Manual-based cognitive behavioral and cognitive rehabilitation therapy for young-onset dementia: a case report

The role and impact of therapeutic counselling on the emotional experience of adults living with dementia: A systematic review

Introduction There is limited psychological support available to help people living with dementia to deal with the emotional consequences of their condition. Anxiety and depression are commonly experienced in this population, yet the use of counselling and psychotherapeutic interventions is not well documented. Aim This systematic review sought to understand the current knowledge on the role and impact of therapeutic counselling on the emotional experience of adults living with dementia. Methods Qualitative and quantitative research designs were accepted for review. A comprehensive search of the main biomedical, nursing and other specialist databases was performed to access articles published between 2015 and 2022. Trial registers and academic journals were also searched. 43 original studies were included: qualitative (n = 15); RCTs (n = 9); other designs (n = 19); plus eight systematic reviews. Results The majority of studies were conducted in Europe, the United Kingdom in particular, although a range of countries from across the globe were represented. The combined evidence from the different study designs suggest a range of ways that people living with different stages of dementia can participate in, and gain emotional benefit from, therapeutic counselling. Key themes identified: (1) The emotional and well-being benefits of therapeutic counselling; (2) No one size fits all - relational and tailored approaches driven by person-centred values; (3) Training, supervision and building community for counsellors; (4) Involvement of people with dementia in therapeutic interventions. Conclusions Our findings from this systematic review show that different therapeutic approaches have been tested with people at different stages of a dementia diagnosis. The results suggest the value of therapeutic counselling as a supportive medium to help with the processing and coping of difficult emotions and feelings across the trajectory of a dementia illness.

Non-pharmacological interventions for people living with young-onset dementia and their carers: A scoping review focussing on the support of participants' needs

WHAT IS KNOWN ON THE SUBJECT?: Young-onset dementia (YOD) refers to a phenomenon in which dementia symptoms appear under age 65. Diagnosing YOD is difficult and its progression is fast. Furthermore, it limits the socio-economic careers of people living with YOD, regardless of their needs. People living with YOD and their carers have unstable occupational status and their dependents also have to face a high burden of care. They claim that existing social support for dementia is limited to the elderly and is not suitable for them. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The characteristics of non-pharmacological intervention studies for people living with YOD and/or their carers so far, and an analysis of the needs supported via the applied interventions. A theoretical basis and direction for the interventions to be studied in the future. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Research and intervention development should focus more on the needs of people living with YOD. In addition, it is necessary to understand and reflect on carers who directly care for people living with YOD. A multidisciplinary programme that supports wide area of the needs should be developed.

ABSTRACT

INTRODUCTION: Young-onset dementia (YOD) is a highly influential disease that exerts force on the normal life of those who still have to continue social life. Research has been lacking in spite of its seriousness, which accounts for about 9% of all dementia cases.

AIM

This study aimed to examine non-pharmacological interventions for people living with YOD and/or their carers, and to analyse how those interventions support their needs.

METHOD

A scoping review methodology was utilized to search the studies examining interventions for people living with YOD and/or their carers, and in English or Korean. The information was extracted, summarized and analysed in CANE categories.

RESULTS

Sixteen studies were included in the review. Five types of interventions were drawn. 'Memory' was the most covered part of the needs by the interventions.

DISCUSSION

This study found that interventions currently do not match the needs of people living with YOD and their carers. Multidisciplinary research would be eligible to cover the subjects' wide range of the needs as much as possible.

IMPLICATIONS FOR PRACTICE

We suggest the development of a specialized needs assessment tool and specialized interventions for people living with young-onset dementia and their carers.

Interventions for Persons with Young-Onset Dementia and Their Families: A Scoping Review

Background

Dementia occurring before age 65 is known as young-onset dementia (YOD), with Alzheimer's disease being the most common type. YOD poses unique challenges for persons and families, impacting their working-age years and family responsibilities. Person-centered interventions and services are essential to improve their quality of life and social engagement.

Objective

This study aims to synthesize non-pharmacological interventions for persons with YOD and their families to inform future targeted interventions.

Methods

We conducted a systematic literature search across four databases: PubMed, PsycINFO, Scopus, and CINAHL. The included articles were carefully screened, categorized, and synthesized by following Arksey and O'Malley's five stages framework.

Results

We included 20 studies reported in 24 papers, with 11 studies (14 papers) on persons with YOD and nine studies (10 papers) on families. Quantitative intervention results vary, but qualitative interviews show positive feedback. Stakeholders provided positive evaluations, stating these interventions provided a sense of normalcy, facilitated communication among families, enhanced the independence of persons with YOD, and improved the families' caregiving self-efficacy, thereby reducing care burden and psychological distress. The heterogeneity among the studies posed integration challenges.

Conclusions

Interventions for YOD can improve the quality of life for both persons with YOD and their families. More extensive intervention studies are urgently needed, especially in developing countries, with a focus on family-centered and life course perspectives. In future intervention research design, a more extensive incorporation of stakeholder involvement is essential for successful implementation. Moreover, the integration of new technologies shows promise as a potential avenue for intervention advancement.

Effect of Self-Efficacy on Quality of Life in People With Mild Cognitive Impairment and Mild Dementia: The Mediating Roles of Depression and Anxiety

OBJECTIVES

To examine the mediating effects of depression and anxiety in the relationship between self-efficacy and quality of life among people with mild cognitive impairment (MCI) or mild dementia.

METHOD

A total of 196 patients diagnosed with MCI or dementia due to Alzheimer disease completed structured measures of self-efficacy, quality of life, and depressive and anxiety symptoms. We examined direct and mediated effects by fitting structural equation models to data.

RESULTS

Our analyses supported that the effects of self-efficacy on quality of life may be partially mediated by depression and anxiety. Both anxiety and depression had significant mediating effects, with depression showing a stronger effect.

CONCLUSION

These results suggest that increased self-efficacy may have a positive effect on quality of life in people with MCI or dementia-partly by reducing depression and anxiety. These findings may have important practical implications for tailoring therapeutic interventions.

Age-appropriate services for people diagnosed with young onset dementia (YOD): a systematic review

BACKGROUND

Literature agrees that post-diagnostic services for people living with young onset dementia (YOD) need to be age-appropriate, but there is insufficient evidence of 'what works' to inform service design and delivery.

OBJECTIVE

To provide an evidence base of age-appropriate services and to review the perceived effectiveness of current interventions.

METHODS

We undertook a systematic review including all types of research relating to interventions for YOD. We searched PubMed, CINHAL Plus, SCOPUS, EBSCO Host EJS, Social Care Online and Google Scholar, hand-searched journals and carried out lateral searches (July-October 2016). Included papers were synthesised qualitatively. Primary studies were critically appraised.

RESULTS

Twenty articles (peer-reviewed [n = 10], descriptive accounts [n = 10]) discussing 195 participants (persons diagnosed with YOD [n = 94], caregivers [n = 91] and other [n = 10]) were identified for inclusion. Services enabled people with YOD to remain living at home for longer. However, service continuity was compromised by short-term project-based commissioning and ad-hoc service delivery.

CONCLUSION

The evidence on the experience of living with YOD is not matched by research and the innovation needed to mitigate the impact of YOD. The inclusion of people with YOD and their caregivers in service design is critical when planning support in order to delay institutional care.