1
|
De Luca R, Calderone A, Gangemi A, Rifici C, Bonanno M, Maggio MG, Cappadona I, Veneziani I, Ielo A, Corallo F, Quartarone A, Cardile D, Calabrò RS. Is Virtual Reality Orientation Therapy Useful to Optimize Cognitive and Behavioral Functioning Following Severe Acquired Brain Injury? An Exploratory Study. Brain Sci 2024; 14:410. [PMID: 38790389 PMCID: PMC11119343 DOI: 10.3390/brainsci14050410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Severe acquired brain injury (SABI) is a leading cause of death and disability, and it is defined as a brain injury that occurs after birth due to traumatic or non-traumatic causes. Reality orientation therapy (ROT) uses repeated time-place-person orientation and meaningful stimuli to develop a better understanding of the environment and has great potential as an effective strategy to improve cognitive and behavioral functioning. OBJECTIVE This study aims to investigate the feasibility and potential effects of virtual reality orientation therapy (VR-rot) on optimizing cognitive and behavioral functioning and depressive symptoms post-SABI. METHOD Forty patients with SABI were enrolled from October 2022 to December 2023 and divided into two groups: the experimental group (EG, n = 20) received VR_rot, while the control group (CG, n = 20) received standard ROT (S_rot). All patients were evaluated with a psychometric battery, including the Mini-Mental State Examination (MMSE) and the Hamilton Rating Scale for Depression (HRS-D), administered before (T0) and after the end (T1) of rehabilitation. RESULTS Within-group comparisons indicated a statistically significant change in MMSE scores from T0 to T1 in the EG and CG, with the EG showing a greater improvement than the CG. Regarding HRS-D scores, the EG showed a statistically significant change. VR-ROT could be a valuable tool for improving cognitive-behavioral functioning in SABI patients. CONCLUSIONS The VRRS can help reduce depressive symptoms and improve the reality orientation deficit caused by traumatic brain injury and stroke on brain tissue. This study highlights the benefits of virtual reality.
Collapse
Affiliation(s)
- Rosaria De Luca
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Andrea Calderone
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Antonio Gangemi
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Maria Grazia Maggio
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Irene Cappadona
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Isabella Veneziani
- Department of Nervous System and Behavioural Sciences, Psychology Section, University of Pavia, Piazza Botta, 11, 27100 Pavia, Italy
| | - Augusto Ielo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| |
Collapse
|
2
|
Parlak MM, Köse A, Güç M, Munis ÖB. Development of mobile compatible software for cognitive-communication disorder in individuals with Alzheimer's disease. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:234-254. [PMID: 37528064 DOI: 10.1111/1460-6984.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive neurodegenerative disease. Cognitive functions and communication skills worsen as the disease progresses, thereby reducing patients' independence levels. Therefore, recommending software that can be used at home may be a useful means of slowing down the cognitive and communicative decline in AD. AIMS To develop software that can be used at home to slow down the cognitive and communicative decline and increase independence in individuals with AD; and to examine the effect of this software on the cognitive communication skills of individuals with AD. METHODS & PROCEDURES The study was completed in four stages: the development of the application; the evaluation of the participants and their training for the application; their use of the application at home; and the re-evaluation of the participants. A total of 32 individuals who met the inclusion criteria were included in the study. These individuals were randomly divided into study and control groups, each consisting of a total of 16 participants, including six in the mild stage, six in the moderate stage, and four in the severe stages. The developed software was loaded on tablets and given to the participants in the study group. The participants in the control group only received their pharmacological treatment, while those in the study group received both their pharmacological treatment and used the developed application. All participants were evaluated with the Mini-Mental State Examination (MMSE) and Language Assessment Test for Aphasia (LATA) before and after application use. A survey was administered to the caregivers of the participants in the study group after the use of the application. OUTCOMES & RESULTS The results revealed a positive change in the cognitive-communication skills of the individuals in the study group, even if they were in the severe stage, according to the LATA and MMSE, as well as the survey. The application led to the greatest improvements in grammar on the LATA and orientation on the MMSE. No rapid cognitive decline was seen in individuals at all stages in the control group. CONCLUSIONS & IMPLICATIONS In this study, software was developed in Turkish that can be used in every stage of AD as part of a holistic cognitive-communication intervention programme offering alternative and supportive communication for individuals with AD, even those in the severe stage. Results prove the effectiveness of the developed software on the cognitive-communication skills of individuals with AD. WHAT THIS PAPER ADDS What is already known on the subject There are a few (as far as is known, three) applications developed in English for cognitive-communication disorders due to dementia. What this study adds to the existing literature In this study, for the first time in Turkish, mobile-compatible software has been developed for both cognitive and communication disorders that is specific to individuals with AD and can be used by individuals at all stages of the disease. The effects of the application we developed on the cognitive-communication skills of individuals with AD were shown in a randomised controlled trial. What are the potential or actual clinical implications of this work? Using the app can help people with all stages of AD keep their cognitive and communication skills and have a better prognosis in terms of cognitive-communication skills, especially grammar and orientation.
Collapse
Affiliation(s)
- Mümüne Merve Parlak
- Department of Speech and Language Therapy, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Murat Güç
- Computer Engineering and Software Development, D-Market Electronic Services and Trade Joint Stock Company (hepsiburada.com), Istanbul, Turkey
| | | |
Collapse
|
3
|
Maggio MG, De Domenico C, Manuli A, Latella D, Marra A, La Rosa G, Portaro S, Calabrò RS. Alzheimer cafè: toward bridging the gap between cure and care in patients with dementia. Int J Neurosci 2023; 133:1024-1030. [PMID: 35184665 DOI: 10.1080/00207454.2022.2040024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/10/2022] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common form of degenerative dementia, whose symptoms usually appear in the pre-senile age. In the early stages, patients present social difficulties due to the general cognitive decline in memory, language and executive domains. These problems also affect patients' quality of life, emotions, and mood, leading to social isolation. OBJECTIVE The aim of this study is to evaluate the effects of Alzheimer's Cafè (AC) on the cognitive and behavioral outcomes of AD patients. METHODS Twenty patients diagnosed with AD, who attended the Cognitive and Behavioral Rehabilitation Laboratory of the IRCCS Centro Neurolesi 'Bonino-Pulejo' of Messina, Italy, from December 2017 to December 2018, were enrolled in this study. As these patients belonged to the experimental group (EG: n = 20), they received specific cognitive-behavior training using the AC modality. The patients were assessed by a neuropsychological evaluation at the beginning and at the end of the program. Their outcomes were compared to a matched group of patients with neurodegenerative dementia (CG: 20) receiving conventional cognitive training. RESULTS The pre-post comparisons showed that both CG and EG had a significant improvement in global cognitive functioning (MoCA p < 0.001) and in perceived quality of life (<0.001). However, only in the EG, we observed a significant increase in social functioning (SASS p < 0.00), the perception of mental well-being (SF-12 Mental p < 0.00), and a reduction in the depressive state (GDS p < 0.00). CONCLUSIONS The present study suggests the importance of AC for patients with AD and the potential effect on psychological and social well-being.
Collapse
Affiliation(s)
| | | | | | | | - Angela Marra
- IRCCS Centro Neurolesi 'Bonino Pulejo', Messina, Italy
| | | | | | | |
Collapse
|
4
|
Kume Y, Nagaoka M, Uemura S, Saito A, Tsugaruya M, Fujita T, Terui Y, Kodama A, Sato A, Ota H, Ando H. Effect of a multicomponent programme based on reality orientation therapy on the physical performance and cognitive function of elderly community-dwellers: a quasi-experimental study. Psychogeriatrics 2023; 23:847-855. [PMID: 37474259 DOI: 10.1111/psyg.13008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Effects of a multicomponent exercise programme have an impact on the physical, cognitive, and psychological domains in elderly community-dwellers. However, some individuals aged 65 years or more have not shown positive effects after the intervention as reported in similar research. The objective of this quasi-experimental study was to clarify the effectiveness of a multicomponent programme based on reality orientation therapy (ROT) on the physical performance, cognitive ability, and psychological state in the elderly. METHOD Participants were recruited from the general public in 20 areas of Akita Prefecture, Japan, and they took part in each exercise programme for 90 min a day, once every 2 weeks, for 3 months, according to the group classification using cluster randomization into 20 cohorts in Akita. Physical, cognitive, and geriatric depression assessments were performed at baseline and after the 3-month intervention in both the ROT-based intervention group and the control group. RESULT The final samples for analysis consisted of 31 participants in the control group and 30 participants in the intervention group. The results of the statistical analysis comparing the two groups showed that the 5-repetition sit-to-stand test was performed significantly faster (P < 0.05) and that the results of the word list memory (WM) test and the Symbol Digit Substitution Task also had significantly improved (P < 0.05) after the intervention in both groups. The WM score did not show an interactive effect between the group and time factors, but it had a significant main effect on time in both groups (P < 0.05). CONCLUSION The results of our quasi-experimental study indicated that the multicomponent programme based on the ROT would be as effective as the original multicomponent programme combined with aerobic exercise and cognitive tasks, as highlighted in the WM.
Collapse
Affiliation(s)
- Yu Kume
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| | - Makiko Nagaoka
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| | - Sachiko Uemura
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| | - Akira Saito
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| | - Megumi Tsugaruya
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| | - Tomoe Fujita
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| | - Yoshino Terui
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| | - Ayuto Kodama
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
- Center for Aging in Place, Akita University, Akita, Japan
| | - Akiko Sato
- Center for Aging in Place, Akita University, Akita, Japan
| | - Hidetaka Ota
- Advanced Research Center for Geriatric Medicine, Akita University, Akita, Japan
| | - Hideaki Ando
- Graduate School of Medicine, Doctorial Course in Health Sciences, Akita University, Akita, Japan
| |
Collapse
|
5
|
Cao Y, Wang N, Zhang Q, Shen N, Bai J, Luo X, Liu Y. Effects of cognitive stimulation therapy on patients with dementia: An umbrella review of systematic reviews and meta-analyses. Exp Gerontol 2023; 177:112197. [PMID: 37146891 DOI: 10.1016/j.exger.2023.112197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/20/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Dementia is characterized by significant cognitive decline that results in disturbance of daily activities. Increasing number of meta-analyses has examined the efficacy of cognitive stimulation therapy (CST) for dementia. However, there is a lack of comprehensive reports that specifically discuss the strength of evidence to support CST for dementia. PURPOSE This study aimed to summarize evidence regarding the efficacy of CST on people with dementia. DESIGN Umbrella review of systematic reviews and meta-analyses. METHODS We searched Cochrane Library, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBMdisc), and VIP databases from inception to December 31, 2022. The methodological quality of the identified studies was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Studies scoring 9-12 (moderate quality) points or higher were further analyzed using Grades of Recommendations Assessment, Development and Evaluation (GRADE) principles. RESULTS A total of 14 systematic reviews and meta-analyses were included in the umbrella review. The methodological quality of most included reviews was rated as moderate according to AMSTAR 2 rating system. In these studies, we summarized the characteristics of the content, providers, frequency, period and setting of CST, and examined eight health outcomes related to CST, including cognition, depression, behavioral symptoms, quality of life (QoL), activities of daily living (ADL), language and communication, anxiety, and memory. Eleven studies with low to high rating of overall confidence (OC) consistently reported that CST could significantly improve cognition of people with dementia, including high-quality supporting evidence. However, the effect of CST on other health outcomes for people with dementia (e.g., depression, behavioral symptoms, QoL, ADL) is inconsistent, with low- to moderate-quality evidence ratings. Compared with the above results, few studies have reported the effects of CST on communication, anxiety, and memory for people with dementia. CONCLUSIONS In the future, the design and reporting of systematic reviews and meta-analyses should incorporate high-quality research metrics in accordance with AMSTAR 2 criteria. The current review supports CST as an effective treatment for improving cognitive function in patients with dementia. Multi-component interventions are more effective than single-component interventions and need to be delivered regularly. REGISTRATION The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022364259).
Collapse
Affiliation(s)
- Yanan Cao
- School of Public Health, Wuhan University, Wuhan 430071, China.
| | - Nana Wang
- Home for The Aged Guangzhou, Guangzhou 510550, China
| | - Qianping Zhang
- School of Nursing, Wuhan University, Wuhan 430071, China
| | - Natalie Shen
- Emory University Rollins School of Public Health, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA.
| | - Xianwu Luo
- School of Nursing, Wuhan University, Wuhan 430071, China.
| | - Yanqun Liu
- School of Nursing, Wuhan University, Wuhan 430071, China.
| |
Collapse
|
6
|
Fox A, Dulhunty J, Ballard E, Fraser M, Macandrew M, Taranec S, Waters R, Yang M, Yates M, Yelland C, Beattie E. The impact of a cognitive impairment support program on patients in an acute care setting: a pre-test post-test intervention study. BMC Geriatr 2023; 23:260. [PMID: 37127621 PMCID: PMC10150670 DOI: 10.1186/s12877-023-03930-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/24/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Patients with cognitive impairment are at greater risk of hospital acquired complications, longer hospital stays, and poor health outcomes compared to patients without cognitive impairment. The Cognitive Impairment Support Program is a multi-disciplinary approach to improve screening rates and awareness of patients with cognitive impairment and guide clinician response and communication during their hospitalisation to improve health outcomes. OBJECTIVE This study evaluated the impact of implementing the Cognitive Impairment Support Program on patient hospital acquired complications, patient reported quality of life and staff satisfaction in an outer metropolitan hospital. DESIGN A pre-test post-test design was used to collect data in two 6-month time periods between March 2020 and November 2021. PARTICIPANTS Patients aged ≥ 65 years, admitted to a participating ward for > 24 h. INTERVENTION The Cognitive Impairment Support Program consisted of four components: cognitive impairment screening, initiation of a Cognitive Impairment Care Plan, use of a Cognitive Impairment Identifier and associated staff education. MEASURES The primary outcome was hospital acquired complications experienced by patients with cognitive impairment identified using clinical coding data. Secondary outcomes were patient quality of life and a staff confidence and perceived organisational support to care for patients with cognitive impairment. RESULTS Hospital acquired complication rates did not vary significantly between the two data collection periods for patients experiencing cognitive impairment with a 0.2% (95% confidence interval: -5.7-6.1%) reduction in admissions with at least one hospital acquired complication. Patients in the post intervention period demonstrated statistically significant improvements in many items in two of the Dementia Quality of Life Measure domains: memory and everyday life. The staff survey indicated statistically significant improvement in clinical staff confidence to care for patients with cognitive impairment (p = 0.003), satisfaction with organisational support for patients (p = 0.004) and job satisfaction (p ≤ 0.001). CONCLUSION This study provides evidence that a multicomponent Cognitive Impairment Support Program had a positive impact on staff confidence and satisfaction and patient quality of life. Broader implementation with further evaluation of the multicomponent cognitive impairment intervention across a range of settings using varied patient outcomes is recommended.
Collapse
Affiliation(s)
- Amanda Fox
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia.
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia.
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia.
| | - Joel Dulhunty
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia
| | - Emma Ballard
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Maria Fraser
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia
| | - Margaret Macandrew
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia
| | - Sally Taranec
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia
| | | | - Min Yang
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia
| | - Mark Yates
- Ballarat Health Services, Ballarat, Australia
| | | | - Elizabeth Beattie
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia
| |
Collapse
|
7
|
Tz-Han L, Wan-Ru W, I-Hui C, Hui-Chuan H. Reminiscence music intervention on cognitive, depressive, and behavioral symptoms in older adults with dementia. Geriatr Nurs 2023; 49:127-132. [PMID: 36495795 DOI: 10.1016/j.gerinurse.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
This study aimed to examine the efficacy and feasibility of a reminiscence music therapy program on improving cognition and decreasing depressive and behavioral symptoms in older adults with dementia. Participants in the reminiscence music therapy group participated in 60-minute reminiscence music therapy twice a week over a period of 4 weeks. Control group received usual care. Results showed that the intervention group exhibited a significant decrease in depressive symptoms compared to the control group (B=-5.30, p=.003). The reminiscence music therapy program exerted non-significant effects on cognition and behavioral symptoms in patients with dementia (p>.05). High adherence (96%) and positive participation data indicated that this reminiscence music program is feasible for people with dementia. Healthcare professionals in community or geriatric care units can create supportive environments and conduct regular reminiscence music activities that are related to festival features and reminiscence music for older adults with dementia to reduce depressive symptoms.
Collapse
Affiliation(s)
- Lin Tz-Han
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Wu Wan-Ru
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan.
| | - Chen I-Hui
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Huang Hui-Chuan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| |
Collapse
|
8
|
Caramelli P, Marinho V, Laks J, Coletta MVD, Stella F, Camargos EF, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Chaves MLF, Brucki SMD, Nitrini R, Durgante HB, Bertolucci PHF. Treatment of dementia: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s106en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
ABSTRACT There is currently no cure for neurodegenerative or vascular dementias, but some pharmacological and non-pharmacological interventions may contribute to alleviate symptoms, slow disease progression and improve quality of life. Current treatment approaches are based on etiology, symptom profile and stage of dementia. This manuscript presents recommendations on pharmacological and non-pharmacological treatments of dementia due to Alzheimer’s disease, vascular cognitive impairment, frontotemporal dementia, Parkinson’s disease dementia, and dementia with Lewy bodies.
Collapse
Affiliation(s)
| | | | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Brasil; Universidade do Estado do Rio de Janeiro, Brasil
| | | | - Florindo Stella
- Universidade Estadual Paulista, Brasil; Universidade de São Paulo, Brasil
| | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Caramelli P, Marinho V, Laks J, Coletta MVD, Stella F, Camargos EF, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Chaves MLF, Brucki SMD, Nitrini R, Durgante HB, Bertolucci PHF. Tratamento da demência: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:88-100. [DOI: 10.1590/1980-5764-dn-2022-s106pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
RESUMO Atualmente não há tratamento curativo para as demências neurodegenerativas ou para a demência vascular, mas algumas intervenções farmacológicas e não farmacológicas podem contribuir para aliviar os sintomas, retardar a progressão da doença e melhorar a qualidade de vida. As abordagens terapêuticas atuais são baseadas na etiologia, no perfil dos sintomas e no estágio da demência. Neste artigo apresentamos recomendações sobre os tratamentos farmacológicos e não farmacológicos da demência devida à doença de Alzheimer, comprometimento cognitivo vascular, demência frontotemporal, demência da doença de Parkinson e demência com corpos de Lewy.
Collapse
Affiliation(s)
| | | | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Brasil; Universidade do Estado do Rio de Janeiro, Brasil
| | | | - Florindo Stella
- Universidade Estadual Paulista, Brasil; Universidade de São Paulo, Brasil
| | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Cohen-Mansfield J, Golander H. Responses and Interventions to Delusions Experienced by Community-Dwelling Older Persons With Dementia. J Geriatr Psychiatry Neurol 2022; 35:627-635. [PMID: 34510943 PMCID: PMC9210107 DOI: 10.1177/08919887211042937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We examined how family caregivers react, and what interventions they use in response to delusions exhibited by relatives with dementia in a community setting. Structured interviews were conducted with 68 family caregivers whose relatives were described as experiencing delusions based on the BEHAVE-AD or the NPI. Quantitatively, we cross-tabulated the type of response to delusion by the type of person providing the response and by the type of delusion manifested. Qualitatively, we analyzed open-ended responses to understand the types of caregivers' responses to delusions, the contextual circumstances, and the impact of the responses. Caregiver responses to delusions included "Explaining that the delusion was wrong" (34% of responses), "Trying to calm down" (27%), "Agreeing with the delusion" (13%), "Distracting" (12%), and "Ignoring" (10%). Responses including "Anger, yelling or scolding," were rare. The vast majority of reactions were by family caregivers of the persons with dementia. The relative frequency of the type of reaction tended to be consistent across delusion types. The qualitative analyses added some categories of reactions, but mostly highlighted issues to be considered when examining responses and their efficacy, including the use of multiple responses, and the manner and mood in which responses are conveyed. To cope with delusions, family caregivers develop intuitive intervention techniques. Understanding those interventions and reactions by caregivers and their relative efficacy can inform guidance programs for family caregivers. Improved support for family caregivers has the potential to positively influence the behavior of caregivers and older adults with dementia and improve their respective quality of life.
Collapse
Affiliation(s)
- Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,Minerva Center for the Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel,The Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel,Jiska Cohen-Mansfield, Tel-Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv, 6139001, Israel.
| | - Hava Golander
- Minerva Center for the Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel,The Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel,Department of Nursing, The Stanley Seyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
11
|
Jeon BR, Kim DJ. Impact of Mixed Cognitive Intervention Training on Early Onset Dementia. Osong Public Health Res Perspect 2021; 12:29-36. [PMID: 33659152 PMCID: PMC7899232 DOI: 10.24171/j.phrp.2021.12.1.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/26/2020] [Accepted: 12/06/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the impact of mixed cognitive intervention training using spaced retrieval training, and errorless learning in participants with early onset dementia. This was based on reality orientation therapy for cognitive function, depression, and occupational performance of patients. METHODS Two early onset vascular dementia patients (> 65 years) with mild or moderate impairment were enrolled in a pre-test - post-test single-subject research design study. Prior to the study, the caregivers were interviewed about meaningful times, people, places, and areas of interest for the participant. A list of individual training words were selected based upon this information, and the participant was instructed to recall them after a 45-second, 90-second, 6-minute, and 12-minute delay. Baseline (3 sessions), intervention (20 sessions), and a second baseline period (3 sessions) were conducted. Activities of daily living were measured, and cognition was measured using the Consortium to Establish a Registry of Alzheimer's Disease Korean version, whilst depression was measured using the Korean Form Geriatric Depression Scale, and task performance and satisfaction measured by the Canadian Occupational Performance Measure. RESULTS After intervention, both participants showed improvements in activities of daily living (ADL), word list memory/recognition, trail making A, occupational performance, and satisfaction improvement, which was clinically significant in 1 participant who also had a reduced score in the scale of depression classifying him as not depressed. CONCLUSION Spaced retrieval training and errorless learning based on reality orientation therapy is an effective intervention in patients with early onset dementia and mild or moderate impairment.
Collapse
Affiliation(s)
- Bo-Ra Jeon
- Department of Occupational Therapy, Graduate School, Cheongju University, Cheongju, Korea
| | - Deok-Ju Kim
- Department of Occupational Therapy, College of Health and Medical Sciences, Cheongju University, Cheongju, Korea
| |
Collapse
|
12
|
Chan JYC, Chan TK, Kwok TCY, Wong SYS, Lee ATC, Tsoi KKF. Cognitive training interventions and depression in mild cognitive impairment and dementia: a systematic review and meta-analysis of randomized controlled trials. Age Ageing 2020; 49:738-747. [PMID: 32378715 DOI: 10.1093/ageing/afaa063] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression is common in people with cognitive impairment but the effect of cognitive training in the reduction of depression is still uncertain. AIMS The purpose of this paper is to evaluate the effect of cognitive training interventions in the reduction of depression rating scale score in people with cognitive impairment. METHODS Literature searches were conducted via OVID databases. Randomized controlled trials (RCTs) evaluated the effect of cognitive training interventions for the reduction of depression rating scale score in people with mild cognitive impairment (MCI) or dementia were included. Mean difference (MD) with 95% confidence interval (CI) was used to combine the results of Geriatric Depression Scale (GDS). Standardized mean difference (SMD) was used to combine the results of different depression rating scales. Subgroup analyses were conducted according to the types of cognitive training and severity of cognitive impairment, i.e. MCI and dementia. RESULTS A total of 2551 people with MCI or dementia were extracted from 36 RCTs. The baseline mean score of GDS-15 was 4.83. Participants received cognitive training interventions had a significant decrease in depression rating scale score than the control group (MD of GDS-15 = -1.30, 95% CI = -2.14--0.47; and SMD of eight depression scales was -0.54 (95% CI = -0.77--0.31). In subgroup analyses, the effect size of computerized cognitive training and cognitive stimulation therapy were medium-to-large and statistically significant in the reduction of depression rating scale score. CONCLUSIONS Cognitive training interventions show to be a potential treatment to ameliorate depression in people with cognitive impairment.
Collapse
Affiliation(s)
- Joyce Y C Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Tak Kit Chan
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, Hong Kong
| | - Timothy C Y Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, Hong Kong
| | - Allen T C Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kelvin K F Tsoi
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, Hong Kong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
13
|
Lok N, Buldukoglu K, Barcin E. Effects of the cognitive stimulation therapy based on Roy's adaptation model on Alzheimer's patients' cognitive functions, coping-adaptation skills, and quality of life: A randomized controlled trial. Perspect Psychiatr Care 2020; 56:581-592. [PMID: 31930518 DOI: 10.1111/ppc.12472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 11/28/2019] [Accepted: 12/25/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to specify the effects of Cognitive Stimulation Therapy based on Roy's adaptation model (RAM) on Alzheimer's patients' coping and adaptation skills, cognitive functions, and quality of life (QOL). DESIGN AND METHODS This is an experimental and randomized controlled trial. Patients in the experimental group received cognitive stimulation therapy (CST) based on RAM. FINDINGS The cognitive function level of the experimental group was found to be higher than that of the control group at the end of the measurements (performed in the 7th week); the difference was found to be statistically significant (P < .05). In the experimental group, dimensions of troubleshooting and focusing, making physical decisions, attention processing, systematizing, learning, and establishing relationships were found to be better than those of the control group after the application, and the difference was found to be statistically significant (P < .05). However, after the application, QOL of the experimental group was found to be better than that of the control group following the measurements; the difference was found to be statistically significant (P < .05). PRACTICE IMPLICATIONS Psychiatric nurses should evaluate the patients using Standardize Mini-Mental Test Examination before applying RAM-based CST, and they should apply CST to early- and mid-stage Alzheimer's disease (AD) patients at the end of the evaluation and work with groups consisting of six persons at most. Since the cognitive functions of individuals with AD decline from the first stage, coping-adaptation, and QOL levels will also be affected, so it is recommended to evaluate the cognitive functions, coping-adjustment and QOL levels of individuals before applying RAM-based CST. TRIAL REGISTRATION NUMBER NCT02229474.
Collapse
Affiliation(s)
- Neslihan Lok
- Department of Psychiatric Nursing, Faculty of Nursing, Selcuk University, Konya, Turkey
| | - Kadriye Buldukoglu
- Department of Psychiatric Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Ebru Barcin
- Department of Neurology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| |
Collapse
|
14
|
Chao ICI, Nicpon K, Roduta Roberts M. Effect of Cognitive Stimulation Therapy on Quality of Life: A Critical Review. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1716915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Iris C. I. Chao
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Katarzyna Nicpon
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | |
Collapse
|