Reminiscence therapy for dementia

German Society of Neurology guidelines for the diagnosis and treatment of cognitive impairment and affective disorders in people with Parkinson's disease: new spotlights on diagnostic procedures and non-pharmacological interventions

BACKGROUND AND OBJECTIVE

Cognitive impairment and dementia as well as affective disorders are common and debilitating syndromes that develop in people with Parkinson's disease (PwPD). The authors summarized recommendations for the 2023 updated German guidelines on "Parkinson's disease" from the German Neurological Society (DGN), focusing on the diagnosis and treatment of these disorders.

METHODS

The recommendations were based on literature reviews, other relevant guidelines, and expert opinions.

RESULTS

Measurements to assess cognitive and affective states were reviewed for psychometric properties, use in routine clinical practice, and availability in German. To improve mild cognitive impairment, cognitive training and physical aerobic training are recommended. To treat Parkinson's disease (PD)-related dementia, cognitive stimulation (as a non-pharmacological intervention) and acetylcholinesterase inhibitors (AChEIs, i.e., rivastigmine) are recommended. Cognitive behavioral therapy is recommended to treat depression, anxiety, and fear of progression. Physical interventions are recommended to treat depression, fatigue, and apathy. Optimized dopaminergic treatment is the first-line pharmacological strategy recommended to manage depression, apathy, anhedonia, fatigue, and mood swings. Major depression can be additionally treated using venlafaxine or desipramine, while moderate depression can be treated pharmacologically according to its clinical phenotype (psychomotor retardation or agitation) and comorbidities (e.g., sleep disturbances, pain). Venlafaxine and nortriptyline can be used to treat anhedonia, while citalopram can be used for anxiety.

CONCLUSIONS

In addition to the updated pharmacological treatment options, new insights into recommendations for standardized diagnostics and non-pharmacological interventions were provided for the German health care system. However, more studies are needed to explore the full potential of non-pharmacological interventions to treat and prevent cognitive impairment and affective disorders.

Virtual reality-based reminiscence therapy for older adults to improve psychological well-being and cognition: A systematic review

BACKGROUND

Virtual reality-reminiscence therapy (VR-RT) has increasingly been applied to older adults to improve psychological well-being and cognition.

OBJECTIVE

This review aims to identify (1) the design characteristics of conducting a VR-RT and (2) the effects of VR-RT on the user experience, cognitive outcomes and psychological well-being.

DESIGN

Systematic review.

METHODS

Eligible studies were sourced across nine electronic databases, trial registries, grey literature and hand-searching of the reference list. A narrative synthesis was conducted. Twenty-two studies were included, and most were appraised as high quality. Most of the VR-RTs were highly immersive and personalised, with participants having the autonomy of control. VR-RT has the potential to improve anxiety and depression, and cognitive outcomes for older adults. Overall, VR-RT was reported to be an enjoyable experience for older adults.

CONCLUSIONS

VR-RT is a promising innovation that can improve older adults' psychological well-being and cognition without significant side effects, including cybersickness and with the potential for scalability across various settings. More randomised controlled studies are needed to evaluate the effectiveness of VR-RT and its features and treatment dosage. These studies could also examine the effectiveness of VR-RT as an intervention to promote independence in activities of daily living and physical rehabilitation.

RELEVANCE TO CLINICAL PRACTICE

VR-RT is a promising intervention for older adults in community settings to enhance psychological well-being and cognition. VR's versatility enables personalised experiences within dynamic virtual environments, possibly enhancing engagement and therapeutic outcomes.

NO PATIENT OR PUBLIC CONTRIBUTION

This systematic review did not directly involve patient or public contribution to the manuscript.

Assessment of dementia knowledge in Indian speech-language pathology students

OBJECTIVES

Speech-language pathologists (SLPs) have a crucial role in assisting individuals with dementia due to the communication and swallowing challenges associated with the disease. As the number of dementia cases rises in India at an increasing rate, investigating the level of dementia knowledge of SLP students can offer insight into the preparedness of the healthcare system to meet this emerging demand.

METHOD

A cross-sectional survey was conducted on SLP students pursuing their final year undergraduate, postgraduate and doctoral degrees from four universities across India. Dementia knowledge was assessed using the Dementia Knowledge Assessment Scale (DKAS) and information about previous dementia exposure (both formal and informal) was collected. The collected data were analysed using quantitative methods.

RESULTS

A total of 220 students (64.70% response rate) completed the survey. Overall dementia knowledge was inadequate with an average score of 22.08 ± 10.06. Previous dementia exposure among the students was also found to be low and did not affect dementia knowledge scores.

DISCUSSION

Despite the fundamental role SLPs play in the care of individuals with dementia, the lack of knowledge in this area emphasizes the need for enhancing dementia training programs through educational curricula and clinical placements.

Incorporating Spirituality into Cognitive Stimulation Therapy Groups for Persons with Dementia: An Exploratory Study

Cognitive Stimulation Therapy (CST) is an evidence-based, non-pharmacological intervention for older adults with mild to moderate dementia. While CST has been adapted in various ways, this study explored the impact of adding a spiritual dimension to CST. Participants (N = 34) were divided into spiritual and traditional CST groups based on their residence. After a 14-session intervention involving interactive conversations, the spiritual CST group showed significantly lower depression scores (M = 2.7) compared to traditional CST (M = 6.5). With the global increase in dementia-related disorders, non-pharmacological interventions like CST offer crucial support for addressing memory loss. Social workers are uniquely positioned to deliver CST to diverse populations who value spirituality or faith in their daily lives.

Network meta-analysis of non-pharmacological interventions for cognitive impairment after an ischemic stroke

Objective

This study aims to evaluate the effectiveness of non-pharmacological interventions in improving cognitive function in patients with ischemic stroke through network meta-analysis.

Methods

We searched databases including the Cochrane Library, PubMed, EmBase, and Web of Science for randomized controlled trials (RCTs) on non-pharmacological treatments to improve cognitive impairment following ischemic stroke. The publication date was up to 15 March 2023. Due to the insufficiency of included studies, supplementary searches for high-quality Chinese literature were performed in databases such as CNKI, WanFang Data, and VIP Chinese Science Journals Database. Two reviewers independently went through the literature, extracted data, and assessed the risk of bias in the included studies using the risk of bias assessment tool recommended by the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. By utilizing R 4.2.3 RStudio software and the GeMTC package, a Bayesian network meta-analysis was conducted to assess the improvement in Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores under a variety of non-pharmacological interventions.

Results

A total of 22 RCTs involving 2,111 patients and 14 different non-pharmacological treatments were included. These interventions were transcranial direct current stimulation (tDCS), reminiscence therapy (RT), remote ischemic conditioning (RIC), physical fitness training (PFT), intensive patient care program (IPCP), moderate-intensity continuous training + high-intensity interval training (MICT + HIIT), medium intensity continuous training (MICT), grip training (GT), acupuncture, cognitive behavioral therapy (CBT), cognitive rehabilitation training (CRT), high pressure oxygen (HPO), moxibustion, and repetitive transcranial magnetic stimulation (rTMS). The results of the network meta-analysis indicated that rTMS had the highest likelihood of being the most effective intervention for improving MMSE and MoCA scores.

Conclusion

The evidence from this study suggests that rTMS holds promise for improving MMSE and MoCA scores in patients with cognitive impairment following ischemic stroke. However, further high-quality research is needed to confirm and validate this finding.

Evaluation of an exercise program incorporating an international cycling competition: a multimodal intervention model for physical, psychological, and social wellbeing in residential aged care

BACKGROUND

The transition into residential aged care is frequently associated with a reduction in physical activity, social engagement, and emotional wellbeing. Our aim was to evaluate the impact of a 26-day international cycling competition (Road Worlds Competition for Seniors), incorporating elements of exercise, audiovisual cycling footage, social engagement, and gamification, on the physical, psychological, and social well-being of aged care residents. We aimed to use findings to inform the development of a multi-modal intervention model to maximise wellbeing for older adults.

METHODS

Residents (N = 32) participated in a mixed-methods single-group intervention pilot study that compared pre-and post-competition measures for the following wellbeing domains; physical, psychological, and social. In addition, interviews were conducted with residents (n = 27) and staff (n = 6) to explore their experiences.

RESULTS

Measures identified significant improvements across multiple wellbeing domains, including functional fitness, depression, self-efficacy, and social network sizes. Findings from the interview data indicated that the multimodal components involved in the program delivery were valued by staff and residents who enjoyed the gamification, audiovisual cycling footage, social engagement, opportunities for reminiscence, and camaraderie between peers, staff, and volunteers.

CONCLUSIONS

Findings highlight a constellation of benefits across physical, psychological, and social domains of wellbeing and inform a model for innovative multidimensional programs in residential aged care. The benefits for residents with varying physical and cognitive abilities support the use of creative strategies that maximise inclusion and engagement for residents.

Reimagining neuroscientific and andragogical principles for dementia care education

This article aims to explore the integration of Louis Cozolino's (2013) andragogical strategies with the tenets of person-centered dementia care practices to enhance dementia care education. The article examines the multiple dimensions of learning in adulthood, highlighting the role of neural plasticity and lifelong brain adaptation in shaping learning and experiential strategies. This in-depth evaluation underscores the significance of tailoring andragogical approaches to the needs of adult learners, who, in this context, are care providers for persons with dementia. This is done through proper understanding of the neurobiological realities and the unique learning needs of adults. Such tailored approaches can be aligned with the brain's adaptive nature by recognizing the intricate interplay of cognitive, emotional, and social dimensions. Highlighting the need for including lessons on the person-centered approach in dementia care education, the paper argues that adult learners - who are essentially part of the dementia care workforce - first need to learn, appreciate, and embrace the approach before applying it in their caregiving practices. This article presents an overarching argument that integration of Cozolino's principles of adult learning with tenets of person-centered dementia care could provide a robust framework for dementia care education.

Self-Transcendence as a Mediator of the Relationship Between Reminiscence Functions and Death Anxiety: Implications for Psychiatric Nurses

BACKGROUND

Jordan's population of older adults is growing due to improved health care and lifestyle, but the country has limited mental health care resources, causing challenges for the health care system. Reminiscence is a point of nursing intervention and a way for psychiatric nurses to help people improve their mental health by expanding their personal boundaries (self-transcendence).

AIMS

The study aimed to examine the mediating effects of self-transcendence on the relationship between reminiscence functions and death anxiety in a sample of Jordanian older adults. Psychiatric nurses can refine reminiscence therapy by targeting aspects of self-transcendence to reduce death anxiety.

METHODS

An online cross-sectional survey was employed to collect the data. A total of 319 older adults participated in the study. The sample was recruited using convenience and snowball sampling strategies through social media and personal contacts.

RESULTS

The reminiscence function of "Bitterness Revival," gender, the presence of a life-threatening disease, a history of psychiatric disorder, and the work sector were statistically significant predictors of death anxiety. This model accounts for 24% of the death anxiety score (F = 7.789, p < .001). Reminiscence functions 1, 2, and 5 predicted self-transcendence. This model explained 25% of the variance in the self-transcendence score (F = 6.548, p < .001). Self-transcendence exerts a positive, partial mediating effect between "Bitterness Revival" and death anxiety, controlling for other covariates in the death anxiety model (p = .016).

CONCLUSIONS

The study is informative for understanding the role of self-transcendence in buffering death anxiety, notwithstanding "Bitterness Revival" reminiscences. This knowledge reveals practical implications for psychiatric nurses about the importance of developing reminiscence interventions to promote self-transcendence and ease death anxiety.

Mental Time Travel as Self-Affirmation

ACADEMIC ABSTRACT

This article integrates and advances the scope of research on the role of mental time travel in bolstering the self. We propose that imagining the self in the future (prospection) or in the past (retrospection) highlights central and positive self-aspects. Thus, bringing to mind one's future or past broadens the perceived bases of self-integrity and offers a route to self-affirmation. In reviewing corresponding research programs on self-prospection and nostalgia, we illustrate that mental time travel serves to affirm the self in terms of self-esteem, coherence, and control. Mental time travel could be implemented as a source of self-affirmation for facilitating coping and behavior change in several domains such as relationships, health, education, and organizational contexts.

PUBLIC ABSTRACT

People can mentally travel to their future or to their past. When people imagine what they will be like in the future, or what they were like in the past, they tend to think about themselves in terms of the important and positive attributes that they possess. Thinking about themselves in such an affirming way expands and consolidates their self-views. This broader image of themselves can increase self-esteem (the extent to which one likes who they are), coherence (the extent to which one perceives life as meaningful), and control (the extent to which one feels capable of initiating and pursuing goals or effecting desirable outcomes). Mental time travel, then, has favorable or affirming consequences for one's self-views. These consequences can be harnessed to modify one's behavior in such life domains as relationships, health, education, and work.

Livestream, group movement program for people living with cognitive impairment and care partners: A randomized clinical trial

INTRODUCTION

There are few widely-available, evidence-based options to support quality of life (QOL) for people living with Alzheimer's disease and related dementias.

METHODS

We performed a randomized, controlled trial with a Waitlist control group to determine whether an online, livestream, mind-body, group movement program (Moving Together, 1 hour, 2 days/week, 12 weeks) improves QOL in people with cognitive impairment (PWCI) or care partners (CPs) and explore mechanisms of action. The primary outcome for both participants was self-reported QOL. Secondary outcomes and potential mediators included mobility, isolation, well-being, cognitive function, and sleep in PWCI and burden, positive emotions, caregiver self-efficacy, stress management, and sleep in CPs. Blinded assessors collected outcome data at baseline, 12, and 24 weeks. We assessed adverse events including falls through monthly check-in surveys and collected qualitative data through evaluation surveys. Intention-to-treat analyses used linear mixed models to compare mean change over time between groups and calculated standardized effect sizes (ESs).

RESULTS

Ninety-seven dyads enrolled (PWCI: age 76 ± 11 years, 43% female, 80% non-Hispanic White; CPs: age 66 ± 12 years, 78% female, 71% non-Hispanic White); 15% withdrew before 12 weeks and 22% before 24 weeks. PWCI self-reported significantly better QOL from baseline to 12 weeks in the Moving Together group compared to the Waitlist group (ES = 0.474, p = 0.048) and CPs self-reported improved ability to manage stress (ES = 0.484, p = 0.021). Improvements in participant self-reported QOL were mediated by improvements in their self-reported well-being and CP-reported ability to manage stress. Results were similar when the Waitlist group participated in the program (QOL ES = 0.663, p = 0.006; stress management ES = 0.742, p = 0.002) and were supported by qualitative data. Exploratory analyses suggested possible fall reduction in PWCI. There were no study-related serious adverse events.

DISCUSSION

Online programs such as Moving Together offer a scalable strategy for supporting high QOL for PWCI and helping CPs manage stress.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04621448.

Highlights

The approval of new medications that slow cognitive decline in people living with Alzheimer's disease and related disorders (ADRD) has raised hope and excitement. However, these medications do not appear to impact quality of life, which is often considered by patients and care partners to be the most important outcome.In this randomized clinical trial, we found that an evidence-based, online, livestream, mind-body, group movement program significantly and meaningfully improves self-rated quality of life in people with ADRD and helps care partners manage stress. Mediation analyses revealed that the key drivers of improvements in participants' quality of life were improvements in their feelings of well-being and care partners' ability to manage stress. Exploratory analyses also suggested a 30% reduction in falls.These results are important because they suggest that an online program, which is available now and can be performed by people from the comfort of home or other location of choice, could be recommended as a complement or alternative to new therapies to help maximize quality of life for people living with ADRD and their care partners.

Rumination in dementia and its relationship with depression, anxiety, and attentional biases

Rumination (self-referential and repetitive thinking), attentional biases (AB), and impaired cognitive control are theorized as being integral factors in depression and anxiety. Yet, research examining the relationship between rumination, mood, and AB for populations with reduced cognitive control, e.g., people living with dementia (PwD), is lacking. To explore whether literature-based relationships are demonstrated in dementia, PwD (n = 64) and healthy controls (HC) (n = 75) completed an online self-report survey measuring rumination and mood (twice), and a telephone cognitive status interview (once). Rumination was measured as an emotion-regulation style, thinking style, and response to depression. We examined the test-retest reliability of PwD's (n = 50) ruminative-scale responses, ruminative-scale internal consistency, and correlations between rumination, age, cognitive ability, and mood scores. Also, nine participants (PwD = 6, HC = 3) completed an AB measure via eye-tracking. Participants fixated on a cross, naturally viewed pairs of facial images conveying sad, angry, happy, and neutral emotions, and then fixated on a dot. Exploratory analyses of emotional-face dwell-times versus rumination and mood scores were conducted. Except for the HC group's reflective response to depression measure, rumination measures were reliable, and correlation strengths between rumination and mood scores (.29 to .79) were in line with literature for both groups. For the AB measure subgroup, ruminative thinking style scores and angry-face metrics were negatively correlated. The results of this study show that literature-based relationships between rumination, depression, and anxiety are demonstrated in dementia, but the relationship between rumination and AB requires further investigation.

Group Reminiscence Programs for Older Adults Without Cognitive Impairment: A Scoping Review

Reminiscence interventions have been tested with people with and without cognitive impairment. However, the literature on reminiscence interventions for the latter is less extensive. The purpose of the current scoping review was to list and describe group session reminiscence protocols used with older adults without cognitive impairment and not involving psychotherapy. Arksey and O'Malley's five stages scoping framework was used for this review. Seven databases were searched, and nine articles were included. Results show the heterogeneity of reminiscence programs available for older adults without cognitive impairment and highlight that key elements for replication are often lacking. Well-defined reminiscence programs should be selected for replication and evaluation studies. However, few well-defined reminiscence programs not involving psychotherapy are available for older adults without cognitive impairment. [Journal of Psychosocial Nursing and Mental Health Services, 62(3), 15-21.].

Promoting Personalized Reminiscence Among Cognitively Intact Older Adults Through an AI-Driven Interactive Multimodal Photo Album: Development and Usability Study

BACKGROUND

Reminiscence, a therapy that uses stimulating materials such as old photos and videos to stimulate long-term memory, can improve the emotional well-being and life satisfaction of older adults, including those who are cognitively intact. However, providing personalized reminiscence therapy can be challenging for caregivers and family members.

OBJECTIVE

This study aimed to achieve three objectives: (1) design and develop the GoodTimes app, an interactive multimodal photo album that uses artificial intelligence (AI) to engage users in personalized conversations and storytelling about their pictures, encompassing family, friends, and special moments; (2) examine the app's functionalities in various scenarios using use-case studies and assess the app's usability and user experience through the user study; and (3) investigate the app's potential as a supplementary tool for reminiscence therapy among cognitively intact older adults, aiming to enhance their psychological well-being by facilitating the recollection of past experiences.

METHODS

We used state-of-the-art AI technologies, including image recognition, natural language processing, knowledge graph, logic, and machine learning, to develop GoodTimes. First, we constructed a comprehensive knowledge graph that models the information required for effective communication, including photos, people, locations, time, and stories related to the photos. Next, we developed a voice assistant that interacts with users by leveraging the knowledge graph and machine learning techniques. Then, we created various use cases to examine the functions of the system in different scenarios. Finally, to evaluate GoodTimes' usability, we conducted a study with older adults (N=13; age range 58-84, mean 65.8 years). The study period started from January to March 2023.

RESULTS

The use-case tests demonstrated the performance of GoodTimes in handling a variety of scenarios, highlighting its versatility and adaptability. For the user study, the feedback from our participants was highly positive, with 92% (12/13) reporting a positive experience conversing with GoodTimes. All participants mentioned that the app invoked pleasant memories and aided in recollecting loved ones, resulting in a sense of happiness for the majority (11/13, 85%). Additionally, a significant majority found GoodTimes to be helpful (11/13, 85%) and user-friendly (12/13, 92%). Most participants (9/13, 69%) expressed a desire to use the app frequently, although some (4/13, 31%) indicated a need for technical support to navigate the system effectively.

CONCLUSIONS

Our AI-based interactive photo album, GoodTimes, was able to engage users in browsing their photos and conversing about them. Preliminary evidence supports GoodTimes' usability and benefits cognitively intact older adults. Future work is needed to explore its potential positive effects among older adults with cognitive impairment.

Enabling Personalization for Digital Cognitive Stimulation to Support Communication With People With Dementia: Pilot Intervention Study as a Prelude to AI Development

BACKGROUND

Maintaining good communication and engagement between people with dementia and their caregivers is a major challenge in dementia care. Cognitive stimulation is a psychosocial intervention that supports communication and engagement, and several digital applications for cognitive stimulation have been developed. Personalization is an important factor for obtaining sustainable benefits, but the time and effort required to personalize and optimize applications often makes them difficult for routine use by nonspecialist caregivers and families. Although artificial intelligence (AI) has great potential to support automation of the personalization process, its use is largely unexplored because of the lack of suitable data from which to develop and train machine learning models.

OBJECTIVE

This pilot study aims to evaluate a digital application called Aikomi in Japanese care homes for its potential to (1) create and deliver personalized cognitive stimulation programs to promote communication and engagement between people with dementia and usual care staff and (2) capture meaningful personalized data suitable for the development of AI systems.

METHODS

A modular technology platform was developed and used to create personalized programs for 15 people with dementia living in 4 residential care facilities in Japan with the cooperation of a family member or care staff. A single intervention with the program was conducted with the person with dementia together with a care staff member, and for some participants, smell stimulation was provided using selected smell sticks in conjunction with the digital program. All sessions were recorded using a video camera, and the combined personalized data obtained by the platform were analyzed.

RESULTS

Most people with dementia (10/15, 67%) showed high levels of engagement (>40 on Engagement of a Person with Dementia Scale), and there were no incidences of negative reactions toward the programs. Care staff reported that some participants showed extended concentration and spontaneous communication while using Aikomi, which was not their usual behavior. Smell stimulation promoted engagement for some participants even when they were unable to identify the smell. No changes in well-being were observed following the intervention according to the Mental Function Impairment Scale. The level of response to each type of content in the stimulation program varied greatly according to the person with dementia, and personalized data captured by the Aikomi platform enabled understanding of correlations between stimulation content and responses for each participant.

CONCLUSIONS

This study suggests that the Aikomi digital application is acceptable for use by persons with dementia and care staff and may have the potential to promote communication and engagement. The platform captures personalized data, which can provide suitable input for machine learning. Further investigation of Aikomi will be conducted to develop AI systems and create personalized digital cognitive stimulation applications that can be easily used by nonspecialist caregivers.

Mild cognitive impairment prediction and cognitive score regression in the elderly using EEG topological data analysis and machine learning with awareness assessed in affective reminiscent paradigm

Introduction

The main objective of this study is to evaluate working memory and determine EEG biomarkers that can assist in the field of health neuroscience. Our ultimate goal is to utilize this approach to predict the early signs of mild cognitive impairment (MCI) in healthy elderly individuals, which could potentially lead to dementia. The advancements in health neuroscience research have revealed that affective reminiscence stimulation is an effective method for developing EEG-based neuro-biomarkers that can detect the signs of MCI.

Methods

We use topological data analysis (TDA) on multivariate EEG data to extract features that can be used for unsupervised clustering, subsequent machine learning-based classification, and cognitive score regression. We perform EEG experiments to evaluate conscious awareness in affective reminiscent photography settings.

Results

We use EEG and interior photography to distinguish between healthy cognitive aging and MCI. Our clustering UMAP and random forest application accurately predict MCI stage and MoCA scores.

Discussion

Our team has successfully implemented TDA feature extraction, MCI classification, and an initial regression of MoCA scores. However, our study has certain limitations due to a small sample size of only 23 participants and an unbalanced class distribution. To enhance the accuracy and validity of our results, future research should focus on expanding the sample size, ensuring gender balance, and extending the study to a cross-cultural context.

Effect of Immersive Virtual Reality Reminiscence versus Traditional Reminiscence Therapy on Cognitive Function and Psychological Well-being among Older Adults in Assisted Living Facilities: A randomized controlled trial

BACKGROUND

Virtual reality (VR) reminiscence is an innovative strategy that integrates technology into the care of older adults. Limited research was conducted to compare the role of VR reminiscence and traditional RT in improving older adults' cognitive and psychological well-being.

AIM

Investigate the effect of virtual reality reminiscence versus traditional reminiscence therapy on cognitive function and psychological well-being among older adults in assisted living facilities.

METHODS

A randomized controlled trial research design was followed. Sixty older adults were recruited and randomly assigned to three equal groups (20 older adults for each group).

RESULTS

Post interventions, a significant increase in the mean scores of cognitive function and psychological well-being was evident among the VR and RT groups with statistically significant differences (P <0.05) compared with pre-intervention and the control group.

CONCLUSION

Application of VR reminiscence or traditional RT is efficacious in improving cognitive function and psychological well-being among institutionalized older adults.

The effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer undergoing chemotherapy

PURPOSE

To determine the effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer (PwGC) undergoing chemotherapy.

METHODS

In this quasi-experimental study, we randomly allocated 152 PwGC who met the inclusion criteria as 1:1 ratio to control (N = 76) and intervention (N = 76) groups. The patients in the control group received routine post-chemotherapy care, while those in the intervention group received reminiscence therapy over the phone in addition to routine care. The participants of both groups completed Beck's Depression Inventory and Zung's Self-rating Anxiety Scale before the study, 6 weeks after the beginning of the study, and 3 months after the intervention.

RESULTS

Although the mean depression score before chemotherapy indicated moderate depression in both groups, the reminiscence therapy group showed a significant reduction in the depression score compared to the control group (P < 0.001) following intervention. The mean anxiety scores indicated mild to moderate anxiety in both groups, which was later placed within the normal range, there was a significant difference between the two groups. Intra-group comparison revealed that the mean depression and anxiety scores decreased significantly in the reminiscence therapy group (P < 0.001).

CONCLUSION

This study indicated that virtual reminiscence therapy can decrease anxiety and depression in PwGC undergoing chemotherapy. Therefore, it can be a supportive psychological method for these patients.

Improved Mental Health, Social Connections and Sense of Self: A Mixed Methods Systematic Review Exploring the Impact and Experience of Community Reminiscence Programs

Older people can experience health and social challenges such as loneliness, depression, and lack of social connectedness. One initiative that has been trialed to address these challenges is reminiscence programs. These programs can include music, art, photographs, sports, and general discussion to stimulate memories. This review aimed to systematically search for literature that explored the impact and experience of reminiscence programs for older people living in the community for the purposes of informing community programming. The PICOS framework was used to develop the review parameters and search strategy. Qualitative and quantitative research focused on community-based reminiscence programs were included. Commercially produced databases and grey literature were searched. The Critical Appraisal Skills Program qualitative critical appraisal tool and McMaster quantitative critical appraisal tool were used to assess the methodological quality of the included studies. Quantitative data were descriptively synthesized, and qualitative data were thematically analyzed, with each reported separately. Twenty-seven studies were included in the review. All quantitative studies (n = 17) provided clear information regarding the purpose, sample size, and justification. The measures adopted were reliable and valid. All studies reported clear data collection/analysis information and statistically significant findings. All qualitative studies (n = 10) clearly articulated a purpose with nine clearly describing recruitment, data collection, and researcher relationship. Synthesis of quantitative data demonstrated positive findings through a reduction in depression, anxiety, and loneliness and improvements in quality of life and mastery. These findings were supported and broadened by qualitative findings with three key themes identified: program processes, program ingredients, and program benefits. Providing opportunities for older adults to come together to tell stories about their past experiences may positively contribute to social outcomes. As reminiscence programs gain popularity, their implementation in practice should be underpinned by clear and reproducible practices.

Perceived barriers and solutions identified by healthcare professionals in utilizing web-based reminiscence therapy to support dementia care during the pandemic

This paper presents findings from a qualitative study conducted in Ontario, Canada, exploring healthcare professionals' perceptions of barriers and solutions for implementing Web-Based Reminiscence Therapy (WBRT) in an institutionalized settings for dementia care during the COVID-19 pandemic. The study identified five major barriers, including the lack of on-boarding/educational training, need for technology availability and technical support, limited attention span of persons with dementia (PWD), availability of multi-sensory features, and time constraints due to staff workload. Seven major themes emerged related to proposed solutions/suggestions: (1) involving younger generations, (2) focusing on technology training, (3) integrating with other digital platforms, (4) adding narratives/descriptions to recollect memories, (5) ensuring accessibility, (6) adding QR codes for retrieving information, and (7) combining digital/traditional reminiscence methods. These findings provide valuable insights for implementing WBRT to facilitate dementia care and for the future refinement of its application.

Digital storytelling intervention to enhance social connections and participation for people with mild cognitive impairment: a research protocol

Introduction

Interventions utilizing the principles of digital storytelling can improve cognitive ability by cultivating positive emotions and framing a new way to enhance social participation among people with mild cognitive impairment. However, existing research has understudied group-based storytelling, focusing instead on building individual stories and connections with family and friends. In response to this research gap, this paper proposes co-designing a digital storytelling intervention for people with Mild Cognitive Impairment (MCI) to enhance their social participation and build meaningful connections.

Methods

We will conduct two co-design workshops with people with MCI (n = 12), their caregivers (n = 4-12), and therapists (n = 5) in Beijing, China, to facilitate the co-development of the digital storytelling application. During the first workshop, we will utilize card sorting and voting to define potential facilitators of social participation, identifying the abilities people with MCI want to improve through storytelling. During the second workshop, we will build on these findings to facilitate people with MCI and their caregivers to visualize the interfaces. After reflexive thematic analysis of the co-design workshops, we will develop a digital storytelling application and test its usability and efficacy among people with MCI and therapists, respectively. A single-blinded field test will be conducted with 20 community-dwelling adults with MCI (Age: 65+). The testing will consist of an intervention group of 10 participants who use the co-designed digital storytelling intervention and a control group of 10 participants who will not use the co-designed intervention on the waiting list. The intervention period will extend over 7 weeks, with individual intervention sessions lasting 30 min. We will evaluate its efficacy in terms of social participation, social connectedness, self-efficacy, subjective sense of happiness, and user experience of people with MCI.

Discussion

This study will examine an innovative digital storytelling intervention to enhance social participation among people with MCI. This study is expected to advance the concept of community-centric social groups in social health service contexts by integrating technological solutions with the self-identified needs and lived experiences of people with MCI, increasing the motivation of people with MCI to cultivate social participation.

Ethics and dissemination

Swinburne University of Technology's Human Research Ethics Committee gave ethics approval for this research (Approval Number: 20226525-11105; Date: 26/09/2022). Our findings shall be reported in peer-reviewed journal articles and at relevant conferences.

The Application of Fully Immersive Virtual Reality on Reminiscence Interventions for Older Adults: Scoping Review

BACKGROUND

The increasing number of older adults with mental, behavioral, and memory challenges presents significant public health concerns. Reminiscence is one type of nonpharmacological intervention that can effectively evoke memories, stimulate mental activities, and improve psychological well-being in older adults through a series of discussions on previous experiences. Fully immersive virtual reality (FIVR) may be a useful tool for reminiscence interventions because it uses realistic virtual environments connected to a person's significant past stories.

OBJECTIVE

This review aims to examine empirical evidence regarding the application of FIVR in reminiscence interventions, its usability and acceptability, and its effectiveness in assisting the intervention to achieve optimal outcomes.

METHODS

We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach for scoping reviews. The PubMed, PsycINFO, Embase, CINAHL, Web of Science, ACM, and IEEE Xplore electronic databases were used for the search. We included peer-reviewed studies that used FIVR as an assistive tool for reminiscence interventions; were published between January 1, 2000, and August 1, 2022; reported empirical research; involved older adults as participants; and addressed health- and behavior-related outcomes or the feasibility and usability of FIVR. We used Endnote X9 to organize the search results and Microsoft Excel for data extraction and synthesis.

RESULTS

Of the 806 articles collected from the databases and other resources, 11 were identified. Most of the studies involved participants aged between 70 and 90 years. Only 1 study did not involve those with cognitive impairments, whereas 3 specifically targeted people living with dementia. The results indicated that FIVR reminiscence interventions enhanced engagement and reduced fatigue. Although some studies have observed positive effects on anxiety, apathy, depression, cognitive functions, and caregiver burden reduction, these findings were inconsistent across other research. In addition, FIVR showed overall usability and acceptability with manageable side effects among older adults across various health conditions during reminiscence sessions. However, 1 study reported adverse feelings among participants, triggered by unpleasant memories evoked by the virtual reality content.

CONCLUSIONS

The role of FIVR in reminiscence interventions remains nascent, with limited studies evaluating its impacts on older adults. Many of the reviewed studies had notable limitations: small sample sizes, absence of rigorous research design, limited assessment of long-term effects, lack of measures for health and behavior outcomes, and quality of life. Beyond these limitations, this review identified a list of future research directions in 6 categories. On the basis of the review findings, we provide practical recommendations to enhance FIVR reminiscence interventions, covering topics such as virtual reality content, device choice, intervention types, and the role and responsibility of facilitators.

The effects of psychosocial interventions using generic photos on social interaction, mood and quality of life of persons with dementia: a systematic review

BACKGROUND

Although family photos are often used in the psychosocial care for people with dementia, little is known about the use and effectiveness of generic photos. This systematic literature review explored psychosocial interventions using generic photos for people with dementia, and the effects they have on their social interaction and/or mood and/or quality of life. In addition, it was investigated whether these interventions made use of technology in its implementation.

METHODS

A systematic search on the following databases was performed: PubMed, Embase, APA PsychInfo, Cinahl, Web of Science, Scopus and Cochrane Central. Inclusion and exclusion criteria were based on the PICO model (Population, Intervention, Comparison, Outcome), and quality assessment was undertaken using the Weight of Evidence Framework. Narrative synthesis was undertaken to summarize study characteristics- settings and designs, type of psychosocial interventions identified, type of photos and technology used, outcome measures, and results.

RESULTS

A total of 2,035 results were found, however after title, abstract and full-text screening, a total of 8 studies were included. The most common psychosocial intervention using generic photos was found to be reminiscence therapy, followed by art-viewing activities. In studies that used technology, it was reported that viewing digitalized photos were either similar or better to conventional printed photos. Despite photos being generic, it was found that generic photos could still hold personal significance to the person with dementia. Some positive and significant effects were found for the outcomes social interaction, mood and quality of life, though no study evaluated all three outcomes. Two studies were rated as having high overall quality, 4 were rated as fair, and 2 studies had a low quality assessment rating.

CONCLUSION

Studies found using generic photos were limited, showing varying outcomes and methodological quality. Firm conclusions on the effectiveness of interventions using generic photos are not possible. However, the use of generic photos in psychosocial interventions is a promising area for future research. Researchers should consider studies with better methodological quality and larger samples; and qualitative studies where the intention is to get better insight into successful implementation and impact mechanisms of such psychosocial interventions.

TRIAL REGISTRATION

n/a.

Reminiscence and Digital Storytelling to Improve the Social and Emotional Well-Being of Older Adults With Alzheimer's Disease and Related Dementias: Protocol for a Mixed Methods Study Design and a Randomized Controlled Trial

BACKGROUND

Increasing attention is being given to the growing concerns about social isolation, loneliness, and compromised emotional well-being experienced by young adults and older individuals affected by Alzheimer disease and related dementias (ADRD). Studies suggest that reminiscence strategies combined with an intergenerational approach may yield significant social and mental health benefits for participants. Experts also recommended the production of a digital life story book as part of reminiscence. Reminiscence is typically implemented by trained professionals (eg, social workers and nurses); however, there has been growing interest in using trained volunteers owing to staffing shortages and the costs associated with reminiscence programs.

OBJECTIVE

The proposed study will develop and test how reminiscence offered by trained young adult volunteers using a digital storytelling platform may help older adults with ADRD to improve their social and emotional well-being.

METHODS

The proposed project will conduct a randomized controlled trial to assess the effects of the intervention. The older and young adult participants will be randomly assigned to the intervention (reminiscence based) or control groups and then be randomly matched within each group. Data will be collected at baseline before the intervention, in the middle of the intervention, at end of the intervention, and at 3 months after the intervention. An explanatory sequential mixed methods design will be used to take advantage of the strengths of both quantitative and qualitative methods. The quantitative data from surveys will be entered into SPSS and analyzed using covariate-adjusted linear mixed models for repeated measures to compare the intervention and control groups over time on the major outcomes of participants. Conventional content analysis of qualitative interviews will be conducted using data analysis software.

RESULTS

The project was modified to a telephone-based intervention owing to the COVID-19 pandemic. Data collection started in 2020 and ended in 2022. In total, 103 dyads were matched at the beginning of the intervention. Of the 103 dyads, 90 (87.4%) dyads completed the midtest survey and 64 (62.1%) dyads completed the whole intervention and the posttest survey. Although we are still cleaning and finalizing data analyses, the preliminary results from both quantitative and qualitative data showed promising results of this intergenerational reminiscence approach that benefits both the older adults who have cognitive impairments and the young adult participants.

CONCLUSIONS

Intergenerational reminiscence provided by young adult college student offers promising benefits for both the younger and older generations. Future studies may consider scaling up this pilot into a trackable, replicable model that includes more participants with diverse background (eg, public vs private college students and older adults from other agencies) to test the effectiveness of this intervention for older adults with ADRD.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05984732; https://classic.clinicaltrials.gov/ct2/show/NCT05984732.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/49752.

Current Diagnostic and Treatment Methods of Alzheimer's Disease: A Narrative Review

To diagnose and predict the possibility of Alzheimer's or a different kind of dementia, medical professionals employ tests that look at a patient's mental competence; however, such methods are impracticable. A reliable diagnosis at the start of treatment is essential for therapy. Except in situations with apparent genetic variations, most Alzheimer's patients lack a known etiology. Therefore, every Alzheimer's patient receives the same treatment plan, regardless of the etiology, which may or may not be successful in slowing or preventing the disease's progression. Tau pathology is further complicated by the amyloid buildup that arises from the cellular phase of Alzheimer's disease (AD). Alzheimer's is a degenerative, diverse, complicated, and incurable neurological disorder primarily affecting elderly individuals. The currently accepted drugs available for treating AD, which involve cholinesterase inhibitors and N-methyl-D-aspartate (NMDA)-receptor antagonists only provide temporary relief from symptoms. The neurological disorder primarily affecting elderly individuals is degenerative, diverse, complicated, and incurable. Accurate diagnosis is the most essential prerequisite before beginning therapy. Most Alzheimer's patients' causes are still unclear, except for instances where hereditary variations have been noted. The gut microbiota composition significantly influences AD and any age-associated neurological illness. Therapies are very useful in improving the cognitive functions of AD. New microbiota-based therapy alternatives may now be available due to the more recent connection between the altered gut microbiome and neurodegeneration through the gut microbiota-brain axis.

Dance movement therapy for dementia

BACKGROUND

Dementia is a syndrome of acquired cognitive impairment which is severe enough to interfere with independent living. Over the course of the illness, people with dementia also experience changes in emotions, behaviour and social relationships. According to Alzheimer's Disease International, dementia affects approximately 55 million people worldwide. The latest NICE guideline for dementia highlights the value of diverse treatment options for the different stages and symptoms of dementia, including non-pharmacological treatments. Relevant literature also argues for the value of interventions that acknowledge the complexity of the condition and address the person as a whole, including their physical, emotional, social and cognitive processes. A growing literature highlights the capacity of the arts and has embodied practices to address this complexity. Dance movement therapy (DMT) is an embodied psychological intervention that can address complexity and thus may be useful for people with dementia, but its effectiveness remains unclear.

OBJECTIVES

To assess the effects of dance movement therapy on behavioural, social, cognitive and emotional symptoms of people with dementia in comparison to no treatment, standard care or any other treatment. Also, to compare different forms of dance movement therapy (e.g. Laban-based dance movement therapy, Chacian dance movement therapy or Authentic Movement) SEARCH METHODS: We searched the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), CINAHL (EBSCOhost), Web of Science Core Collection (Clarivate), LILACS (BIREME), ClinicalTrials.gov and the World Health Organization's meta-register of the International Clinical Trials Registry Portal until 8 December 2022.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) that included people with dementia, of any age and in any setting. The DMT intervention had to be delivered by a dance movement therapy practitioner who (i) had received formal training (ii) was a dance movement therapist in training or (iii) was otherwise recognised as a dance movement therapist in the country in which the study was conducted.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed studies for inclusion, extracted data and evaluated methodological quality. We expressed effect estimates using the mean difference (MD) between intervention groups and presented associated confidence intervals (CIs). We used GRADE methods to rate our certainty in the results.

MAIN RESULTS

We found only one study eligible for inclusion in this review. This was a 3-arm parallel-group RCT conducted in Hong Kong involving 204 adults with mild neurocognitive disorder or dementia. The study examined the effects of short-term (12 weeks) group DMT in comparison with exercise and a waiting-list control group immediately post-intervention and three and nine months later. We found that, at the end of the intervention, DMT may result in little to no difference in neuropsychiatric symptoms assessed with the 12-item Neuropsychiatric Inventory when compared with waiting list (MD 0.3, 95% CI -0.96 to 1.56; low-certainty evidence) or exercise (MD -0.30, 95% CI -1.83 to 1.23; low-certainty evidence). Nor was there any evidence of effects at later time points. Cognitive functioning was assessed with a variety of instruments and there were no statistically significant between-group differences (low-certainty evidence). When compared to exercise or waiting list, DMT may result in little to no difference in cognitive function immediately after the intervention or at follow-up. In comparison to waiting list, DMT may result in a slight reduction in depression assessed with the 4-item Geriatric Depression Scale at the end of therapy (MD -0.60, 95% CI -0.96 to -0.24; low-certainty evidence). This slight positive effect of DMT on depression scores was sustained at three and nine months after the completion of the intervention. DMT may also reduce depression slightly in comparison with exercise at the end of therapy (MD -0.40, 95% CI -0.76 to -0.04, low-certainty evidence), an effect also sustained at three and nine months. Our fourth primary outcome, quality of life, was not assessed in the included study. There were data for two of our secondary outcomes, social and occupational functioning and dropouts (which we used as a proxy for acceptability), but in both cases the evidence was of very low certainty and hence our confidence in the results was very low. For all outcomes, we considered the certainty of the evidence in relation to our review objectives to be low or very low in GRADE terms due to indirectness (because not all participants in the included study had a diagnosis of dementia) and imprecision.

AUTHORS' CONCLUSIONS

This review included one RCT with a low risk of bias. Due to the low certainty of the evidence, the true effects of DMT as an intervention for dementia may be substantially different from those found. More RCTs are needed to determine with any confidence whether DMT has beneficial effects on dementia.

Cognitive Exercise for Persons with Alzheimer's Disease and Related Dementia Using a Social Robot

Reminiscence therapy (RT) can improve the mood and communication of persons living with Alzheimer's Disease and Alzheimer's Disease related dementias (PLWD). Traditional RT requires professionals' facilitation, limiting its accessibility to PLWD. Social robotics has the potential to facilitate RT, enabling accessible, home-based RT. However, studies are needed to investigate how PLWD would perceive a robot-mediated RT (RMRT) and how to develop RMRT for positive user experience and successful adoption. In this paper, we developed a prototype of RMRT using a humanoid social robot and tested it with 12 participants (7 PLWD, 2 with mild cognitive impairment, and 3 informal caregivers). The robot automatically displayed a memory trigger on its tablet and engaged participants in a relatable conversation during RMRT. A mixed-method approach was employed to assess its acceptability and usability. Our results showed that PLWD had an overall positive user experience with the RMRT. Participants laughed and sang along with the robot during RMRT and demonstrated intention to use it. We additionally discussed robot control method and several critical problems for RMRT. The RMRT can facilitate both verbal and nonverbal social interaction for PLWD and holds promise for engaging, personalized, and efficient home-based cognitive exercises for PLWD.

Social connections and participation among people with mild cognitive impairment: barriers and recommendations

Objective

Social connections and participation are essential for individuals with mild cognitive impairment (MCI) to prevent the progression of cognitive decline and enhance their overall well-being. However, existing research has primarily focused on environmental barriers, overlooking personal factors and the interconnected nature of these barriers. Moreover, there is a lack of understanding regarding social connections and participation challenges specific to people with MCI in low- and middle-income countries. Therefore, this study aimed to explore the barriers that hinder social connections and participation among people with MCI in China and investigate opportunities to design appropriate supportive interventions.

Methods

Thirty-one people with MCI (13 males and 18 females; mean age = 82.74 years, SD = 7.69; mean MoCA score = 21.26, SD = 2.44) and 13 caregivers were recruited to attend focus groups. In addition, 10 therapists were interviewed using a semi-structured interview guide. Focus groups and interviews were audio-recorded, transcribed, and analyzed using a framework analysis approach.

Results

We found that the ability to build social connections among people with MCI is affected by mobility challenges, intensive grandparenting responsibilities, availability of suitable activities, and feelings of exclusion in a closed-minded community environment. Personal reasons, such as lower social efficacy, inability to find suitable social activities, and intensive family responsibilities, discourage people with MCI from social participation. The digital literacy of people with MCI depends on their motivation to learn and use digital tools; people with MCI who live in a community have a higher digital literacy than those living in care centers. The motivation to achieve digital literacy is affected by perceived benefits, costs of technology use, and social influence.

Conclusion

Multidimensional initiatives are needed to address barriers to social connections, participation, and technology adoption among individuals with MCI. This includes organizing and engaging in social activities, promoting awareness and education on the importance of social participation, and exploring technology-based interventions to improve memory and storytelling abilities. These efforts can create a supportive environment and empower individuals with MCI to participate actively in social interactions, enhancing their overall well-being.

Healthcare professionals' perception of using a web-based reminiscence therapy to support person with dementia during the COVID-19 pandemic

BACKGROUND

Reminiscence therapy (RT) is the most common non-pharmacological treatment for dementia care. The therapy stimulates the senses to evoke memories having the potential to reduce Behavioral and Psychological Symptoms of Dementia (BPSD). Digital RT, such as web-based reminiscence therapy (WBRT), has the potential to support dementia care and reduce the caregiving burden.

AIMS

This study aimed to explore healthcare professionals (HCPs) perceptions of utilizing WBRT in institutionalized settings to support persons with dementia during the COVID-19 pandemic.

METHODS

A qualitative phenomenological descriptive study was adopted and guided by Graham's Knowledge to Action framework. Online training on the use of WBRT was conducted, followed by interviews with HCPs.

RESULTS

Four major themes were identified on the potential use of WBRT in dementia care, including usability and efficacy, impact on caregiving, capability of reducing BPSD, and. feasibility during COVID-19 social distancing.

DISCUSSION

This study recognized the potential use of WBRT to support the person with dementia during the pandemic in institutionalized settings.

CONCLUSION

The knowledge generated from this study will guide the future application of WBRT to support dementia care in diverse healthcare settings.

Effects of reminiscence therapy on psychological outcome among older adults without obvious cognitive impairment: A systematic review and meta-analysis

Introduction

Reminiscence therapy has been a high-benefit and low-cost measure of psychosocial intervention for older adults in recent years. It has attracted much attention in the intervention study of older adults without obvious cognitive impairment. This study aimed to evaluate the effects of reminiscence therapy on psychosocial outcomes among older adults without obvious cognitive impairment and analyze the divergences of different intervention programs (form, duration, and setting) on outcomes.

Methods

We searched the commonly used databases and used RevMan 5.4 in the meta-analysis (PROSPERO-ID: CRD42022315237). All eligible trials used the Cochrane Risk of Bias Tool and the Effective Public Health Practice Project quality assessment tool to identify the quality and determine the bias risk grade.

Results

Twenty-seven studies were included, involving 1,755 older adults. Meta-analysis showed that reminiscence therapy has a significant effect on both depression and life satisfaction. Group reminiscence played a significant role in improving life satisfaction. Depression symptoms were not affected by the intervention duration (P = 0.06), while life satisfaction was significantly improved after more than 8 weeks of intervention (P < 0.00001). Intervention settings drove differences in depressive symptoms (P = 0.02), and the effect size of the community was larger.

Conclusion

Reminiscence therapy can significantly reduce depressive symptoms and improve life satisfaction. There are different effects of reminiscence therapy in different intervention schemes on psychological outcomes among older adults. More well-designed trials with large sample sizes and long-term follow-ups are necessary to confirm and expand the present results.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315237, identifier: CRD42022315237.

Life review on psychospiritual outcomes among older adults with life-threatening illnesses: A systematic review and meta-analysis

Background

At the intersection of old age and illness, older adults with life-threatening illnesses (LTI) are a group who often show resilience and seek validation of life, acceptance, and integration of past and now, even under the fear of loss, suffering, and dying evoked by life adversities. Life review has been widely conducted to help older adults enhance well-being and cope with burdens. Spirituality is an important part of an older adult' overall well-being, especially for those with LTI. However, few review studies examined the effectiveness of life review interventions on psychospiritual outcomes among this population. The aim of the study was to examine the effectiveness of life review on psychospiritual well-being among older adults with LTI.

Methods

A systematic review with meta-analysis following the recommendations of the Cochrane Collaboration was conducted. Database searches included PubMed, PsycINFO, the Cochrane Library, the Campbell Library, EBSCO, CNKI, and the Airiti Library up to March 2020. Gray literature and reference lists from relevant articles were also searched and reviewed.

Results

In total, 34 studies were included in the systematic review and the meta-analysis for outcomes of depression (n = 24), quality-of-life (QOL) (n = 10), anxiety (n = 5), life satisfaction (n = 3), mood (n = 3), apathy (n = 2), and general well-being (n = 2). Other psychospiritual outcome measures included spirituality, self-esteem, meaning in life, hope, and some multi-dimensional instruments. The studies greatly varied in program design, content, format, length, and more. Although with high heterogeneity, meta-analysis results demonstrated standardized mean differences in favor of life review in decreasing depression, anxiety, negative mood, and increasing positive mood and QOL compared with the control group.

Conclusion

This review calls for including more psycho-spiritual well-being measures among interventions for older adults with LTI, as well as studies with rigorous designs in future research.

The Effects of a New Integrated and Multidisciplinary Cognitive Rehabilitation Program Based on Mindfulness and Reminiscence Therapy in Patients with Parkinson's Disease and Mild Cognitive Impairment: A Pilot Study

Background: Mindfulness trainings have shown promising results as treatment for behavioural symptoms in several pathologies. In addition, mindfulness protocols induced an improvement in memory and attention. Therefore, mindfulness could be an effective intervention for patients affected by Parkinson's disease (PD) and mild cognitive impairment (MCI), who are characterized by both behavioural and cognitive dysfunctions. Methods: We assessed differences in Montreal Cognitive Assessment (MoCA) scores and in Beck Depression Inventory II (BDI-II) scores in patients affected by PD and MCI enrolled in two different rehabilitation programs (an experimental vs. an usual structured program for cognitive rehabilitation). Participants in the experimental group (MILC-tr) underwent innovative rehabilitation program involving mindfulness and reminiscence activities. Assessments were performed before (T0) and at the end of the rehabilitation program (T1). Results: Friedman test showed a significant improvement between timepoints in MoCA global score (x² = 4.000, p = 0.046), MoCA memory sub-scale score (x² = 4.571, p = 0.033), and BDI-II cognitive and affective factors (x² = 4.000, p = 0.046) only for patients in MILC-tr group. Mann-Whitney test showed a significant difference between group comparing differences in Δ scores between T0 and T1 in the MoCA memory sub-scale score (U = 190.50, p = 0.035). Conclusions: Mindfulness-based rehabilitation programs could be effective in patients affected by PD and MCI.

Pioneering the Metaverse: The Role of the Metaverse in an Aging Population

Amid a worldwide pandemic in the setting of an era of rapidly developing technologies, we turn now to the novel and exciting endeavor of pioneering the metaverse. Described as the conglomeration of augmented reality, virtual reality, and artificial intelligence, the metaverse has widespread applications in multiple settings, including revolutionizing health care. It also holds the potential to transform geriatric medicine, introducing new dimensions through which we can prevent social isolation, encourage health and well-being, and offer a new dimension through which we manage chronic disease. Although it is still a futuristic and novel technology, the metaverse's realization may indeed be closer than we think.

The Efficacy of Reminiscence Therapy in Cancer-Related Symptom Management: A Systematic Review and Meta-Analysis

BACKGROUND

At present, simple reminiscence has been widely used in the field of neurocognitive disorders, life review/life review therapy has been widely used in the field of cancer, and both simple reminiscence and life review/life review therapy are suitable for psychological disorders such as depression and anxiety. However, the efficacy of reminiscence in treating cancer-related symptom has not been fully assessed.

OBJECTIVES

To evaluate the effect of reminiscence therapy (RT) on relieving cancer-related symptoms such as anxiety and depression in cancer survivals.

METHODS

China National Knowledge Infrastructure (CNKI), VIP database, Wanfang Data Knowledge Service Platform, China Biomedical Database, PubMed, Cochrane Library, Embase, EBSCO, Scopus, and Ovid databases were searched. To collect clinical randomized controlled trials (RCT) on RT and cancer-related studies published from the establishment of the database to October 05, 2021. Two researchers independently evaluated the articles that met the inclusion criteria, meta-analysis was performed using RevMan5.4 software.

RESULTS

A total of 20 RCTs published in 2010 to 2021 were included, with a total of 1853 cancer patients. Meta-analysis results showed that the anxiety scale (HADS-A and HAMA and SAS) and depression scale (HADS-D and HAMD and SDS) scores of the RT group were significantly lower than those of the control group (HADS-A: P = .0002; HAMA: P < .00001; SAS: P = .0010; HADS-D: P = .01; HAMD: P < .00001; SDS: P = .0001). Meta-analysis results showed that RT can improve overall quality of life of cancer patients of RT group to a certain extent hope (P < .00001). Meta-analysis results showed that the scores on the hope and dignity were significantly increased, and the difference were statistically significant (P < .001).

CONCLUSION

This review indicates that RT has significant efficacy on cancer-related symptoms such as anxiety and depression. RT for cancer survivals can effectively improve quality of life, self-hope, and self-esteem. The findings of this meta-analysis can provide direction for future symptom management research.

Voice Over Body? Older Adults' Reactions to Robot and Voice Assistant Facilitators of Group Conversation

Intelligent agents have great potential as facilitators of group conversation among older adults. However, little is known about how to design agents for this purpose and user group, especially in terms of agent embodiment. To this end, we conducted a mixed methods study of older adults' reactions to voice and body in a group conversation facilitation agent. Two agent forms with the same underlying artificial intelligence (AI) and voice system were compared: a humanoid robot and a voice assistant. One preliminary study (total n = 24) and one experimental study comparing voice and body morphologies (n = 36) were conducted with older adults and an experienced human facilitator. Findings revealed that the artificiality of the agent, regardless of its form, was beneficial for the socially uncomfortable task of conversation facilitation. Even so, talkative personality types had a poorer experience with the "bodied" robot version. Design implications and supplementary reactions, especially to agent voice, are also discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12369-022-00925-7.

Putting "the broken bits together": A qualitative exploration of the impact of communication changes in dementia

INTRODUCTION

Communication is an area of health and functioning that is profoundly affected by dementia. While it is known that people living with dementia and their care partners experience disruptions to daily activities and social engagement, detailed knowledge about the lived impact of dementia-related communication changes is lacking. This study sought an in-depth understanding of the lived experience of dementia-related communication changes and the associated impact, needs, and strategies.

METHODS

As part of an overarching participatory design study, a qualitative (interpretive description) exploration was undertaken with people living with dementia and their care partners. Data from semi-structured interviews were analysed using thematic analysis.

RESULTS

We interviewed 13 people living with dementia and 21 care partners and drew three themes and 10 subthemes from the interviews. The first theme illustrates how dementia changes communication which in turn changes life; the second captures the impact of changes on people living with dementia and care partners emotionally and in the context of relationships; and the third describes some positive and constructive ways of moving forward with dementia-related communication changes.

CONCLUSIONS

Interventions to enhance function, participation, and wellbeing for people living with dementia and their care partners need to encompass support for communication changes. There is a need to ensure that people living with dementia feel dignified and respected during communication, and that care partners and inclusive communities are educated, trained, and supported to facilitate communication.

Palliative care for people with dementia

Dementia is the most common neurologic disease, affecting approximately 55 million people worldwide. Dementia is a terminal illness, although not always recognized as such. This chapter discusses the key issues in providing palliative care for people with living with dementia and their families. Common palliative care needs and symptoms are presented, including psychosocial, physical, emotional, and spiritual, and the need to actively anticipate and seek symptoms according to the dementia type and stage is emphasized. Families are hugely impacted by a dementia diagnosis, and throughout this chapter, they are considered in the unit of care, and also as a member of the care team. Multiple challenges particular to dementia palliative care are highlighted throughout, such as the lack of timely dementia diagnoses, difficulty with symptom prognostication, the person's inability to verbally express their symptoms and care preferences, and a low threshold for medication side effects. Finally, service models for dementia palliative care in community, residential, and acute hospital settings are discussed, along with the evidence for each. Overall, this chapter reinforces that the individual needs of the person living with dementia and their family must be considered to provide person-centered and comprehensive palliative care, enabling them to live well until death.

Comparative efficacy and acceptability of treatments for depressive symptoms in cognitive impairment: A systematic review and Bayesian network meta-analysis

Background

Depressive symptoms play an essential role in cognition decline, while the benefit and acceptability of treatments for depressive symptoms in cognitive impairment are still unknown.

Objective

To comprehensively evaluate the comparative efficacy and acceptability of treatments for depressive symptoms in cognitive impairment based on the quantitative Bayesian network meta-analysis method (NMA).

Method

We searched MEDLINE, Embase, the Cochrane Library, CINAHL, and PsycINFO from inception until August 2022 to identify randomized clinical trials (RCTs) evaluating treatments for depressive symptoms in cognitive impairment. Efficacy was evaluated by the Cornell Scale for Depression in Dementia (CSDD), the Hamilton Depression Rating Scale (HDRS), and the Geriatric Depression Scale (GDS) for depression; the Neuropsychiatric Inventory (NPI) and the Cohen-Mansfeld Agitation Inventory (CMAI) for behavior; and the Mini-Mental State Examination (MMSE) for cognition. Safety was evaluated by total adverse events (AEs), serious AEs, diarrhea, headache, and nausea.

Results

In this study, 13,043 participants from 107 RCTs were included, involving 28 treatments and the discontinuation of antidepressants. On CSDD, aerobic exercise (MD -4.51, 95%CrI -8.60 to -0.37), aripiprazole (MD -1.85, 95%CrI -3.66 to -0.02), behavioral training (MD -1.14, 95%CrI -2.04 to -0.34), electrical current stimulation (MD -3.30, 95%CrI -5.94 to -0.73), massage (MD -12.67, 95%CrI -14.71 to -10.59), music therapy (MD -2.63, 95%CrI -4.72 to -0.58), and reminiscence therapy (MD -2.34, 95%CrI -3.51 to -1.25) significantly outperformed the placebo. On MMSE, cognitive stimulation therapy (MD 1.42, 95%CrI 0.49 to 2.39), electrical current stimulation (MD 4.08, 95%CrI 1.07 to 7.11), and reminiscence therapy (MD 1.31, 95%CrI 0.04 to 2.91) significantly outperformed the placebo. Additionally, no treatments showed a significantly higher risk than the placebo.

Conclusion

Our NMAs indicated that non-pharmacological interventions were more efficacious and safe than pharmacological treatments for reducing depressive symptoms as well as improving cognitive impairment. Electrical current stimulation, aerobic exercise, and reminiscence therapy could be first recommended considering their beneficial performance on both depression and cognition. Hence, non-pharmacological treatments deserve more attention and extensive application and should at least be considered as an alternative or assistance in clinical settings.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021239621, identifier: CRD42021239621.

The effect of group reminiscence therapy on death anxiety and adaptation of the elderly to old age

AIM

In the present study, we aimed to evaluate the effectiveness of group reminiscence on death anxiety and adaptation of the elderly to old age.

METHODS

This is a clinical trial study. Using simple random sampling method, we divided 32 elderly people into the intervention (n = 16) and control (n = 16) groups. Reminiscence therapy was held in 12 sessions. The study instruments including demographic characteristics questionnaire, Mini Mental Status Examination, Templer Death Anxiety, and aging adjustment questionnaires were filled out by the samples in 3 steps before the intervention, after the last day of the intervention, and 30 days after the end of the interventional sessions.

RESULTS

In the intervention group, the mean score of death anxiety and adjustment to old age before the intervention showed a statistically significant difference with the post-intervention stages (P < 0.05); however, in the control group, the mean scores of death anxiety and adjustment to old age in the 3 steps were not statistically significant (P > 0.05). Also, no statistically significant difference was found between the intervention and control groups before the intervention (P > 0.05), but there was a statistically significant relationship in the steps immediately after the last day of the intervention and 30 days after the end of the interventional sessions (P < 0.05).

CONCLUSION

The findings of the present study indicate that reminiscence therapy is able to effectively reduce the anxiety of death in the elderly; also, reminiscence therapy can be used to improve the adaptation ability of the elderly to old age.

Interdisciplinary Approaches to Deal with Alzheimer's Disease-From Bench to Bedside: What Feasible Options Do Already Exist Today?

Alzheimer's disease is one of the most common neurodegenerative diseases in the western population. The incidence of this disease increases with age. Rising life expectancy and the resulting increase in the ratio of elderly in the population are likely to exacerbate socioeconomic problems. Alzheimer's disease is a multifactorial disease. In addition to amyloidogenic processing leading to plaques, and tau pathology, but also other molecular causes such as oxidative stress or inflammation play a crucial role. We summarize the molecular mechanisms leading to Alzheimer's disease and which potential interventions are known to interfere with these mechanisms, focusing on nutritional approaches and physical activity but also the beneficial effects of cognition-oriented treatments with a focus on language and communication. Interestingly, recent findings also suggest a causal link between oral conditions, such as periodontitis or edentulism, and Alzheimer's disease, raising the question of whether dental intervention in Alzheimer's patients can be beneficial as well. Unfortunately, all previous single-domain interventions have been shown to have limited benefit to patients. However, the latest studies indicate that combining these efforts into multidomain approaches may have increased preventive or therapeutic potential. Therefore, as another emphasis in this review, we provide an overview of current literature dealing with studies combining the above-mentioned approaches and discuss potential advantages compared to monotherapies. Considering current literature and intervention options, we also propose a multidomain interdisciplinary approach for the treatment of Alzheimer's disease patients that synergistically links the individual approaches. In conclusion, this review highlights the need to combine different approaches in an interdisciplinary manner, to address the future challenges of Alzheimer's disease.

DMapp: a developing promising approach to monitor symptoms progression and stimulate memory in Italian people with cognitive impairments

BACKGROUND

Based on recent researches on the use of natural language processing techniques for very early detection of cognitive decline and the benefits of cognitive stimulation for people with cognitive impairments, the Dementia Monitoring application (DMapp) is developed inside the Memento project.

AIMS

The aims of this work are: (1) to present DMapp; (2) to report the results of two preliminary studies on DMapp; (3) to describe the clinical and experimental potentiality of DMapp.

METHODS

Italian people with the diagnosis of mild cognitive impairment due to Alzheimer's disease or dementia due to Alzheimer's Disease with a Mini-Mental-State-Examination between 24 and 28 (inclusive) were involved in the DMapp development prototype during the Lab Trial (4 subjects) and Filed Trial (5 subjects) of the Memento project. Qualitative and quantitative data were collected to evaluate participants' opinions, the DMapp ability to perform the automatic analysis of the speech and participants' visible emotional state effective. Ad hoc interviews, the Observed Emotion Rating Scale and performance metrics to solve different tasks were used. The relation between cognitive measures (global cognitive measures) and linguistic indexes values was considered using Euclidean distances between the participants.

RESULTS

Linguistic indexes were calculated and seemed to classify the participants' performance as expected from cognitive measures. The DMapp was appreciated by people with cognitive impairment. Positive emotions were present.

CONCLUSION

DMapp seems an interesting approach to monitor dementia symptoms progression and stimulate memory. Possible developments and open questions are discussed.

[Effect of psychological interventions on psychosocial variables in patients with colorectal cancer: a narrative review of the literature]

Objective

To describe the effects of psychological interventions on anxiety, depression, emotional distress and/or quality of life (QoL) of patients with colorectal cancer.

Methods

Narrative literature review in MEDLINE, PsycINFO, CINAHL and Cochrane Library, 2011-2021.

Results

A total of 553 articles were obtained, of which twelve were included. Most were brief, individual, face-to-face interventions. Cognitive Behavioral Therapy was the most reported intervention, showing positive effects on QoL, specifically in stoma patients; Acceptance and Commitment Therapy and solution-focused therapy also identified improvements in QoL. Reminiscence therapy and a self-efficacy intervention reported significant improvements in anxiety and depression. Relaxation and writing training were not proven effective; psychoeducation showed inconsistent effects.

Conclusion

There is a paucity of studies conducted during the last years, which do not evidence a consensus of the therapeutic model that produces consistent improvements in psychological well-being.

Multicenter randomized controlled trial of the effects of individual reminiscence therapy on cognition, depression and quality of life: Analysis of a sample of older adults with Alzheimer's disease and vascular dementia

Objective: To determine the effectiveness of a 13-week individual reminiscence therapy (RT) intervention on cognition, memory, executive function, mood, and quality of life of people with Alzheimer's disease and vascular dementia. Method: Non-protocolized analysis using data from a larger multicenter, single-blind, randomized, parallel two-arm RCT of RT for people with neurocognitive disorders. A sample of 148 people with probable Alzheimer's disease or vascular dementia attending 23 Portuguese institutions providing care and support services for older adults were selected. Intervention group (n = 74) received 26 individual RT sessions, twice a week for 13 weeks. Control group (n = 74) maintained their treatment as usual. Outcomes were global cognitive function (MMSE), memory (MAT), executive function (FAB), mood (GDS-15), and self-reported quality of life (QoL-AD). All participants were assessed at baseline (T0) and 15 weeks later (T1). Results: The results showed a significant effect of the intervention on global cognition (Group X Time interaction F(1, 128) = 10.542, p = .001, η_p² = .076), memory (F(1,128) = 9.881, p = .002, η_p² = .072), and quality of life (F(1,128) = 0.181, p = .671, η_p² = .001), with medium effect sizes. A small effect on executive function (F(1,127) = 11.118, p = .001, η_p² = .080) was also found. No effects were found on depressive symptoms (F(1,128) = 0.181, p = .671, η_p² = .001). Conclusion: Individual RT may have beneficial effects on cognition and quality of life of people with Alzheimer's disease or vascular dementia.

Effects of Reminiscence Therapy on Cognition, Depression and Quality of Life in Elderly People with Alzheimer’s Disease: A Systematic Review of Randomized Controlled Trials

Background: Patients with Alzheimer’s disease (AD) present with cognitive function deterioration, neuropsychiatric symptoms (NPS)—especially depression—and low quality of life (QoL). Management of AD remains difficult, especially in the elderly. Reminiscence therapy (RT) is a well-known cognitive rehabilitation intervention that can be adopted in nursing and residential care homes to restore autobiographical memory, ameliorate NPS, and improve the QoL of people with dementia. However, the evidence-based efficacy of RT for elderly patients with AD remains to be determined. Methods: Here, we synthesized findings of randomized controlled trials (RCTs) exploring the effects of RT on cognition, depression, and QoL in elderly people with AD, according to the most recent PRISMA statement. We searched for RCTs in PubMed, Web of Science, and Cochrane Central Register of Controlled Trials, and in trial registries (i.e., clinicaltrials.gov and International Clinical Trials Registry Platform of the World Health Organization). Two review authors extracted data of interest, with cognition, depression, and QoL measures as outcomes. Results: A total of five articles were included in the final analysis. Findings globally showed that RT, both administered in individual or group sessions at least once a week for 30–35 min over a period of 12 weeks, is effective in supporting global cognition, ameliorating depression, and improving specific aspects of the QoL in elderly people with AD. Conclusions: RT has the potential to be a routine non-pharmacological therapy for elderly people with AD, thanks to its wider effects on the individual in terms of cognitive vitality and emotional status promotion, with positive implications for patient’s daily life. Despite such evidences, caution should be used in findings’ generalizability in relation to the paucity of existing RCTs with long-term follow-up.

An integrated intervention of computerized cognitive training and physical exercise in virtual reality for people with Alzheimer's disease: The jDome study protocol

Introduction

Alzheimer's disease is a neurodegenerative syndrome characterized by cognitive deficits, loss of daily functions, and mental and behavioral disorders, which cause stress and negatively affect the quality of life. Studies in the field suggest that combining cognitive training with physical activity can reduce the risk of developing the disease and, once neurodegeneration has begun, it slows its progress. In particular, virtual reality and augmented reality administer cognitive stimulation while providing a link to autobiographical memory through reminiscence, enabling the improvement of the person's quality of life. The present protocol aims to evaluate the effectiveness of cognitive and physical treatments, integrated with the addition of virtual reality and reminiscence elements, using the Brainer software, in which people will find cognitive training, and the jDome® BikeAround™ system, which will allow participants to pedal along a personalized path projected on a schematic, using an exercise bike connected to the system.

Methods and analysis

For this study, 78 patients with mild Alzheimer's dementia were recruited and divided into the Experimental Group (EG) and Control Group (CG). Sixteen treatment sessions of 60 min each were conducted for both groups (2 training sessions per week, for 8 weeks), including 1 patient at a time. The EG received cognitive treatment with Brainer and physical training with jDome, while the CG received cognitive treatment with Brainer and physical training with a classic bicycle. The evaluation mainly focused on the assessment of the person's cognitive status. Other analyses were conducted on the quality of life, mood, behavioral disorders, and physical function, which were considered secondary outcomes.

Discussions

The ultimate goal of the present study is to test the effectiveness of a treatment for people with mild Alzheimer's focused on the integration of cognitive training and aerobic physical activity, using an exercise bike, with the addition of virtual reality and reminiscence elements.

Ethics and dissemination

The study was approved by the Ethics Committee of the IRCCS INRCA. It was recorded in ClinicalTrials.gov on 2 June 2022 with the number NCT05402423. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.

Reminiscence Therapy as a Potential Method to Improve Psychological Health and Quality of Life in Elderly Hepatocellular Carcinoma Patients: A Randomized, Controlled Trial

Background

Reminiscence therapy mitigates psychological issues and improves the quality of life of cancer survivors. However, its role in elderly patients with hepatocellular carcinoma (HCC) is unclear. Thus, we aimed to detect the effect of reminiscence therapy on anxiety, depression, and the quality of life of elderly patients with HCC.

Methods

In total, 106 elderly patients with HCC after resection were randomized in a 1:1 ratio to the reminiscence therapy group (N = 54) and control care group (N = 52) and then received intervention for 12 months. Anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale (HADS) at baseline [Month (M) 0], 3 months (M3), 6 months (M6), 9 months (M9), and 12 months (M12). Meanwhile, quality of life was assessed using the European Organization for Research and Treatment of Cancer quality of life Questionnaire—Core 30 (QLQ-C30) at M0, M6, and M12.

Results

The HADS for anxiety score at M9 (6.8 ± 2.3 vs. 7.8 ± 2.4, P = 0.039) and M12 (6.6 ± 2.4 vs. 7.8 ± 2.6, P = 0.013) and the anxiety proportion at M12 (27.8% vs. 46.2%, P = 0.050) were reduced in the reminiscence therapy group compared with those in the control care group. Moreover, the HADS for depression score declined at M9 (6.6 ± 2.0 vs. 7.5 ± 2.2, P = 0.025) and M12 (6.3 ± 2.3 vs. 7.7 ± 2.6, P = 0.005), but the proportion of those with depression was not different at each visit (P > 0.05) in the reminiscence therapy group compared with that of the control care group. In addition, the QLQ-C30 global health status score increased at M6 (71.3 ± 12.8 vs. 66.3 ± 12.9, P = 0.048) and M12 (74.5 ± 12.9 vs. 68.2 ± 13.3, P = 0.014) in the reminiscence therapy group compared to that in the control care group.

Conclusion

Reminiscence therapy effectively mitigates anxiety and depression and improves the quality of life of elderly patients with HCC.

The Long-term Effects of Immersive Virtual Reality Reminiscence in People With Dementia: Longitudinal Observational Study

Background

Novel nonpharmacological therapies are being developed to prevent cognitive decline and reduce behavioral and psychological symptoms in patients with dementia. Virtual reality (VR) reminiscence was reported to improve anxiety, apathy, and cognitive function immediately after intervention in individuals at residential aged care facilities. However, its effect on elderly patients with dementia and how long this effect could last remain unknown.

Objective

The aim of this paper is to investigate the effect of immersive VR reminiscence in people with dementia both immediately after and 3-6 months after intervention.

Methods

A pilot study was conducted in 2 dementia care units. VR reminiscence therapy sessions were conducted twice per week for a 3-month period. Cognitive function, global status, depressive symptoms, and caregiver burden were assessed before and immediately after VR intervention in 20 participants. Subsequently, 7 participants were reassessed 3-6 months after the VR intervention. Wilcoxon sign-rank test was used for statistical comparisons of the changes.

Results

There were no significant changes in cognitive function, global status, and caregiver burden immediately after the VR intervention, but there was a significant reduction in depressive symptoms (P=.008). Moreover, compared with the cognitive function immediately after VR, it kept declining 3-6 months after.

Conclusions

Immersive VR reminiscence can improve mood and preserve cognitive function in elderly patients with dementia during the period of the intervention. Studies using a control group and comparing the use of VR with traditional forms of reminiscence should be conducted in the future to confirm and expand on these findings.

Interactive Somatosensory Games in Rehabilitation Training for Older Adults With Mild Cognitive Impairment: Usability Study

BACKGROUND

In aging societies, dementia risk increases with advancing age, increasing the incidence of dementia-related degenerative diseases and other complications, especially fall risk. Dementia also escalates the care burden, impacting patients, their families, social welfare institutions, and the social structure and medical system.

OBJECTIVE

In elderly dementia, traditional card recognition rehabilitation (TCRR) does not effectively increase one's autonomy. Therefore, from the usability perspective, we used the Tetris game as a reference to develop an interactive somatosensory game rehabilitation (ISGR) with nostalgic style for elders with mild cognitive impairment (MCI). Through intuitive gesture-controlled interactive games, we evaluated subjective feelings concerning somatosensory game integration into rehabilitation to explore whether the ISGR could improve the willingness to use and motivation for rehabilitation among elders with MCI.

METHODS

A total of 15 elders with MCI (7 males and 8 females with an average age of 78.4 years) underwent 2 experiments for 15 minutes. During experiment 1, TCRR was performed, followed by completing the questionnaire of the System Usability Scale (SUS). After 3-5 minutes, the second experiment (the ISGR) was conducted, followed by completing another SUS. We used SUS to explore differences in impacts of TCRR and ISGR on willingness to use among elders with MCI. In addition, we further investigated whether the factor of gender or prior rehabilitation experience would affect the rehabilitation willingness or not.

RESULTS

The novel ISGR made the elderly feel interested and improved their willingness for continuous rehabilitation. According to the overall SUS score, the ISGR had better overall usability performance (73.7) than the TCRR (58.0) (t₂₈=-4.62, P<.001). Furthermore, the ISGR individual item scores of "Willingness to Use" (t₂₈=-8.27, P<.001), "Easy to Use" (t₂₈=-3.17, P<.001), "System Integration" (t₂₈=-5.07, P<.001), and "Easy to Learn" (t₂₈=-2.81, P<.001) were better than TCRR. The somatosensory game was easier to learn and master for females than for males (t₁₃=2.71, P=.02). Besides, the ISGR was easier to use (t₁₂=-2.50, P=.02) and learn (t₁₄=-3.33, P<.001) for those without prior rehabilitation experience. The result indicates that for elders with no rehabilitation experience ISGR was easier to use and simpler to learn than TCRR.

CONCLUSIONS

Regardless of prior rehabilitation experience, the ISGR developed in this study was easy to learn and effective in continuously improving willingness to use. Furthermore, the adoption of a nostalgic game design style served the function of cognitive training and escalated interest in rehabilitation. The ISGR also improved user stickiness by introducing different game scenarios and difficulties, increasing long-term interest and motivation for rehabilitation. For future research on the adoption of interactive somatosensory games in rehabilitation, additional rehabilitation movements can be developed to benefit the elderly with MCI.

Scoping review of reminiscence research undertaken in long-term care communities

Mental health conditions ranging from minor depressive symptoms to major depression, loneliness and poor quality of life are significant concerns in long-term care communities. Reminiscence is one intervention that has shown to reduce depressive symptoms and improve quality of life. The purpose of this scoping review was to determine the extent of reminiscence research undertaken in long-term care communities. Arksley and O'Malley's six stage method provided the framework for the review. Studies published in peer reviewed literature were identified based on searches in three databases (CINAHL, PUBMED, PsycINFO). Thirty-two studies met inclusion criteria. Of the 32 articles examined, 2 studies were conducted in the United States. Twenty-five health outcomes were examined, including twenty-three psychological outcomes and two physiological outcomes. Depression and cognitive functions were the most frequently measured outcomes. Lack of theoretical frameworks underpinning the studies, inadequate sample sizes, and weak methodology were noted in this review. Recommendations for future reminiscence research in long-term care communities are discussed.

Experiences of Carers and People with Dementia from Ethnic Minority Groups Managing Eating and Drinking at Home in the United Kingdom

Eating and drinking difficulties, such as loss of appetite and swallowing problems, are common in dementia, but little is known about the experiences of ethnic minority groups who are managing these difficulties at home. The purpose of our study was to explore the meaning of food, the impact of dementia on eating and drinking, and carers’ experiences of support. We undertook semi-structured interviews with 17 carers and people with dementia from ethnic minority backgrounds living in England, using thematic analysis to analyse the data. Food/drink had strong links to identity, culture and emotions. Providing culturally familiar foods, celebrating traditional festivals and supporting previous food-related roles promoted reminiscence, which encouraged the people living with dementia to eat and drink, as did social interactions, although these could lead to distress in those with more advanced dementia. Food choices were also influenced by carer strain, generational differences and the impact of health conditions. Despite a strong sense of duty to care for relatives at home, there was low awareness of community support services. The carers expressed a need for culturally tailored support for managing dementia-related eating and drinking difficulties at home. Healthcare professionals must provide contextually relevant advice to carers, being mindful of how cultural backgrounds can affect dietary choices.