francesca Caramelli
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy
| | | | | | - Luc Pieter De Vreese
- Department of Mental Health and Addictions, Cognitive Clinic, Azienda USL Modena, Italy
| | - Gianluca Darvo
- Department of Architecture, University of Florence, Florence, Italy
| | - Claudio Vampini
- Psychiatric and Psychogeriatric Service, San Francesco Hospital, Garofalo Health Care, Verona, Italy
| | - Mabel Gotti
- Psychotherapist and Psychoanalyst, Italian Society of Interpersonal Psychoanalysis, Florence, Italy
| | - Andrea Fabbo
- Cognitive Disorders and Dementia Unit, Health Authority and Services of Modena, Modena, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Chiara Cavallini
- Continuity of Care Agency, Department of Geriatrics, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Guido Gori
- Scientific Director, PAS Pubbliche Assistenze Foundation, Florence, Italy
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Monica Marini
- Staff Coordinator, Healthcare Executive, Tuscany Region, Italy
| | - Davide Ceron
- Opera Immacolata Concezione Foundation, Padua, Italy
| | - Alessandro Lanzoni
- Cognitive Disorders and Dementia Unit, Primary Care Department, Health District of Modena, Modena, Italy
| | | | | | | | | | | | | | - David Simoni
- Health Area Manager, Arnera Cooperativa Sociale, Pontedera, Italy
| | - Patrizia Mecocci
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | - Andrea Ungar
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy
| | - Giulio Masotti
- Department of Experimental and Clinical Medicine, Research Unit of Medicine of Ageing, University of Florence, Florence, Italy
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Abstract
BackgroundWomen in many cohorts have a higher risk for Alzheimer's disease (AD), the most common form of dementia. Sex is a biological construct whereby differences in disease manifestation and prevalence are rooted in genetic differences between XX and XY combinations of chromosomes. This chapter focuses specifically on sex-driven differences in dementia, as opposed to differences driven by gender - a social construct referring to the societal norms that influence people's roles, relationships, and positional power throughout their lifetime.MethodsUsing a narrative review, this chapter explored the characteristics and risk factors for the dementias, alongside a discussion of sex differences including loss of sex steroid hormones in middle-aged women, differences in the prevalence of cardiovascular diseases and engagement in lifestyle protective factors for dementia.ResultsThe sex difference in AD prevalence may exist because of systematic and historic differences in risk and protective factors for dementia, including level of education obtained and socioeconomic status differences, which can impact on health and dementia risk.Levels of sex steroids decline significantly after menopause in women, whereas this is more gradual in men with age. Animal and cell culture studies show strong biological plausibility for sex steroids to protect the ageing brain against dementia. Sex steroid hormone replacement therapy has in some observational studies shown to protect against AD, but treatment studies in humans have mainly shown disappointing results. Cardiovascular disease (CVD) shares midlife medical risk (e.g. hypertension, hyperlipidaemia, obesity etc.) factors with AD and other forms of dementia, but also with related lifestyle risk - and protective factors (e.g. exercise, not smoking etc.). Men tend to die earlier of CVD, so fewer survive to develop AD at an older age. Those who do survive may have healthier lifestyles and fewer risk factors for both CVD and AD. An earlier age at menopause also confers great risk for both without hormone treatment.DiscussionIt could be the case that the decline in sex steroids around the menopause make women more susceptible to lifestyle-related risk factors associated with dementia and CVD, but this remains to be further investigated. Combining hormone treatment with lifestyle changes in midlife (e.g. exercise) could be an important preventative treatment for dementia and CVD in later life, but this also requires further research.
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Abstract
BACKGROUND People with young onset dementia can experience stigmatization and social isolation. Peer support provides an opportunity for social connection and support. However, access to in-person peer support groups varies across the UK, and during the COVID-19 pandemic in-person peer support groups moved online. OBJECTIVES We explored the experiences of people with young onset dementia attending peer support meetings through online videoconferencing platforms, and identified barriers and facilitators. METHODS A focus group study with existing peer support groups for people with young onset dementia that had their meetings online was conducted. Participants were people living with young onset dementia. Participants were recruited through convenience and purposeful sampling. Initial contact was made with the group facilitator to discuss the study purposes and assess eligibility of the group members. The data was analysed thematically by two independent researchers, using an inductive approach. FINDINGS Four focus groups with UK-based peer support groups were conducted through the group's usual platform, including 20 participants. Through online peer support people stayed connected during the pandemic. It provided opportunities to meet people from different places and be involved in research projects. People found it a convenient way of connecting with others without having to travel. However, some missed in-person interaction and digital exclusion and challenges to navigate different platforms were identified as barriers. Organisational skills of the facilitator and support with getting into meetings can help overcome these challenges. CONCLUSION Online platforms can make peer support more accessible for people with young onset dementia as it overcomes geographical barriers as well as barriers for those who feel uncomfortable attending an in-person group. Researchers and policy makers should explore how to implement and overcome barriers to online peer support, so that peer support is more widely accessible and clearly signposted to people with young onset dementia.
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Affiliation(s)
- Esther Vera Gerritzen
- Esther V Gerritzen, Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, UK.
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Koh WQ, Hoel V, Casey D, Toomey E. Strategies to Implement Pet Robots in Long-Term Care Facilities for Dementia Care: A Modified Delphi Study. J Am Med Dir Assoc 2023; 24:90-99. [PMID: 36332687 DOI: 10.1016/j.jamda.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/07/2022] [Accepted: 09/24/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Pet robots are technology-based substitutes for live animals that have demonstrated psychosocial benefits for people living with dementia in long-term care. However, little research has been conducted to understand how pet robots should be implemented in routine care. This study aims to identify, contextualize, and achieve expert consensus on strategies to implement pet robots as part of dementia care in long-term care facilities. DESIGN A 2-round modified Delphi study. SETTINGS AND PARTICIPANTS An international panel of 56 experts from 14 countries, involving care professionals, organizational leaders, and researchers. METHODS A list of potentially relevant strategies was identified, contextualized, and revised using empirical data and through stakeholder consultations. These strategies constituted statements for Round 1. Experts rated the relative importance of each statement on a 9-point scale, and free-text fields allowed them to provide justifications. Consensus was predefined as ≥75% agreement. Statements not reaching an agreement were brought forward to Round 2. Quantitative data were analyzed using descriptive statistics, and textual data were analyzed using inductive content analysis. RESULTS Thirteen strategies reached consensus; 11 were established as critical: (1) assess readiness and identify barriers and facilitators, (2) purposely reexamine the implementation, (3) obtain and use residents' and their family's feedback, (4) involve residents and their family, (5) promote adaptability, (6) conduct ongoing training, (7) conduct educational meetings, (8) conduct local consensus discussions, (9) organize clinician implementation team meetings, (10) provide local technical assistance, and (11) access new funding. Other strategies received differing extents of agreement. Reasons for variations included contextual differences, such as resource availability, organizational structures, and staff turnover. CONCLUSIONS AND IMPLICATIONS This study identified the most relevant strategies that can be used by technology developers, care providers, and researchers to implement pet robots in long-term care facilities for dementia care. Further development, specification, and testing in real-world settings are needed.
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Affiliation(s)
| | - Viktoria Hoel
- Institute for Public Health and Nursing Research, University of Bremen, Germany; Leibniz Science Campus Digital Public Health, Bremen, Germany
| | | | - Elaine Toomey
- School of Allied Health, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
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García-Alberca JM, de la Rosa MD, Solo de Zaldívar P, Ledesma M, Oltra E, Gris E, Ocejo O, Torrecilla J, Zafra C, Sánchez-Fernández A, Mancilla T, López-Romero M, Jerez R, Santana N, Lara JP, Barbancho MÁ, Blanco-Reina E. Effect of Nordic Sensi® Chair on Behavioral and Psychological Symptoms of Dementia in Nursing Homes Residents: A Randomized Controlled Trial. J Alzheimers Dis 2023; 96:1609-1622. [PMID: 38007648 PMCID: PMC10741310 DOI: 10.3233/jad-230391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Behavioral and psychological symptoms of dementia (BPSD) are present in most people with dementia (PwD), including Alzheimer's disease. There is consensus that non-pharmacological therapies represent the first line of treatment to address BPSD. OBJECTIVE We explore the efficacy of the use of a rocking chair (Nordic Sensi® Chair, NSC) in the treatment of BPSD in nursing home residents with moderate and severe dementia. METHODS We carried out a 16-week randomized, single-blind, controlled, clinical trial with PwD admitted to nursing homes. Participants were assigned to a treatment group (n = 40) that received three times a week one session per day of 20 minutes in the NSC and a control group (n = 37). The Neuropsychiatric Inventory-Nursing Home (NPI-NH) was used as primary efficacy outcome. Occupational distress for the staff was evaluated using the NPI-NH Occupational Disruptiveness subscale (NPI-NH-OD). Statistical analyses were conducted by means of a Mixed Effects Model Analysis. RESULTS Treatment with the NSC was associated with a beneficial effect in most of BPSD, as reflected by differences between the treatment and control group on the NPI-NH total score (mean change score -18.87±5.56 versus -1.74±0.67, p = 0.004), agitation (mean change score -2.32±2.02 versus -0.78±1.44, p = 0.003) and irritability (mean change score -3.35±2.93 versus -1.42±1.31, p = 0.004). The NPI-NH-OD total score also improved the most in the treatment group (mean change score -9.67±7.67 versus -7.66±6.08, p = 0.003). CONCLUSIONS The reduction in overall BPSD along with decreased caregiver occupational disruptiveness represent encouraging findings, adding to the potential of nonpharmacological interventions for nursing home residents living with dementia.
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Affiliation(s)
- José María García-Alberca
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - María Dolores de la Rosa
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - Paloma Solo de Zaldívar
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - María Ledesma
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - Estela Oltra
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - Esther Gris
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - Olga Ocejo
- Centro Residencial Almudena, Rincón de laVictoria, Spain
| | | | - Carmen Zafra
- Centro Residencial Almudena, Rincón de laVictoria, Spain
| | | | - Tomás Mancilla
- Residencia DomusVi Fuentesol, Alhaurín de la Torre, Spain
| | | | - Raquel Jerez
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - Nuria Santana
- Alzheimer Research Center and Memory Clinic, Instituto Andaluz de Neurociencia (IANEC), Málaga, Spain
| | - José Pablo Lara
- Brain Health Unit, School of Medicine, University of Málaga, Málaga, Spain
| | | | - Encarnación Blanco-Reina
- Pharmacology and Therapeutics Department, School of Medicine, University of Málaga, Málaga, Spain
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Bartels C, Abdel-Hamid M, Wiltfang J, Schneider A, Belz M. Antidepressant Effects of a Multimodal Group Therapy Program for Mild Dementia: A Retrospective Evaluation of Clinical Routine Data. J Alzheimers Dis 2022; 90:1725-1737. [PMID: 36336930 DOI: 10.3233/jad-220578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The multimodal CORDIAL treatment concept for mild dementia, combining cognitive rehabilitation, cognitive behavioral and humanistic psychology interventions, has proven its feasibility and demonstrated a reduction of depressive symptoms in individual dyadic/triadic settings. OBJECTIVE We investigate antidepressant effects of an adapted group-based CORDIAL program in clinical routine care. METHODS During 2013 and 2017, 51 outpatients with mild dementia (45% female, mean age 72.4 years, 67% Alzheimer's dementia, mean MMST 24.8) periodically received a modified CORDIAL group treatment as part of our regular outpatient care. Treatment comprised 10 bi-weekly sessions, partly involving caregivers. Systematic pre- and post-treatment assessments of clinical routine data were evaluated retrospectively (median time-interval of 6.6 months). RESULTS Depressive symptoms as measured by the Geriatric Depression Scale significantly decreased over time (p = 0.007, Cohen's d = 0.39), and irrespective of gender. Patients with longer disease duration before treatment start showed significantly higher initial levels of depressive symptoms (p = 0.044), followed by a reduction to a level of those with shorter disease duration (ns). Most secondary outcomes (cognitive symptoms, disease severity, quality of life, caregiver burden) remained unchanged (ns), while competence in activities of daily living declined from pre- to post-measurement (p = 0.033). CONCLUSION A group-based CORDIAL treatment is feasible in a clinical routine setting and demonstrated antidepressant effects comparable to those of the individual treatment design, further suggesting its implementation in regular care. Future trials might also investigate its potentially preventive effects by reducing depressive symptoms in pre-dementia stages, even at a subsyndromal level.
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Affiliation(s)
- Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
| | - Mona Abdel-Hamid
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany.,Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, LVR-Hospital Essen, Essen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.,Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Michael Belz
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
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Home-Based Individualized Cognitive Stimulation (iCS) Therapy in Portuguese Psychiatric Patients: A Randomized Controlled Trial. Brain Sci 2022; 12:brainsci12121655. [PMID: 36552114 PMCID: PMC9775072 DOI: 10.3390/brainsci12121655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Cognitive difficulties are common in people with mental health issues, including psychotic disorders, although this population may have difficulty accessing treatments due to various challenges, including transportation, remembering appointments, or discomfort in crowded or unfamiliar places. Home-based services can be crucial and effective for reaching populations with accessibility issues; one home-based intervention technique is individual cognitive stimulation (iCS), which has been shown to be an effective strategy to target and improve cognitive functioning in various samples. Using a previously established Portuguese iCS protocol, based on an initial brief cognitive assessment and the subsequent administration of cognitive stimulation materials and reflection exercises, the current randomized controlled trial explored the effectiveness of the iCS intervention on participants in Portugal with psychotic disorders. Outcome tools included measures of cognition, depression, quality of life, and functional abilities at baseline, the completion of the intervention, and post-intervention follow-up. With two well-matched groups at baseline, the results revealed significant improvements in the intervention group on cognitive functioning, depression, quality of life, and, more modestly, functional activities. These results offer an important contribution to the field of iCS protocols, in an effort to enhance the lives and well-being of various clinical populations, including those with psychotic disorders.
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Begde A, Jain M, Hogervorst E, Wilcockson T. Does physical exercise improve the capacity for independent living in people with dementia or mild cognitive impairment: an overview of systematic reviews and meta-analyses. Aging Ment Health 2022; 26:2317-2327. [PMID: 34951548 PMCID: PMC9662184 DOI: 10.1080/13607863.2021.2019192] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To summarise existing systematic reviews which assessed the effects of physical exercise on activities of daily living, walking, balance and visual processing in people with dementia or mild cognitive impairment. METHODS In this overview of systematic reviews and meta-analyses, seven electronic databases were searched to identify eligible reviews published between January 2015 and April 2021. RESULTS A total of 30 systematic reviews were identified and included in the overview. The most frequent type of exercise for the intervention group was multimodal exercises. Mind-body exercises, exergames, dance intervention and aerobic exercise were other exercise types. Most of the reviews reported that exercise is significantly effective for improving activities of daily living (SMD 95%CI, from 0.27 to 1.44), walking (SMD 95%CI, from 0.08 to 2.23), balance (SMD 95%CI, from 0.37 to 2.24) and visuospatial function (SMD 95%CI, from 0.16 to 0.51), which are among the most leading determinants of independent living in individuals with dementia or mild cognitive impairment. CONCLUSION Evidence has shown that exercise (especially multicomponent exercise programmes including cognitive, physical and multitasking exercises) with sufficient intensity improves the activities of daily living skills. Exercise also improves walking, balance and visual processing, which can provide a more independent life for people with dementia and mild cognitive impairment. Cognitively impaired people should therefore be encouraged to exercise regularly in order to be more independent. UNLABELLED Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2019192.
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Affiliation(s)
- Ahmet Begde
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK,CONTACT Ahmet Begde
| | - Manisha Jain
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Thomas Wilcockson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Mabire JB, Bouaziz N, de Malherbe A, Charras K. Inclusive Choir for Persons Living with Dementia: A Qualitative Study. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2151801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
| | - Nathalie Bouaziz
- Centre d’Accueil de Jour la Porte Verte, Accueil de jour, Versailles, France
| | - Adèle de Malherbe
- Centre d’Accueil de Jour la Porte Verte, Accueil de jour, Versailles, France
| | - Kevin Charras
- Living lab Vieillissement et Vulnérabilités, Service de Gériatrie, CHU de Rennes, Rennes, France
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Haaksma ML, O'Driscoll C, Joling KJ, Achterberg WP, Francke AL, van der Steen JT, Smaling HJA. Evaluating the feasibility, experiences, facilitators of and barriers to carers and volunteers delivering Namaste Care to people with dementia in their own home: a qualitative interview study in the UK and the Netherlands. BMJ Open 2022; 12:e063422. [PMID: 36375973 PMCID: PMC9664309 DOI: 10.1136/bmjopen-2022-063422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility, facilitators of and barriers to delivering Namaste Care by volunteers and family carers to community-dwelling people with dementia, and to map family carers and volunteers' experiences with the programme. DESIGN Qualitative interview study with two phases: (1) preparation phase; (2) pilot phase. SETTING Private residences of community-dwelling people with dementia in the UK and the Netherlands. PARTICIPANTS Family carers and volunteers of community-dwelling people with dementia (phase 1: 36 Dutch interviews, phase 2: 9 Dutch and 16 UK interviews). INTERVENTION Namaste Care is a multicomponent psychosocial programme, originally developed for people with dementia residing in long-term care facilities. Meaningful activities were offered by carers and volunteers. Each person with dementia was offered 10 one-hour sessions. RESULTS Phase 1: Namaste Care was deemed feasible for community-dwelling people with dementia and no major adaptations to the programme were considered necessary. Phase 2: perceived effects of Namaste Care on people with dementia included improved mood and increased interaction. The programme appeared enriching for both family carers and volunteers, providing joy, respite from care and new insights for coping with challenging behaviour. A flexible attitude of the Namaste provider facilitated its delivery. High caregiver burden and a strained relationship between the family carer and person with dementia were considered barriers. Experiences of family carers and volunteers with Namaste Care were very positive (mean satisfaction rating: 8.7 out of 10, SD=0.9, range 7-10). CONCLUSION We recommend offering Namaste Care delivered by volunteers, preferably multiple sessions per week of 1.5-2 hours to optimise quality of life of community-dwelling people with dementia. Working with well-matched, flexible Namaste providers is pivotal. Family involvement should be encouraged, although the extent should be adapted depending on preference, caregiver burden and the relationship between the family carer and the person with dementia. TRIAL REGISTRATION NUMBER NL5570.
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Affiliation(s)
- Miriam L Haaksma
- University Network for the Care Sector South Holland, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | | | - Karlijn J Joling
- Amsterdam Public Health research Institute, Department of Medicine for Older People, Amsterdam UMC, VUmc site, Amsterdam, Netherlands
| | - Wilco P Achterberg
- University Network for the Care Sector South Holland, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Anneke L Francke
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
- Amsterdam Public Health research institute, Department of Public and Occupational Health, Amsterdam UMC, VUmc site, Amsterdam, Netherlands
- Expertise Center Palliative Care, Amsterdam UMC, VUmc site, Amsterdam, Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
| | - Hanneke J A Smaling
- University Network for the Care Sector South Holland, Leiden University Medical Center, Leiden, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
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Shubina I. Scientific Publication Patterns of Systematic Reviews on Psychosocial Interventions Improving Well-being: Bibliometric Analysis. Interact J Med Res 2022; 11:e41456. [DOI: 10.2196/41456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/01/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Despite numerous empirical studies and systematic reviews conducted on the effectiveness of interventions improving psychological well-being, there is no holistic overview of published systematic reviews in this field.
Objective
This bibliometric study explored the scientific patterns of the effectiveness of different psychosocial interventions improving well-being among various categories of individuals with mental and physical diseases, to synthesize well-being intervention studies, and to suggest gaps and further studies in this emerging field.
Methods
The bibliometric analysis included identifying the most productive authors, institutions, and countries; most explored fields and subjects of study; most active journals and publishers; and performing citation analysis and analyzing publication trends between 2014 and 2022. We focused on data retrieved from known databases, and the study was conducted with a proven bibliometric approach.
Results
In total, 156 studies were found concerning the research domains and retrieved using LENS software from high-ranking databases (Crossref, Microsoft Academic, PubMed, and Core). These papers were written in English by 100 authors from 24 countries, among which, the leading country was the United Kingdom. Descriptive characteristics of the publications involved an increased number of publications in 2017 (n=35) and 2019 (n=34) and a decreased number in 2021 (n=4). The top 2 leading authors by citation score are James Thomas (3 papers and 260 citations) and Chris Dickens (3 papers and 182 citations). However, the most cited study had 592 citations. BMJ Open (n=6 articles) is the leading journal in the field of medicine; Clinical Psychology Review (n=5), in psychology; and Frontiers in Psychology, in psychological intervention (n=5) and psychology (n=5). The top 2 publishers were Wiley (n=28) and Elsevier (n=25).
Conclusions
This study indicates an overall interest in the declared domains within the last decade. Our findings primarily indicate that psychosocial interventions (PIs) were evaluated as being effective in managing mental and physical problems and enhancing well-being. Cognitive behavioral therapy was assessed as being effective in treating anxiety, psychoeducation in relapse prevention, and gratitude interventions in improving overall health, and the mindfulness approach had a positive impact on decreasing distress and depression. Moreover, all these intervention types resulted in an overall increase in an individuals’ well-being and resilience. Integrating social and cultural factors while considering individual differences increases the efficiency of PIs. Furthermore, PIs were evaluated as being effective in managing symptoms of eating disorders, dementia, and cancer. Our findings could help provide researchers an overview of the publication trends on research domains of focus for further studies, since it shows current findings and potential research needs in these fields, and would also benefit practitioners working on increasing their own and their patients' well-being.
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García Santelesforo R, Rodríguez del Rey T, Pérez‐Sáez E, Peláez Hernández B. Impact of confinement measures due to the COVID-19 pandemic on people living with dementia and their caregivers in Spain. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5391-e5400. [PMID: 35971778 PMCID: PMC9537907 DOI: 10.1111/hsc.13960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/06/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has particularly affected people living with dementia (PLWD) and their caregivers, who have seen their access to social support services and opportunities for socialisation limited. The objective of the study was to explore the impact of COVID-19 on PLWD and their caregivers in Spain. An online survey was conducted between November 27, 2020, and January 19, 2021, that explored compliance with prevention guidelines, changes at the family level and in access to social support services. Instruments were included to estimate levels of anxiety and depression. The survey was answered by 229 people (161 current caregivers, 54 former caregivers, 13 formal caregivers and 1 person with dementia). Analysis of the current and former caregivers showed that they felt well informed, although they find it difficult for PLWD to comply with prevention guidelines. The use of social support services was reduced and the difficulty of access to social and health services increased, there was a negative impact on the economic situation and family relationships, with an increase in perceived overload. In addition, caregivers of PLWD scored above the cut-off points in the tests used to assess depression and anxiety, although the results of the multiple regression analysis do not allow us to conclude that the loss of resources influences the anxiety and depression scores. The negative impact of the pandemic on caregivers of PLWD is verified. It is necessary to adapt social support services and design strategies to maintain the provision of support to these vulnerable groups.
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Affiliation(s)
| | | | - Enrique Pérez‐Sáez
- National Reference Centre for Alzheimer's Disease and Dementia Care, ImsersoSalamancaSpain
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Tan WJ, Lim XYH, Lee T, Wong SC, Koh HJ, Yeo D. Enhancing the caregiving experience of family care partners in Singapore through an arts programme for persons with dementia: an exploratory study. Aging Ment Health 2022; 26:1942-1948. [PMID: 34856835 DOI: 10.1080/13607863.2021.2008306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: Arts-based programmes for persons with dementia have shown promise in alleviating some of the caregiving challenges for family care partners. The present study sought to broaden the sociocultural perspectives of arts-based programmes by investigating the impact of a locally developed Arts & Dementia programme for persons with dementia on their family care partners in Singapore.Methods: Thirty-two family care partners of persons with dementia who participated in the Arts & Dementia programme were recruited. A mixed-methodological study was employed utilising quantitative pre- and post-programme data from the Zarit Burden Interview and Gain in Alzheimer care Instrument, and qualitative data from semi-structured group interviews.Results: Although there were no self-reported short-term changes in perceived caregiving difficulties and gains, semi-structured group interviews revealed potential caregiving benefits. Six overarching themes were identified: (1) contentment and social engagement, (2) re-connecting and developing new interests, (3) positive influence on caregiving, (4) enhancements to the programme, (5) more arts programmes, and (6) more support for families living with dementia.Conclusion: The present study highlights potential benefits of community-based arts activities in enabling caregiving to be a more positive experience for care partners.Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2008306'I kept blaming myself for not spending enough time with him. Communication with him is different now. Watching him on the stage, he is happy and with a purpose'. (Gary, male).
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Affiliation(s)
- Wan Jie Tan
- Dementia Singapore Ltd., Singapore, Singapore
| | | | - Theresa Lee
- Dementia Singapore Ltd., Singapore, Singapore
| | | | | | - Donald Yeo
- KALL Psychological & Counselling Services Pte Ltd., Singapore
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Gambella E, Valenza S, Giulietti MV, Gagliardi C, Civerchia P, Fabbietti P, Lattanzio F, Pelliccioni G. "The Community That Takes Care of Itself": A Feasibility Study to Support Families Caring for a Loved One With Alzheimer Disease. FAMILY & COMMUNITY HEALTH 2022; 45:238-246. [PMID: 35985024 DOI: 10.1097/fch.0000000000000333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This pilot project was aimed at supporting those families caring at home for loved ones suffering from Alzheimer dementia. Fourteen dyads of "caregivers-loved ones with dementia" were recruited and assigned either to the experimental group (n = 7) or to the control group (n = 7). The experimental group attended a training course, an Alzheimer Café, a self-help group for caregivers, and the support from a volunteer and professional nurse in-home visits, while the control group's dyads attended a standard intervention. To investigate the effects of this integrated and interprofessional model of care, caregivers completed the Caregiver Burden Inventory and 2 ad hoc structured questions to evaluate whether quality of life of the dyads was changed. Moreover, the caregivers of the experimental group completed the Self-Assessment Single Questionnaire, version 6 (Q-UAV6). Only caregivers of the experimental group reported a significant reduction in burden and an improved quality of life of the dyad. They also showed a greater acceptance of the disease, became experts in the care of their loved ones, and improved their relationship. The creation of a service integration network of professionals, volunteers, and families has been shown to be useful in supporting those families caring at home for loved ones suffering from Alzheimer dementia.
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Affiliation(s)
- Elena Gambella
- Department of Neurology (Ms Gambella and Drs Giulietti, Civerchia, and Pelliccioni), Centre for Socio-Economic Research on Ageing (Ms Gagliardi), Laboratory of Geriatric Pharmacoepidemiology (Mr Fabbietti), and Scientific Direction (Dr Lattanzio), IRCCS INRCA-National Institute of Health & Science on Ageing, Ancona, Italy; and Department of Hospital Psychology, Ospedali Riuniti Marche Nord, Pesaro, Italy (Dr Valenza)
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Quialheiro A, Bobinski F, Haefliger JDG, Del Antonio R, Lins EF, Martins DF, d'Orsi E, Xavier AJ, Peres MA. A comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction can modify BDNF levels and improve cognition in adults over 50: a randomized controlled pilot study. Aging Ment Health 2022; 26:1979-1987. [PMID: 34405737 DOI: 10.1080/13607863.2021.1966742] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To analyze the effect of a comprehensive program of cognitive stimulation with digital inclusion, physical activity and social interaction, called "Oficina da Lembrança" (OL), on the cognitive status and concentration of biomarkers of neuroplasticity, neurodegeneration in adults aged 50 years and over attending a Memory Clinic. METHODS In this pilot randomized controlled study, 64 patients without dementia aged 45 to 79 years, seen at a University Memory Clinic in Southern Brazil, were randomly allocated to the intervention and control groups. The intervention consisted of participation in OL for 12 weeks. Serum biomarkers (brain-derived neurotrophic factor [BDNF], S100β, and neuron-specific enolase [NSE]) and cognitive status were analyzed as primary and secondary outcomes. The Wilcoxon test and Generalized Estimating Equations (GEE) were applied. RESULTS Of the 64 patients invited to participate in the study, 33 (intervention: 17, control: 16) completed the study with all data. Improvement of cognitive status was significant in the intervention group (22.6 to 24.5) but not in the control group (20.1 to 21.1). There was a significant reduction of BDNF in OL participants, but no significant change was observed in the neurodegenerative biomarkers S100β or NSE. The concentration of BDNF decreased significantly post-OL in the intervention group (-288.1, 95%CI -362.1 to -94.1), even after adjusting for sex, age, and educational level. Cognitive status was significantly improved in OL participants. CONCLUSION The OL program improved cognitive status, reduced serum BDNF levels, and empowered digitally excluded older adults. There was no effect of this intervention on S100β or NSE. CLINICAL TRIAL REGISTRATION This study has a Universal Trial Number (UTN) U1111-1195-2642 and was registered in the Brazilian Clinical Trials Registry (ReBEC), number RBR-38X665.
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Affiliation(s)
- Anna Quialheiro
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.,Physiotherapy Course, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil.,Life and Health Sciences Research Institute (ICVS), Medicine School, University of Minho, Portugal
| | - Franciane Bobinski
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | | | - Renata Del Antonio
- Hospital of the Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - Elisa Flores Lins
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Daniel Fernandes Martins
- Experimental Neuroscience Laboratory (LaNex), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Eleonora d'Orsi
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil
| | - André Junqueira Xavier
- Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.,Medicine Course, University of Southern Santa Catarina (UNISUL), Palhoca, Brazil
| | - Marco Aurélio Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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Musical Bridges to Memory: A Pilot Dyadic Music Intervention to Improve Social Engagement in Dementia. Alzheimer Dis Assoc Disord 2022; 36:312-318. [PMID: 36030819 DOI: 10.1097/wad.0000000000000525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/20/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Music-based psychosocial interventions may provide effective management of behavioral symptoms in persons with dementia (PWDs). However, there has been a paucity of studies that measured their effect on social engagement. This proof-of-concept study evaluates efficacy of the Musical Bridges to Memory (MBM) intervention on PWD's social engagement, behavioral symptoms, and associated caregiver distress. METHODS Twenty-nine PWDs and caregivers (8 control dyads, 21 intervention) participated in this dyadically designed, prospective, blinded, 12-week controlled interventional study. The intervention consisted of weekly MBM sessions, led by board-certified music therapists and performers, including caregiver training, live performances, and social breakout groups. Outcomes were measured by the Verbal and Nonverbal Interaction Scale for Care Receivers (VNVIS-CR) to code interactions between PWDs and caregivers for verbal and nonverbal sociable and unsociable behaviors. Symptom severity and caregiver distress were measured using Neuropsychiatric Inventory. RESULTS Nonverbal sociable interactions significantly increased ( P =0.012) in those who completed the MBM program as compared with a decrease observed in the control group. Family/caregiver distress associated with PWDs neuropsychiatric symptoms showed significant improvement in the experimental group as compared with controls ( P =0.045). CONCLUSIONS This study provides proof-of-concept that MBM improves nonverbal sociable content of PWDs interactions and reduces caregivers' distress.
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50
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Yang YH, Situmeang RFV, Ong PA, Liscic RM. Application of virtual reality for dementia management. BRAIN SCIENCE ADVANCES 2022. [DOI: 10.26599/bsa.2022.9050019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Age is recognized as the major factors of dementia, especially in for Alzheimer’s disease (AD). Given to the aged population, the increased number of demented population has been receiving a great impact in our society. Unfortunately, so far, no cured medicines have been demonstrated to provide effective treatment in AD. The combination of pharmacological and non-pharmacological interventions has been proposed to manage dementia with potential benefits especially in decreasing caregiver’s burden and behavior, as well as psychological problems of demented patients. Recently, giving to the glorious development in digital technologies, the virtual reality, one of the non-pharmacological interventions has been used extensively in dementia managements for its strengths which can be adapted in accordance with the heterogeneous needs from demented patients and their caregivers. However, various study designs and other reasons made these results difficult to be interpreted. In this review our goal is to provide a better understanding for these points.
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Affiliation(s)
- Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, China
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, China
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan, China
| | - Rocksy FV Situmeang
- Siloam Hospitals Lippo Village, Pelita Harapan University, Banten, Indonesia
| | - Paulus Anam Ong
- Department of Neurology, Hasan Sadikin Hospital, Bandung, Indonesia
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