Computer Activities for Persons With Dementia

The use of technology by seniors with neurocognitive disorders in long-term care: a scoping review

BACKGROUND

To map the current state of knowledge about the use of technology with seniors with neurocognitive disorders in long-term care to foster interactions, wellness, and stimulation.

METHODS

Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus); MEDLINE; PsycINFO; Embase and Web of Science were searched in eligible literature, with no limit of time, to describe the current use of technology by seniors with neurocognitive disorders in long-term care. All types of literature were considered except for theses, editorial, social media. This scoping review was built around the recommendations of Peters et al. (2020 version). Three researchers collaborated on the selection of articles and independently reviewed the papers, based on the eligibility criteria and review questions.

RESULTS

The search yielded 3,605 studies, of which 39 were included. Most technology type reported was robotics. Included studies reports different positive effects on the use of such technology such as increase of engagement and positive.

CONCLUSION

The study highlights different types and potential benefits of technology for long-term care residents with neurocognitive disorders, emphasizing the crucial need for additional research to refine interventions and their use.

The Development of a Pilot App Targeting Short-Term and Prospective Memory in People Diagnosed with Dementia

BACKGROUND

According to the World Health Organization, people suffering from dementia exhibit a serious decline in various cognitive domains and especially in memory.

AIMS

This study aims to create a pilot computer app to enhance short-term memory and prospective memory in individuals with dementia using errorless learning based on their individualized needs.

METHODS

Fifteen dementia patients and matched controls, matched for age, sex, and education, were selected. Their daily routines were analyzed, and cognitive abilities were assessed using the MoCA test. Considering the participants' illness severity and daily needs, the pilot app was designed to aid in remembering daily tasks (taking medication and meals), object locations, and familiar faces and names.

RESULTS

An improvement in patients' short-term and prospective memory throughout the training sessions, but not in overall cognitive functioning was observed. A statistically significant difference between patients and healthy controls was indicated in their ability to retain information relevant to them in their short-term memory, or to remember to act in the future following schedules organized at present (p < 0.001).

CONCLUSION

This app appears beneficial for training dementia patients and healthy individuals in addressing memory challenges.

RECOMMENDATION

While the pilot app showed promise, further research with larger samples is recommended.

Experiences of people with progressive memory disorders participating in non-pharmacological interventions: a qualitative systematic review

OBJECTIVE

This review identified, critically appraised, and synthesized the available evidence on the experiences of people with progressive memory disorders who are involved in non-pharmacological interventions.

INTRODUCTION

Non-pharmacological interventions are widely used to improve the quality of life and general well-being of people with progressive memory disorders. While an array of intervention effects has been studied, a systematic review of experiences is needed. First-hand knowledge and experience provides insight into noteworthy aspects of the use and timing of non-pharmacological interventions both in the community and institutionalized care.

INCLUSION CRITERIA

The review included studies of people of all ages with progressive memory disorders who described their experiences of non-pharmacological interventions.

METHODS

The search strategy used a three-step approach and sought to locate both published and unpublished studies. Key databases included MEDLINE (PubMed), CINAHL (EBSCO), Medic, Scopus (Elsevier), and PsycARTICLES (ProQuest). MedNar was used to search for unpublished studies. The databases were searched from the date of inception of the database to May 2020, and a mix of controlled vocabulary (ie, MeSH, CINAHL headings) and keywords were used to capture all existing qualitative studies related to the experiences of people of all ages with progressive memory disorders participating in non-pharmacological interventions. Only English, Swedish, and Finnish studies were included during the screening of the study titles and abstracts. The recommended JBI approach was used for study selection, critical appraisal, data extraction, and data synthesis.

RESULTS

Forty-six studies were included in the review. The study designs included qualitative descriptions (n = 31), mixed methods (n = 8), grounded theory (n = 5), and ethnography (n = 2). The total number of participants was 444. The overall quality of the studies was rated as low or very low on the ConQual score, with dependability rated as low or moderate and credibility as moderate. Altogether, 189 findings were aggregated into eight categories and three synthesized findings. The synthesized findings describing the experiences of people with progressive memory disorders participating in a non-pharmacological intervention were as follows: i) It strengthened the sense of personhood; ii) it lightened up my life; and iii) what I find meaningful is that it was meant for us.

CONCLUSIONS

People with progressive memory disorders welcome non-pharmacological interventions. It is noteworthy that, regardless of what the interventions entailed, the participants experienced strengthened self-esteem and positive alterations to their daily life. To achieve the desired benefits, intervention development should embody communication based on equality and respect for those who suffer from memory disorders. However, the level of evidence of the review findings was evaluated as low or very low, which needs to be considered when applying the results in clinical practice.

Are Video Games Effective to Promote Cognition and Everyday Functional Capacity in Mild Cognitive Impairment/Dementia Patients? A Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Mild cognitive impairment (MCI) and dementia are associated with increased age. MCI is a clinical entity described as a transitional state between normal cognition and dementia. Video games (VGs) can potentially promote cognition and functional capacity since multiple cognitive domains are recruited during gameplay. However, there is still a lack of consensus regarding the efficacy of VGs as therapeutic tools, particularly in neurodegenerative diseases.

OBJECTIVE

We aimed to analyze the impact of VGs on cognition and functional capacity outcomes in MCI/dementia patients.

METHODS

We conducted a systematic review and meta-analysis study (PROSPERO [CRD42021229445]). PubMed, Web of Science, Epistemonikos, CENTRAL, and EBSCO electronic databases were searched for RCT (2000-2021) that analyzed the impact of VGs on cognitive and functional capacity outcomes in MCI/dementia patients.

RESULTS

Nine studies were included (n = 409 participants), and Risk of Bias (RoB2) and quality of evidence (GRADE) were assessed. Data regarding attention, memory/learning, visual working memory, executive functions, general cognition, functional capacity, quality of life were identified, and pooled analyses were conducted. An effect favoring VGs interventions was observed on Mini-Mental State Examination (MMSE) score (MD = 1.64, 95%CI 0.60 to 2.69).

CONCLUSION

Although promising, the effects observed should be interpreted with caution since serious methodological shortcomings were identified in the studies included. Nonetheless, the effect observed is higher than the minimum clinically important difference (1.4 points) established to MMSE. Future studies on the current topic urge. Recommendations for the design and conduction of cognitive RCT studies are presented.

Online singing groups for people with dementia: scoping review

Objectives

In the face of the SARS-CoV-2 pandemic, people with dementia and their carers are contending with serious challenges to their health and wellbeing, due to risk of severe illness, limiting of social contact and disruption to usual activities. Many forms of support for people with dementia and their carers, including singing groups, have moved online using videoconferencing. Previous research has demonstrated the benefits of group singing, which include cognitive stimulation, meaningful activity and peer support. However, although we know which aspects of the singing group experience participants find helpful, we do not know how this experience translates into an online videoconferencing format, and this is a very new field with little existing research. This article reviews the literature pertinent to online singing interventions and uses the findings to develop some suggestions for running an online singing group.

Study design: Scoping review. Methods

Systematic literature searches were conducted in EMBASE, Medline, CINAHL, PsycINFO and Web of Science. Owing to the paucity of existing research, searches were also conducted in Google Scholar. The scope of the review covered five related areas: online music making and music therapy, telemedicine and telecare, everyday technology for people with dementia, digital arts and dementia, and use of technology for social interaction and leisure. Our analysis aimed to integrate the results to inform the implementation of online singing groups for people with dementia.

Results

Scoping of evidence from discrete fields of enquiry and different disciplinary traditions can inform the delivery of online singing in dementia. This literature also yields useful insights into the role of the carer and how best to support participants to use technology. Barriers and facilitators to online singing were found to relate both to the technology and to the individual participant.

Conclusion

Lockdown restrictions have led to much innovation, and this is likely to lead to changes in practice even after normal life resumes. The suggestions in this article will be helpful primarily for practitioners moving into online work and researchers investigating this novel area. They may also be useful to commissioners and policymakers because they reflect current knowledge about best practice.

Benefits of Computer Engagement in Older Adults with Dementia

Objectives: Two pilot studies aimed to determine the effects of individual computer engagement on behavioral health outcomes in individuals with dementia. The focus was on participants’ mental health, challenging behaviors, antipsychotic medications, and professional caregiver stress. Methods: Two pilot randomized control trials were conducted. First trial involved residents with advanced dementia in a long-term care facility. The second trial involved residents with mild dementia in an assisted living setting. The participants in the experimental group in both studies were provided with guided iN2L computer engagement followed by unrestricted use. Results: Statistically reliable improvements were found in both studies for participants’ emotional well-being and professional caregiver stress. Reliable improvements in cognition and depression were found in the mild dementia study, but not in the advanced dementia study. No statistically reliable changes were observed for antipsychotic medications or challenging behaviors. Discussion: Computer engagement was associated with improvements in participants’ emotional well-being and with a reduction in professional caregiver stress. Results should be interpreted with caution in the context of high attrition. Future studies may build upon these pilot findings and examine effects of technology use on mood and cognition in larger samples of older adults across a wider range of outcome measures.

Music Therapy in the Treatment of Dementia: A Systematic Review and Meta-Analysis

Background: Dementia is a neurological condition characterized by deterioration in cognitive, behavioral, social, and emotional functions. Pharmacological interventions are available but have limited effect in treating many of the disease's features. Several studies have proposed therapy with music as a possible strategy to slow down cognitive decline and behavioral changes associated with aging in combination with the pharmacological therapy. Objective: We performed a systematic review and subsequent meta-analysis to check whether the application of music therapy in people living with dementia has an effect on cognitive function, quality of life, and/or depressive state. Methods: The databases used were Medline, PubMed Central, Embase, PsycINFO, and the Cochrane Library. The search was made up of all the literature until present. For the search, key terms, such as "music," "brain," "dementia," or "clinical trial," were used. Results: Finally, a total of eight studies were included. All the studies have an acceptable quality based on the score on the Physiotherapy Evidence Database (PEDro) and Critical Appraisal Skills Program (CASP) scales. After meta-analysis, it was shown that the intervention with music improves cognitive function in people living with dementia, as well as quality of life after the intervention and long-term depression. Nevertheless, no evidence was shown of improvement of quality of life in long-term and short-term depression. Conclusion: Based on our results, music could be a powerful treatment strategy. However, it is necessary to develop clinical trials aimed to design standardized protocols depending on the nature or stage of dementia so that they can be applied together with current cognitive-behavioral and pharmacological therapies.

Using Music Technology Creatively to Enrich Later-Life: A Literature Review

Background: A growing body of evidence has demonstrated significant social and emotional benefits of music-making amongst senior citizens. However, several as-yet unresolved age-related barriers to "musicking" have been identified. Positioned within the emergent field of gerontechnology, concerned with the interface between aging and technology research, this review of literature thus explores the potential for music technologies to function as a vehicle for creative musical opportunities in later-life. Methods: ERIC, PsychInfo, and Web of Science databases were searched, focusing on the intersection between music, technology, and aging. The criteria for inclusion were that the paper should: (1) be in English; (2) report empirical research involving the use of music technologies intended to support receptive (listening, interpreting, reflecting) or active (playing, creating, performing) engagement with music amongst older persons, defined as being aged 60 years or above (United Nations, 2017); (3) be published as a peer reviewed journal article. Results: Of 144 papers screened, 18 papers were retained. 10 studies focused on using technology to support musicking in the form of listening, reflecting, and interpreting. Just five studies explored the utility of technology in promoting singing or playing instruments, while a further three were focused on music and movement. Conclusions: Overall, the literature reviewed suggests that older people, even those with complex needs, are capable of, and interested in using music technologies to access and create personally meaningful music. The limited research that does exist points to multiple and significant benefits that may be derived from receptive or active musicking supported by a range of music technologies.

Implementing Montessori Methods for Dementia: A Scoping Review

Purpose of the Study

A scoping review was conducted to develop an understanding of Montessori-based programing (MBP) approaches used in dementia care and to identify optimal ways to implement these programs across various settings.

Design and Methods

Six peer-reviewed databases were searched for relevant abstracts by 2 independent reviewers. Included articles and book chapters were those available in English and published by the end of January 2016. Twenty-three articles and 2 book chapters met the inclusion criteria.

Results

Four approaches to implementing MBP were identified: (a) staff assisted (n = 14); (b) intergenerational (n = 5); (c) resident assisted (n = 4); and (d) volunteer or family assisted (n = 2). There is a high degree of variability with how MBP was delivered and no clearly established "best practices" or standardized protocol emerged across approaches except for resident-assisted MBP.

Implications

The findings from this scoping review provide an initial road map on suggestions for implementing MBP across dementia care settings. Irrespective of implementation approach, there are several pragmatic and logistical issues that need to be taken into account for optimal implementation.

Design Recommendations for Recreational Systems Involving Older Adults Living With Dementia

As the population ages, an increasing number of people will be diagnosed with dementia. Studies have found that insufficient activities are offered in memory care units to people with dementia, even though people benefit tremendously from participating in recreational activities. Information and communication technologies (ICT) can potentially facilitate activities in this setting, yet there is little guidance for designers to develop systems that can support people with dementia in engaging in recreational activities. To fill this gap, recommendations were generated through fieldwork and refined in two rounds of expert feedback. Areas covered include hardware, content, applications, and navigation. Systems should be usable by people with dementia, in addition to staff, to counter disempowerment by not enabling people to use their full abilities. In addition, a diversity of materials is needed to appeal to individuals with dementia who have widely varying backgrounds, abilities, interests, and preferences.