Uses of reminiscence intervention to address the behavioral and psychosocial problems associated with dementia: An integrative review

Comparative efficacy of multiple non-pharmacological interventions for behavioural and psychological symptoms of dementia: A network meta-analysis of randomised controlled trials

Non-pharmacological interventions can improve the behavioural and psychological symptoms of dementia (BPSD). However, the optimal non-pharmacological treatments remain controversial. This study aimed to compare the efficacy of multiple non-pharmacological methods and identify the optimal therapy for BPSD. Potential randomised controlled trials (RCTs) were searched and selected from 15 databases and sources from the inception of the databases until 1 October 2022. Two independent authors implemented study screening, data extraction, and methodological quality assessment. Primary outcome was reduction of Neuropsychiatric Inventory (NPI). The secondary outcome were changes of Cornell Scale for Depression in Dementia (CSDD), the Cohen-Mansfield Agitation Inventory (CMAI), the Quality of Life in Alzheimer's Disease (QoL-AD), the Abilities of Daily Living scale, and the Apathy Evaluation Scale. Meta-analyses were performed using STATA v15.0 and ADDIS v1.16.8. The GRADE approaches were utilised to evaluate evidence quality. The present study included 43 RCTs with 4978 participants. The global methodological quality of the RCTs was moderate. Regarding NPI reduction, with moderate-certainty evidence, exercise plus treatment as usual (TAU) outperformed TAU (mean difference [MD]: -7.13; 95% confidence interval [CI]: -13.22, -0.76) and ranked as the optimal treatment. For reduction in CSDD, with low- to moderate-certainty evidence, massage plus TAU (MD: -15.26; 95% CI: -20.13, -10.52) and music plus TAU (MD: -2.40; 95% CI: -4.62, -0.12) were associated with greater reduction compared with TAU. For reduction in CMAI, with moderate-certainty evidence, aromatherapy plus massage (MD: -15.84; 95% CI: -29.76, -2.42) and massage plus music (MD: -13.12; 95% CI: -25.43, -0.76) were significantly more effective than TAU. For improvement in QoL-AD, with critically low- to low-certainty evidence, there were no statistical differences between any of non-pharmacological treatments and TAU. Due to the limited number of included studies, network meta-analysis was not performed for other outcomes. In conclusion, non-pharmacological treatments are effective for overall symptoms, depression, and agitation. Exercise plus treatment as usual may be an optimal non-pharmacological intervention for improving the overall BPSD. This may help to guide patients, doctors, and policymakers.

Development of mobile compatible software for cognitive-communication disorder in individuals with Alzheimer's disease

BACKGROUND

Alzheimer's disease (AD) is a progressive neurodegenerative disease. Cognitive functions and communication skills worsen as the disease progresses, thereby reducing patients' independence levels. Therefore, recommending software that can be used at home may be a useful means of slowing down the cognitive and communicative decline in AD.

AIMS

To develop software that can be used at home to slow down the cognitive and communicative decline and increase independence in individuals with AD; and to examine the effect of this software on the cognitive communication skills of individuals with AD.

METHODS & PROCEDURES

The study was completed in four stages: the development of the application; the evaluation of the participants and their training for the application; their use of the application at home; and the re-evaluation of the participants. A total of 32 individuals who met the inclusion criteria were included in the study. These individuals were randomly divided into study and control groups, each consisting of a total of 16 participants, including six in the mild stage, six in the moderate stage, and four in the severe stages. The developed software was loaded on tablets and given to the participants in the study group. The participants in the control group only received their pharmacological treatment, while those in the study group received both their pharmacological treatment and used the developed application. All participants were evaluated with the Mini-Mental State Examination (MMSE) and Language Assessment Test for Aphasia (LATA) before and after application use. A survey was administered to the caregivers of the participants in the study group after the use of the application.

OUTCOMES & RESULTS

The results revealed a positive change in the cognitive-communication skills of the individuals in the study group, even if they were in the severe stage, according to the LATA and MMSE, as well as the survey. The application led to the greatest improvements in grammar on the LATA and orientation on the MMSE. No rapid cognitive decline was seen in individuals at all stages in the control group.

CONCLUSIONS & IMPLICATIONS

In this study, software was developed in Turkish that can be used in every stage of AD as part of a holistic cognitive-communication intervention programme offering alternative and supportive communication for individuals with AD, even those in the severe stage. Results prove the effectiveness of the developed software on the cognitive-communication skills of individuals with AD.

WHAT THIS PAPER ADDS

What is already known on the subject There are a few (as far as is known, three) applications developed in English for cognitive-communication disorders due to dementia. What this study adds to the existing literature In this study, for the first time in Turkish, mobile-compatible software has been developed for both cognitive and communication disorders that is specific to individuals with AD and can be used by individuals at all stages of the disease. The effects of the application we developed on the cognitive-communication skills of individuals with AD were shown in a randomised controlled trial. What are the potential or actual clinical implications of this work? Using the app can help people with all stages of AD keep their cognitive and communication skills and have a better prognosis in terms of cognitive-communication skills, especially grammar and orientation.

Transcultural Pilot Study of the Efficacy of Reminiscence Therapy for Mexican and Spanish Older Adults with Different Levels of Cognitive Decline

The main objective for this study is to analyze the impact of a positive reminiscence therapy program (REMPOS) in cognitive functioning and depressive symptomatology for older adults in different vital situations (healthy aging, mild cognitive impairment, and Alzheimer's disease).This is a transcultural comparative study (older people from Spain and Mexico). A randomized design with pre-posttest measurement and twelve groups was formulated, during a period of six months of intervention (3 in Mexico and 3 in Spain). The design had: 6 experimental groups with REMPOS intervention (3 in Mexico and 3 in Spain) during a period of six months and 6 control groups that received cognitive stimulation.While a key aspect of this study is the cross-cultural differences, an important part is to determine whether each experimental group had similar results in terms of the change in magnitude between the pre and post analysis. In general, intervention significantly improved cognitive function and decreased depressive symptoms.These findings provide further evidence about the efficacy of the REMPOS therapy between different types of aging and both geographical and cultural contexts (Spain and Mexico).

Cross-cultural effects of reminiscence therapy on life satisfaction and autobiographical memory of older adults: a pilot study across Mexico and Spain

BACKGROUND

There are increasing reports on the cognitive and emotional benefits of positive reminiscence therapy in older people. The objective of this study is to assess the differential improvement of the quality of life for older people in different vital situations (three different types of aging) and from different countries by implementing a positive reminiscence therapy program (REMPOS).

METHODS

The participants were 144 older adults above the age of 65, 77 participants from Spain (45 experimental groups, 32 control groups) and 67 from Mexico (34 experimental groups, 33 control groups). The participants were recruited from nursing and retirement homes. A factorial randomized design with pre-post measurement with three independent variables: country (Mexico, Spain), condition (experimental, control), and types of aging (healthy aging, HA., mild cognitive impairment, MCI., Alzheimer's disease, AD). The experimental groups received REMPOS therapy and control groups received standard cognitive stimulation program. The quality of life was measured with the Life Satisfaction Inventory for adults (LSI-A) and autobiographical memory test (AMT) before and after REMPOS therapy.

RESULTS

The REMPOS intervention showed significantly higher positive effects than the control condition on the recall of specific positive memories across countries and types of aging, except for the Spanish MCI group. Life satisfaction in the Alzheimer's and MCI group only improved with REMPOS in the Mexican sample.

CONCLUSIONS

The REMPOS effects showed generalizable effects across countries, but the cross-cultural differences shown highlight the necessity of running studies to test those differential effects.

A Systematic Review of the Reminiscence Functions Scale and Implications for Use with Older Adults

OBJECTIVES

The Reminiscence Functions Scale (RFS) is a widely used robust instrument. While reminiscence-based intervention is one of the most effective nonpharmacological interventions for older adults. This systematic review provides a comprehensive synthesis of the literature that used RFS with older adults, summarizes the main outcomes, and highlights implications for practice.

METHODS

This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were eligible if they used RFS and included older adults. Studies were searched from 1993, the year RFS was first published. Electronic databases were searched (Scopus, PsycNET, and Web of Science), from which 44 eligible studies were identified.

RESULTS

Four themes were identified: i) predictive value of reminiscence functions regarding well-being, ii) increased frequency of teach/inform and death preparation functions in older adults, iii) key roles of reminiscence functions in coping with critical life events, iv) reminiscence-based interventions should promote positive memories.

CONCLUSIONS

The RFS outcomes may improve reminiscence-based interventions, since the functions of reminiscence are key players in older adults daily life.

CLINICAL IMPLICATIONS

Reminiscence-based interventions should promote positive memories, which are associated with improved well-being. Particularly, it seems a good practice when supporting older adults regarding critical and traumatic events.

The presence and severity of neuropsychiatric symptoms and their association with quality of life among patients with dementia

BACKGROUND

Neuropsychiatric symptoms are common manifestations of dementia. The presence and severity of these symptoms differ depending on different personal and contextual factors.

PURPOSE

This study aimed to investigate the presence and predictors of neuropsychiatric symptoms and the association between the severity of these symptoms and the quality of life in a sample of patients with dementia in Jordan.

METHODS

In this cross-sectional study, 112 patients with dementia residing in Jordanian nursing homes were recruited using the consecutive sampling method.

RESULTS

The mean severity of neuropsychiatric symptoms was 9.58. The most prevalent neuropsychiatric symptoms among patients were depression (61.6%), followed by irritability (55.4%), and a feeling of euphoria (54.5%). The regression analysis results indicated that gender, marital status, and dementia severity significantly predicted the neuropsychiatric symptoms severity score and explained 17.70% of the variance. A significant negative correlation between the severity of neuropsychiatric symptoms and quality of life was found.

CONCLUSION

The study's results indicate that our sample reported mild neuropsychiatric symptoms. These symptoms' high prevalence and persistence negatively impact patients' quality of life. The study's results can help mental health nurses determine the factors impacting effective treatment strategies to combat these symptoms. Future longitudinal studies are warranted to help explain the importance of early diagnosis and management of these symptoms in preventing dementia progression.

Machine learning approach for early onset dementia neurobiomarker using EEG network topology features

Introduction

Modern neurotechnology research employing state-of-the-art machine learning algorithms within the so-called "AI for social good" domain contributes to improving the well-being of individuals with a disability. Using digital health technologies, home-based self-diagnostics, or cognitive decline managing approaches with neuro-biomarker feedback may be helpful for older adults to remain independent and improve their wellbeing. We report research results on early-onset dementia neuro-biomarkers to scrutinize cognitive-behavioral intervention management and digital non-pharmacological therapies.

Methods

We present an empirical task in the EEG-based passive brain-computer interface application framework to assess working memory decline for forecasting a mild cognitive impairment. The EEG responses are analyzed in a framework of a network neuroscience technique applied to EEG time series for evaluation and to confirm the initial hypothesis of possible ML application modeling mild cognitive impairment prediction.

Results

We report findings from a pilot study group in Poland for a cognitive decline prediction. We utilize two emotional working memory tasks by analyzing EEG responses to facial emotions reproduced in short videos. A reminiscent interior image oddball task is also employed to validate the proposed methodology further.

Discussion

The proposed three experimental tasks in the current pilot study showcase the critical utilization of artificial intelligence for early-onset dementia prognosis in older adults.

Confirmatory factor analysis of the Arabic version of the reminiscence functions scale with strict measurement invariance across gender

PURPOSE

Recognizing reminiscence functions can help psychiatric nurses promote patients' mental health. This study aimed to confirm the six-factor, 39-item structure of the Arabic version of the Reminiscence Functions Scale (RFS) in a sample of Jordanian adults (N = 470) and examine the invariance of structure across gender.

DESIGN AND METHOD

Post hoc model adjustment was conducted sequentially using modification indices (MI) to improve model fit. Measurement invariance across gender was examined using this adjusted Arabic RFS score (ARFS).

FINDINGS

After post hoc adjustment using MI, the fit indices for the adjusted (32-item) ARFS improved, indicating a good fit for the data. The adjusted ARFS factor structure indicated strict measurement invariance across gender.

CONCLUSIONS

CFA supports a 32-item, six-factor model.

PRACTICE IMPLICATIONS

Psychiatric nurses can use the adjusted ARFS to measure subjects' reminiscence functions and predict the psychological and emotional distress associated with these functions.

Reminiscence therapy is a feasible care program for improving cognitive function, anxiety, and depression in recurrent acute ischemic stroke patients: a randomized, controlled study

OBJECTIVE

Reminiscence therapy provides benefits among first-episode acute ischemic stroke (AIS) patients and their caregivers. This study intended to further compare the effect of reminiscence therapy plus usual care (RTUC) and usual care (UC) on cognitive function, anxiety, and depression among recurrent AIS patients.

METHODS

Totally, 160 recurrent AIS patients were enrolled and randomized in a 1:1 ratio into the RTUC group (N = 81) and UC group (N = 79), then a 12-month corresponding intervention was conducted in each group. Mini-Mental State Examination (MMSE) score and Hospital Anxiety and Depression Scale (HADS) were evaluated on discharge (M0), at month (M) 3, M6, M9, and M12 after discharge.

RESULTS

MMSE scores at M6 (27.0 ± 1.6 vs. 26.3 ± 2.3, P = 0.031) and M12 (27.0 ± 1.7 vs. 26.1 ± 2.4, P = 0.009) were elevated, while cognitive impairment rate at M12 (29.2% vs. 45.7%, P = 0.042) and cognitive impairment severity at M12 (P = 0.029) were declined in RTUC group compared to UC group. Meanwhile, the HADS-anxiety scores at M9 (5.7 ± 3.1 vs. 6.9 ± 4.0, P = 0.046) and M12 (5.6 ± 2.7 vs. 7.0 ± 4.3, P = 0.024), anxiety rate at M12 (22.2% vs. 38.2%, P = 0.039) and anxiety severity at M12 (P = 0.018) were declined in RTUC group compared to UC group. Besides, the HADS-depression score at M12 (5.7 ± 3.1 vs. 6.8 ± 3.3, P = 0.043) was decreased in RTUC group compared to UC group, but depression rate and severity were not different between the two groups at each visit point (all P > 0.05).

CONCLUSION

RTUC program elevates cognitive functions and alleviates mental problems in recurrent AIS patients.

The use of digital touch screen technology to deliver reminiscence therapy among people with dementia in Jordanian care homes: a mixed-method feasibility study

BACKGROUND

Using technology to deliver psychosocial interventions such as reminiscence therapy (RT) to people with dementia may improve their mental health. Yet, establishing the feasibility of digital interventions in low- to middle-income countries is still in the early stages. This study aimed to: (i) determine the feasibility of using digital touch screen technology to deliver RT among people with dementia living in Jordanian care homes; and (ii) compare study outcomes pre- and post-reminiscence sessions to investigate whether specific outcomes are sensitive to change and explore the acceptability and experiences of the intervention.

METHODS

A pragmatic mixed-method study design was implemented. Sixty residents with dementia were recruited from two Jordanian care homes (Site 1: n = 35; Site 2: n = 10). A process evaluation was conducted alongside a single-group pre-post-intervention study. The intervention involved 10 supported RT sessions of up to 1 h each, delivered over 5 weeks. Feasibility was determined by assessing the rate of recruitment, adherence, retention, data completion, implementation fidelity, and adverse events. Qualitative semi-structured interview questions were used to explore experience and acceptability, and data were thematically analysed.

RESULTS

Response rate was 100%; loss to follow up at post-intervention was 25%. Median session attendance for those who received the intervention was 80%. No serious adverse events were reported. A positive, statistically significant and clinically relevant difference was found in all outcome measures before and after reminiscence sessions. Qualitative findings suggest that digital RT intervention is generally well accepted by people with dementia who reported positive changes, including enhanced communication and cognitive abilities.

CONCLUSION

Using digital touch screen technology to deliver RT is feasible and acceptable among people with dementia in Jordanian care homes. Digital RT intervention is a promising approach to improving mental health and communication for people living with dementia.