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Carvalho SC, Martins FS, Martins AN, Barbosa RC, Vicente SG. Effectiveness of Snoezelen in older adults with neurocognitive and other pathologies: A systematic review of the literature. J Neuropsychol 2024; 18:312-331. [PMID: 37735859 DOI: 10.1111/jnp.12346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 09/03/2023] [Indexed: 09/23/2023]
Abstract
Snoezelen Multisensory Stimulation (SMSS) is a non-pharmacological intervention that provides controlled multisensorial environments to stimulate the primary senses: sight, hearing, smell, touch, taste, proprioceptive and vestibular. Even though the use and potential of SMSS have been widespread in the literature regarding certain target populations (autism, developmental disabilities) and settings (e.g. leisure, therapeutic), its effectiveness in older adults with neurocognitive disorders (e.g. dementia, mild cognitive impairment) and other pathologies (e.g. psychiatric disorders, oncological diseases) is still unclear. Therefore, a systematic review of the literature was conducted to address this issue. The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and of the Cochrane Collaboration were followed. An initial search on PubMed and Scopus databases resulted in 86 articles of which 14 met inclusion criteria and were reviewed in detail. The outcomes showed that most of the studies (n = 13) focused on the effects of SMSS on behaviour and mood in older adults with major cognitive disorders (i.e. dementia). Although there is scarce literature on its impact on cognition, psychophysiological measures (e.g. heart rate, oxygen saturation), daily living functionality and quality of life, this type of intervention seems to contribute to delaying the worsening in severity of the neurocognitive disorders from the mildest to the most severe stages. Likewise, it is legitimate to consider the possibility of potential benefits to older adults with less severe neurocognitive disorders or other pathologies, but more research is needed.
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Affiliation(s)
- Sónia C Carvalho
- Unidade de Cuidados Continuados da Santa Casa da Misericórdia de Mirandela, Mirandela, Portugal
- Faculty of Psychology and Education Sciences (FPCEUP), Universidade do Porto, Porto, Portugal
| | - Fátima S Martins
- Faculty of Psychology and Education Sciences (FPCEUP), Universidade do Porto, Porto, Portugal
| | | | - Raquel C Barbosa
- Centre for Psychology, Faculty of Psychology and Education Sciences, Universidade do Porto, Porto, Portugal
| | - Selene G Vicente
- Centre for Psychology, Faculty of Psychology and Education Sciences, Universidade do Porto, Porto, Portugal
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Helbling M, Grandjean ML, Srinivasan M. Effects of multisensory environment/stimulation therapy on adults with cognitive impairment and/or special needs: A systematic review and meta-analysis. SPECIAL CARE IN DENTISTRY 2024; 44:381-420. [PMID: 37515496 DOI: 10.1111/scd.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
AIM This review aimed to evaluate the effects of multisensory environments/stimulation (MSE/MSS) therapy, on the behavior and psychological symptoms in adults with cognitive impairment and/or special needs. METHODS Online database searches were performed to identify studies reporting on the effects of MSS/MSE therapy in adults (>18 years). Data were extracted for the following investigated outcomes including anxiety, depression, mood, behavioral attributes, biomedical parameters, cognition, motor skills, quality of life (QoL), pain, and end of life quality. Two reciprocally blinded investigators extracted the data. Inter-investigator reliability (𝝹) was calculated. A meta-analysis and a qualitative analysis were performed on the information extracted. RESULTS Thirty-six studies were included for data extraction and analysis. Meta-analysis of the included studies revealed a significant improvement with the MSE/MSS therapy, for agitation (p = .018), anxiety (p = .023), cognition (p < .001), and depression (p < .001). MSS/MSE therapy demonstrated a tendency for the improvement of the QoL in adults (p = .05). CONCLUSION MSE/MSS therapies are beneficial in cognitively impaired adults and improve their anxiety, depression, cognitive and other behavioral attributes such as agitative behaviors. Promoting these therapies in geriatric care may help to improve/reduce the challenging/care-resistant behaviors in adults and facilitate effective provision of the necessary care.
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Affiliation(s)
- Meret Helbling
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marie-Laure Grandjean
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Kor PPK, Parial LL, Yu CTK, Liu JYW, Liu DPM, Hon JMK. Effects of a Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention for Older People With Dementia During Coronavirus 2019: A Randomized Controlled Trial. THE GERONTOLOGIST 2024; 64:gnad054. [PMID: 37179458 DOI: 10.1093/geront/gnad054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Many community dementia services such as home-visiting services and center-based activities were suspended during the coronavirus 2019 pandemic. This study investigated the efficacy of a caregiver-delivered cognitive stimulation therapy (CDCST) on people with dementia during the pandemic. RESEARCH DESIGN AND METHODS This was a 2-arm randomized controlled trial involving 241 patient-caregiver dyads assigned to a 15-week CDCST or control group (usual care). We hypothesized that CDCST would facilitate significant improvements among people with dementia (cognition, behavioral/psychiatric symptoms, and quality of life) and their caregivers (caregiving appraisal, attitudes, and psychological well-being) at postintervention (T1) and at the 12-week follow-up (T2). Generalized estimating equations evaluated the study outcomes. RESULTS A total of 230 dyads completed the study, with good program adherence (93%). Participants in the CDCST showed significant improvements in cognition (p < .001), behavioral and psychiatric symptoms (p =. 027), and quality of life (p =.001) at the 3-month follow-up period. Family caregivers had improved positive aspects of caregiving (p = .008; p = .049) and decreased negative attitudes toward people with dementia (p =. 013; p < .001) at both T1 and T2. There were nonsignificant changes in the caregivers' perceived burden, distress, and psychological well-being. DISCUSSION AND IMPLICATIONS Family caregivers could be trained to provide cognitive stimulation at home for people with dementia, which could benefit both parties. CDCST could manage to improve the cognition, neuropsychiatric symptoms, and quality of life of people with dementia, while also improving caregiving appraisal and negative attitudes among family caregivers. CLINICAL TRIAL REGISTRATION NUMBER NCT03803592.
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Affiliation(s)
- Patrick Pui Kin Kor
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | | | - Clare Tsz Kiu Yu
- Division of Psychiatry, University of College London, London, UK
| | - Justina Yat Wah Liu
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Denise Pik Mei Liu
- Ming Yue District Elderly Community Centre, Hong Kong Young Women's Christian Association, Hong Kong SAR, China
| | - Joan Mo King Hon
- Hong Kong Young Women's Christian Association, Hong Kong SAR, China
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Dogan TD, Guttenthaler V, Zimmermann A, Kunsorg A, Dinç MÖ, Knuelle N, Schewe JC, Wittmann M. Functional intervention following cardiac surgery to prevent postoperative delirium in older patients (FEEL WELL study). J Intensive Care 2023; 11:62. [PMID: 38093389 PMCID: PMC10716938 DOI: 10.1186/s40560-023-00711-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Postoperative delirium is a common complication in patients after cardiac surgery, especially in older patients, and can manifest as a disturbance of attention and consciousness. It can lead to increased postoperative morbidity, prolonged need for care, and mortality. The presented study investigates whether the occurrence of postoperative delirium after cardiac surgery can be prevented by a multisensory stimulation. It was conducted as a prospective, randomized, controlled, non-pharmacological intervention study in the years 2021 and 2022 at the University Hospital Bonn in Germany. A total of 186 patients over 65 years with elective cardiac surgery were enrolled. Patients were randomized either to the intervention or control group. In both groups, postoperative delirium was assessed with the 3-min diagnostic interview for confusion assessment method on the first 5 days after surgery and pain was assessed using the Numeric Rating Scale. Multisensory stimulation was performed 20 min a day for the first three postoperative days in the intervention group. RESULTS The incidence of postoperative delirium was 22.6% in the intervention group and 49.5% in the control group (p < 0.001). Duration of postoperative delirium was significantly shorter in the intervention group (p < 0.001). Stay in the intensive care unit was significantly longer in the control group (p = 0.006). In the regression model non-intervention, high pain scores, advanced age, and prolonged mechanical ventilation were associated with postoperative delirium (p = 0.007; p = 0.032; p = 0.006; p = 0.006, respectively). CONCLUSIONS Results of the study imply that a multisensory stimulation done on the first 3 days after planned cardiac surgery can reduce the incidence and duration of postoperative delirium in older patients. Influence of the treatment on the incidence of delirium in other patient groups, the length of stay in the intensive care unit, and patients´ postoperative pain should be confirmed in further clinical studies. TRIAL REGISTRATION DRKS, DRKS00026909. Registered 28 October 2021, Retrospectively registered, https://drks.de/search/de/trial/DRKS00026909 .
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Affiliation(s)
- Tuğce Dinç Dogan
- Department of Anaesthesia and Intensive Care Medicine, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Vera Guttenthaler
- Department of Anaesthesia and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
| | | | - Andrea Kunsorg
- Department of Anaesthesia and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Merve Özlem Dinç
- Department of Anaesthesia and Intensive Care Medicine, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | | | - Jens-Christian Schewe
- Department of Anaesthesia and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Medical Centre Rostock, Rostock, Germany
| | - Maria Wittmann
- Department of Anaesthesia and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
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Munis ÖB, Parlak MM. Validity and reliability of the Turkish version of the Holden Communication Scale. Brain Behav 2023; 13:e3223. [PMID: 37587848 PMCID: PMC10498062 DOI: 10.1002/brb3.3223] [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: 07/07/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION The communication skills of individuals with dementia are affected even in the early stages of the condition. To date, there is no scale for the evaluation of communication abilities in Turkish-speaking populations with dementia that can be used in clinical practice and research. The present study aimed to determine the validity and reliability of the Turkish version of the Holden Communication Scale (HCS-TR). MATERIALS AND METHODS The study was carried out with 141 participants (77 female and 64 male). Psychometric analyses were conducted to assess the internal consistency, construct and criterion validity, test-retest reliability, and inter-rater reliability of the HCS-TR. The Standardized Mini-Mental State Examination (SMMSE) test was used for criterion validity. For the inter-rater reliability of the scale, the two different caregivers of individuals with dementia were administered the scale separately at the same time. For test-retest reliability, 2 weeks later, the same caregivers who filled out the HCS-TR the first time were administered to fill out the scale again. To test the validity of the scale, an item factor analysis was performed, and the correlations between the items and subsections were determined. RESULTS The factor loadings indicating the adequate contribution of the scale items to the relevant dimension were within the 0.700-0.831 range. There were positive relationships between all the items of the HCS-TR, and there was a significant negative relationship (r = -.842) between HCS-TR and MMSE. The corrected item-total correlation values were found to be within the .676-.794 range. Cronbach's alpha values for the HCS-TR subsection and total scores in the first and second measurements were found to be in the range of .718-.944. There was no statistically significant difference (p = .709) between the mean total scores in the first and second measurements. CONCLUSION The HCS-TR is a valid and reliable tool that can be used for clinical and research purposes to assess the strengths and limitations of the communication skills of Turkish individuals with dementia.
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Affiliation(s)
| | - Mümüne Merve Parlak
- Department of Speech and Language Therapy, Faculty of Health SciencesAnkara Yıldırım Beyazıt UniversityAnkaraTurkey
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Cao X, Zhou J, Liu J, Chen H, Zheng W. Aromatherapy in anxiety, depression, and insomnia: A bibliometric study and visualization analysis. Heliyon 2023; 9:e18380. [PMID: 37519641 PMCID: PMC10375858 DOI: 10.1016/j.heliyon.2023.e18380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/22/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023] Open
Abstract
Aromatherapy is a natural treatment method that uses essential oils (EOs) extracted from aromatic plants; EOs and their components exhibit a wide range of pharmacological activities, with a special focus on their implementation toward mental disorders, such as anxiety and depression. This study aimed to identify the scientific output and activity related to aromatherapy in anxiety, depression, and insomnia through bibliometric approaches. In this bibliometric study, we utilized CiteSpace and VOSviewer to evaluate the Web of Science Core Collection publications and to build visualizing maps to analyze the research progress on this topic between 2001 and 2021. A total of 1159 original and review articles in English, published in 578 different peer-reviewed journals by 260 authors, were identified. In the recent two decades, there was a steady increase in the number of published articles, especially in the following five years. All publications were distributed among 88 countries/regions. The United States had the most publications, with 188 (16.22%) articles, followed by China [131 (11.30%)], Brazil [110 (9.49%)], and Japan [85 (7.33%)]. Most studies were published in the Journal of Ethnopharmacology, and Physiology & Behavior was the most cited journal. Hritcu L was the top published scientist and Gupta SC was the most frequently co-cited. The knowledge base of this field research mainly included the related efficacy of aromatherapy/EOs, application status, and biochemical mechanism. And the keyword co-occurrence analysis revealed that the topics "oxidative stress," "chemical composition," "systematic review," and "sleep quality" were research frontiers. In conclusion, this comprehensive bibliometric study provides an updated perspective on research hotspots of aromatherapy in anxiety or depression and developmental tendencies of natural remedies for mental health. In addition, this study could also provide valuable information for research teams, practitioners, and decision-makers when designing and implementing natural treatment methods for mental health-promoting interventions for individuals with mood disorders.
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital of Central South University, China
| | - Jiansong Zhou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, China
| | - Jiali Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, China
| | - Hui Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, China
| | - Wei Zheng
- Department of Radiology, The Third Xiangya Hospital of Central South University, China
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Liang S, Pak Chun Chau J, Hoi Shan Lo S, Chow Choi K, Bai L, Cai W. The effects of a sensory stimulation intervention on psychosocial and clinical outcomes of critically ill patients and their families: A randomised controlled trial. Intensive Crit Care Nurs 2023; 75:103369. [PMID: 36528458 DOI: 10.1016/j.iccn.2022.103369] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To explore the effectiveness of a sensory stimulation intervention on intensive care unit patients' psychosocial, clinical, and family outcomes. DESIGN A prospective, assessor-blind, parallel-group randomised controlled trial. SETTING A surgical intensive care unit of one tertiary hospital in Guangzhou, mainland China. INTERVENTION Participants in the intervention group received a daily 30-minute auditory and visual stimulation session starting from recruitment and for a maximum of seven days while in the intensive care unit. MEASUREMENT AND MAIN RESULTS One hundred fifty-two patients and family caregiver dyads were recruited. Patients in the intervention group showed lower total scores of post-traumatic stress disorder (21.92 ± 6.34 vs 27.62 ± 10.35,p = 0.001), depressive symptoms (3.76 ± 3.99 vs 6.78 ± 4.75,p = 0.001) and delusional memories (0.47 ± 0.92 vs 0.82 ± 1.23,p = 0.001) collected immediately post-intervention than those in the control group, while not on depressive symptoms at one-month post-intervention (3.32 ± 4.03 vs 3.28 ± 3.77,p = 0.800). Sensory stimulation did not significantly impact patients' unit length of stay and 30-day mortality (allp > 0.05). For family outcomes, family caregivers in the intervention group had greater satisfaction with care (127.12 ± 14.14 vs 114.38 ± 21.97,p = 0.001) and a lower level of anxiety (28.49 ± 6.48 vs 34.64 ± 7.68,p = 0.001) than family caregivers in the control group. CONCLUSIONS Sensory stimulation may benefit patients' and family caregivers' psychological well-being, and further well-designed multi-centre clustered randomized controlled trials could be considered to strengthen the evidence.
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Affiliation(s)
- Surui Liang
- Nursing Department, Shenzhen Hospital of Southern Medical University, Administrative Building, Xinhu Road, Shenzhen 518101, China
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region, China
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region, China
| | - Liping Bai
- Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Wenzhi Cai
- Nursing Department, Shenzhen Hospital of Southern Medical University, Administrative Building, Xinhu Road, Shenzhen 518101, China.
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Solé C, Celdrán M, Cifre I. Psychological and Behavioral Effects of Snoezelen Rooms on Dementia. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2151805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Carme Solé
- School of Psychology, Education and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Montse Celdrán
- Department of Cognition, Development and Educational Psychology, University of Barcelona (Spain), Barcelona, Spain
| | - Ignacio Cifre
- School of Psychology, Education and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
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Lin LJ, Li KY. Comparing the effects of olfactory-based sensory stimulation and board game training on cognition, emotion, and blood biomarkers among individuals with dementia: A pilot randomized controlled trial. Front Psychol 2022; 13:1003325. [PMID: 36204759 PMCID: PMC9531625 DOI: 10.3389/fpsyg.2022.1003325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
Olfactory dysfunction can indicate early cognitive decline and is associated with dementia symptoms. We developed an olfactory-based sensory stimulation program and investigated its effects on cognition and emotion, and board game training were used as a comparison. In this parallel design pilot study, 30 participants with mild to moderate dementia were equal randomly assigned to the control (CONT), olfactory stimulation with cognitive training (OS), and board game (BG) groups. Two participants were withdrawn from CONT and OS groups, respectively. The intervention was a 12-week program with one 30-min session twice a week. We employed a blood-based biomarker technique and several cognitive and psychological tests to measure basal and after-intervention values. No significant differences were observed between the groups after intervention, as measured using the Mini-Mental State Examination, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Top International Biotech Smell Identification Test, and Geriatric Depression Scale (GDS). The results showed that the OS group had a lower plasma Tau level than the other groups following intervention, whereas the CONT group had a significantly increased plasma amyloid ß1-42 level. OS participants had a lower concentration ratio of plasma Tau and amyloid Aß1-42 and showed more stable or improved cognition, olfactory function, and mood state. Both the OS and BG groups had a higher percentage of participants with stable or improved cognition and emotion. Taken together, these results suggest that olfactory-based sensory stimulation can be a beneficial intervention for patients with dementia.
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Affiliation(s)
- Li-jung Lin
- Graduate Institute of Sport, Leisure, and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
| | - Kuan-yi Li
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Movement Disorders Section, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Kuan-yi Li,
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Cheung DSK, Wang SS, Li Y, Ho KHM, Kwok RKH, Mo SH, Bressington D. Sensory-based interventions for the immediate de-escalation of agitation in people with dementia: A systematic review. Aging Ment Health 2022:1-12. [PMID: 36073320 DOI: 10.1080/13607863.2022.2116404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: Sensory-based interventions are commonly used to reduce the occurrence of agitation in people with dementia over extended periods. However, the evidence regarding their immediate de-escalation effects is unclear. The objectives of this systematic review are to (a) identify which sensory-based interventions have been used for de-escalating agitation and (b) examine the immediate effects of these interventions on de-escalating agitation in people with dementia.Methods: A systematic review was performed in accordance with PRISMA guidelines. Data sources were identified by searching Embase, Medline, PsycINFO, and CINAHL for publications up to 2 March 2022. The de-escalating agitation effect had to be measured during the intervention or within 15 min after commencing the treatment. Only randomized controlled trials or quasi-experimental studies published in English were included.Results: Nine studies met the inclusion criteria: two randomized controlled trials, one cross-over study, and six quasi-experimental studies. All were conducted in Western countries, involving a total of 246 participants. Music-related interventions were investigated in seven studies, and a positive effect on de-escalating agitation was found, with no side-effects. All of the studies had methodological limitations, including a single group design, blinding, an insufficient sample size, and imprecisely reported results.Conclusion: There is a profound dearth of rigorous studies examining the immediate agitation de-escalating effects of sensory-based interventions on people with dementia. However, the limited evidence on music-related interventions is encouraging. More rigorous research is recommended to confirm the effects.
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Affiliation(s)
| | - Shan Shan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ken Hok Man Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Robin Ka Ho Kwok
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Siu Hong Mo
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Casuarina, Northern Territory, Australia
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Walden A, Feliciano L. A Virtual Reality Intervention to Reduce Dementia-Related Agitation Using Single-Case Design. Clin Gerontol 2022; 45:1044-1054. [PMID: 34346857 DOI: 10.1080/07317115.2021.1954121] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The primary objective of this study was to use a single-case design to evaluate the utility of a VR intervention to reduce agitation behaviors in two female participants with a diagnosis of dementia. METHODS A single-case research design with an ideographic approach was selected given the novelty of this intervention. A blended single case experimental design was used combining the Multiple-baseline design across individuals with a reversal design to examine the effects of VR nature scenes on agitation. Visual analysis was used to determine changes in mean, level, and latency of the behaviors. RESULTS For both participants, a significant decrease in their respective agitation behaviors was observed during intervention phases. CONCLUSIONS This study provides preliminary evidence of the utility of VR as a brief and effective intervention to decrease agitation in individuals with dementia. CLINICAL IMPLICATIONS These initial, promising results may help caregivers improve the quality of life for dementia patients. Further, the brevity of the intervention makes this a practical tool for care providers working in clinical settings. The primary objective of this study was to use a single-case design to evaluate the utility of a VR intervention to reduce agitation behaviors in two female participants with a diagnosis of dementia.
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Affiliation(s)
- Allison Walden
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Leilani Feliciano
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
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Horticulture therapy affected the mental status, sleep quality, and salivary markers of mucosal immunity in an elderly population. Sci Rep 2022; 12:10246. [PMID: 35715581 PMCID: PMC9205955 DOI: 10.1038/s41598-022-14534-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/08/2022] [Indexed: 11/09/2022] Open
Abstract
Horticultural therapy (HT) has been reported to be beneficial to mental and physical health. This study investigated the effects of HT on the psychological status and mucosal immunity of elderly individuals. Twenty-four participants aged 70-93 were recruited from residential facilities and adult day-care services. Six different HT activities were designed and guided by licensed instructors who performed saliva collection and helped the participants complete the questionnaires before and after each activity. The sleep quality scores were collected during the 6 weeks of HT activities. Saliva was collected and analyzed to determine the concentrations of immunoglobulin A (IgA), lactoferrin, chromogranin A (CgA), α-amylase (AA) and total protein (TP). Comparisons of the questionnaire scores between preactivity and postactivity showed that feelings of satisfaction and happiness were significantly enhanced after each activity. In addition, sleep quality was significantly improved after the 6-week course of HT activities. Regarding mucosal immunity, the preactivity IgA and IgA/TP were significantly increased at week 3 and week 6; in addition, the ratio of lactoferrin/TP was significantly decreased at week 6 compared to week 1. The postactivity AA and CgA levels were significantly enhanced at weeks 2, 3 and 5 compared to the corresponding preactivity levels. In conclusions, HT activities significantly improved the happiness, satisfaction, well-being and sleep quality of the elderly. Moreover, mucosal immunity proteins, including IgA, lactoferrin, CgA and AA, were significantly increased.
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Developing a Meaningful Garden Space in a Care Home with Staff and Family Members: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127025. [PMID: 35742271 PMCID: PMC9222630 DOI: 10.3390/ijerph19127025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
Background: Care home residents are often passive and lack active engagement in meaningful activities. The aim of this qualitative study was to co-develop a plan for a meaningful garden space in an urban care home in the north of England, to inform the subsequent building of such a garden space on the care home premises. Methods: Members of staff participated in focus groups conducted at the care home. Family carers were interviewed by telephone. Both focus groups and interviews were audio-recorded, with transcripts analysed independently using thematic analysis by two researchers, and consensus achieved on final themes. Findings: Two focus groups with staff (n = 17) and seven interviews with family carers were held. Thematic analysis generated seven key themes for the garden about its meaning and environmental features: (1) Current opinions on physical environment; (2) access; (3) adaptation to the environment; (4) staffing; (5) socialising; (6) sensory features; and (7) active meaningful participation. The garden needed to be accessible to residents in wheelchairs, and in all weathers and seasonal conditions, as well as being adapted to the needs of people living with dementia. Areas for social activities, such as picnics, and intergenerational activities, as well as private spaces, were recommended. Throughout the garden, sensory features were suggested, incorporating the use of vision, smell, touch, and sound, such as through water features. Moreover, it was recommended that residents should be able to contribute to the delivery of the activities themselves, including through a café and a vegetable garden. Conclusions: Family carers and staff considered that the garden would benefit from an intensive update to meet the needs of residents. This study therefore has practical implications for care home design, which are of even greater importance since the pandemic, as outdoor spaces were considered safer for care home visiting.
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Kor PPK, Yu CTK, Liu JYW, Cheung DSK, Kwan RYC, Leung AYM, Liu DPM, Hon JMK. Pilot evaluation of a home-based multi-sensory cognitive stimulation intervention for older people with dementia and caregiver dyads during the COVID-19 pandemic. Int J Older People Nurs 2022; 17:e12471. [PMID: 35581672 PMCID: PMC9347533 DOI: 10.1111/opn.12471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 01/04/2022] [Accepted: 04/13/2022] [Indexed: 01/08/2023]
Affiliation(s)
- Patrick Pui Kin Kor
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Clare Tsz Kiu Yu
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Justina Yat Wa Liu
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Daphne Sze Ki Cheung
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | | | - Angela Yee Man Leung
- Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Denise Pik Mei Liu
- Ming Yue District Elderly Community CentreHong Kong Young Women's Christian AssociationHong Kong SARChina
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15
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Wang Y, Tang C, Fan X, Shirai K, Dong JY. Mind-body therapies for older adults with dementia: a systematic review and meta-analysis. Eur Geriatr Med 2022; 13:881-891. [PMID: 35377128 DOI: 10.1007/s41999-022-00639-z] [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: 11/28/2021] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review of randomised controlled trials (RCTs) aimed to determine the effects of mind-body therapies (MBTs) among older adults with dementia. METHODS We searched five electronic databases (PubMed, PsycINFO, Web of Science, EMBASE, and the Cochrane Library) for publications investigating the effect of MBTs until July 14th, 2020. We included published peer-reviewed RCTs among participants with a mean age of 60 and above and a diagnosis of any dementia. Eligible studies included measurements for all types of health outcomes, including cognitive function, neuropsychiatric inventory, depressive syndromes, agitation, psychosocial status, and other health outcomes. Two investigators extracted data, the risk of bias for each study was evaluated through Review Manager, and statistical meta-analysis was performed using Stata. RESULTS A total of nine studies met the eligibility criteria, with full-text available for systematic review. Five of them, with 338 participants, were included in the meta-analysis. For most included RCTs of the review, the methodological quality was moderate. The meta-analysis showed that Tai Chi had a mild effect on global cognitive function (Mini-Mental State Examination, SMD = 0.40, 95% CI 0.10-0.70). Yoga and aromatherapy may also be beneficial for depression, and these three MBTs improved quality of life. CONCLUSION The current review suggested that MBTs may act as potential non-pharmaceutical approaches to improve certain health outcomes among older populations with dementia. Systematic review and meta-analysis registration: PROSPERO CRD42021198514.
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Affiliation(s)
- Yu Wang
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita Shi, Osaka, 565-0871, Japan
| | - Chengyao Tang
- Biostatistics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Xiaoyan Fan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita Shi, Osaka, 565-0871, Japan
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita Shi, Osaka, 565-0871, Japan.
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16
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Hayden L, Passarelli C, Shepley SE, Tigno W. A scoping review: Sensory interventions for older adults living with dementia. DEMENTIA 2022; 21:1416-1448. [PMID: 35230906 DOI: 10.1177/14713012211067027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This scoping review focused on the existing scholarly literature exploring sensory interventions and immersive environments developed for, and used by, older adults living with dementia. The purpose of the scoping review is 1) to understand the various sensory interventions that have been developed, used, and have provided data to show how such interventions are expected to impact the lives of individuals living with dementia; and 2) to understand how the field is moving forward. We chose to map the literature to understand the types of interventions, the types of outcomes measured, and the contexts of their implementation. Our search was constrained to references from 1990 to 1 June 2019 in the following databases: Academic Search Complete, CINAHL Complete, MEDLINE, PsycINFO databases, and Summon Search discovery layer. We screened 2305 articles based on their titles and abstracts, and 465 were sent to full text review, of which 170 were included in our full text extraction. Once the data were extracted, we created emic categories, which emerged from the data, for data that were amenable to categorization (e.g., study setting, intervention type, and outcome type). We developed ten different categories of interventions: art, aromatics, light, multi-component interventions, multisensory rooms, multisensory, music, nature, touch, and taste. Sensory interventions are a standard psychosocial approach to managing the personal expressions commonly experienced by people living with dementia. Our findings can help providers, caregivers, and researchers better design interventions for those living with dementia, to help them selectively choose interventions for particular outcomes and settings. Two areas emerging in the field are nature interventions (replacing traditional "multisensory rooms" with natural environments that are inherently multisensory and engaging) and multi-component interventions (where cognitive training programs are enhanced by adding sensory components).
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17
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Zarei S, Colman S, Rostas A, Burhan AM, Chu L, Davies SJ, Derkach P, Elmi S, Hussain M, Gerretsen P, Graff-Guerrero A, Ismail Z, Kim D, Krisman L, Moghabghab R, Mulsant BH, Nair V, Pollock BG, Rej S, Simmons J, Van Bussel L, Rajji TK, Kumar S. The Rationale and Design of Behavioral Interventions for Management of Agitation in Dementia in a Multi-Site Clinical Trial. J Alzheimers Dis 2022; 86:827-840. [PMID: 35147535 DOI: 10.3233/jad-215261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Agitation and aggression are common in patients with Alzheimer's disease and related dementias and pose a significant burden on patients, caregivers, and the healthcare systems. Guidelines recommend personalized behavioral interventions as the first-line treatment; however, these interventions are often underutilized. The Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov Identifier # NCT0367220) is a multisite randomized controlled trial comparing an Integrated Care Pathway, that includes a sequential pharmacological algorithm and structured behavioral interventions, with treatment-as-usual to treat agitation in dementia in long-term care and inpatient settings. OBJECTIVE To describe the rationale and design of structured behavioral interventions in the StaN study. METHODS Structured behavioral interventions are designed and implemented based on the following considerations: 1) personalization, 2) evidence base, 3) dose and duration, 4) measurement-based care, and 5) environmental factors and feasibility. RESULTS The process to design behavioral interventions for each individual starts with a comprehensive assessment, followed by personalized, evidence-based interventions delivered in a standardized manner with ongoing monitoring of global clinical status. Measurement-based care is used to tailor the interventions and to integrate them with pharmacotherapy. CONCLUSION Individualized behavioral interventions in patients with dementia may be challenging to design and implement. Here we describe a process to design and implement individualized and structured behavioral interventions in the context of a multisite trial in long-term care and inpatient settings. This process can inform the design of behavioral interventions in future trials and in clinical settings for the treatment of agitation in dementia.
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Affiliation(s)
- Shadi Zarei
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Colman
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Aviva Rostas
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Amer M Burhan
- Department of Psychiatry, Western University, London, Ontario, Canada.,Ontario Shores Centre for Mental Health Sciences, Toronto, Ontario, Canada
| | - Li Chu
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Simon Jc Davies
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Peter Derkach
- Ukrainian Canadian Care Centre, Toronto, Ontario, Canada
| | - Sarah Elmi
- Ontario Shores Centre for Mental Health Sciences, Toronto, Ontario, Canada
| | - Maria Hussain
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Philip Gerretsen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Graff-Guerrero
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Donna Kim
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Linda Krisman
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rola Moghabghab
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Vasavan Nair
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Bruce G Pollock
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Soham Rej
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Jyll Simmons
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lisa Van Bussel
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Context-Enhanced Human-Robot Interaction: Exploring the Role of System Interactivity and Multimodal Stimuli on the Engagement of People with Dementia. Int J Soc Robot 2021. [DOI: 10.1007/s12369-021-00823-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractEngaging people with dementia (PWD) in meaningful activities is the key to promote their quality of life. Design towards a higher level of user engagement has been extensively studied within the human-computer interaction community, however, few extend to PWD. It is generally considered that increased richness of experiences can lead to enhanced engagement. Therefore, this paper explores the effects of rich interaction in terms of the role of system interactivity and multimodal stimuli by engaging participants in context-enhanced human-robot interaction activities. The interaction with a social robot was considered context-enhanced due to the additional responsive sensory feedback from an augmented reality display. A field study was conducted in a Dutch nursing home with 16 residents. The study followed a two by two mixed factorial design with one within-subject variable - multimodal stimuli - and one between-subject variable - system interactivity. A mixed method of video coding analysis and observational rating scales was adopted to assess user engagement comprehensively. Results disclose that when additional auditory modality was included besides the visual-tactile stimuli, participants had significantly higher scores on attitude, more positive behavioral engagement during activity, and a higher percentage of communications displayed. The multimodal stimuli also promoted social interaction between participants and the facilitator. The findings provide sufficient evidence regarding the significant role of multimodal stimuli in promoting PWD’s engagement, which could be potentially used as a motivation strategy in future research to improve emotional aspects of activity-related engagement and social interaction with the human partner.
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19
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20
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Daniel Lai LL, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Affiliation(s)
- L L Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
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21
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Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 08/08/2023] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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Affiliation(s)
- L.L. Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J. Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
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22
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Prins AJ, Scherder EJA, van Straten A, Zwaagstra Y, Milders MV. Sensory Stimulation for Nursing-Home Residents: Systematic Review and Meta-Analysis of Its Effects on Sleep Quality and Rest-Activity Rhythm in Dementia. Dement Geriatr Cogn Disord 2021; 49:219-234. [PMID: 32920562 DOI: 10.1159/000509433] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Disrupted sleep-wake cycles might be associated with an exacerbation of behavioural disturbances and accelerate disease progression in dementia. The effect of sensory stimulation for improving sleep quality is unclear. METHODS A systematic literature search was performed and all studies examining the effects of a sensory stimulation intervention (i.e. bright light, massage, acupuncture, animal-assisted interventions) on rest-activity rhythm (RAR) and/or nocturnal restlessness in nursing-home residents with dementia were included. RESULTS Sensory stimulation was shown to improve nocturnal behavioural restlessness as well as sleep duration and continuation, but the effect on the number of awakenings, RAR, and daytime sleep was negligible. Notable was the high heterogeneity between studies regarding treatments and patients' characteristics and sleep parameters. CONCLUSION Sleep quality and nocturnal restlessness in nursing-home residents with dementia may benefit from sensory stimulation. An environment with sensory stimulation may prevent or improve sleep disturbances in nursing homes, and thereby contribute to a better quality of life for their patients.
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Affiliation(s)
- Angela Joanna Prins
- Atlant (Elderly Care), Beekbergen, The Netherlands, .,Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands,
| | - Erik J Anton Scherder
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Annemieke van Straten
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands
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23
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Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [DOI: 10.12688/wellcomeopenres.16189.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
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24
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Poptsi E, Tsolaki M, Bergh S, Cesana BM, Ciccone A, Fabbo A, Frisoni GB, Frölich L, Lavolpe S, Guazzarini AG, Hugon J, Fascendini S, Defanti CA. Rationale, Design, and Methodology of a Prospective Cohort Study for Coping with Behavioral and Psychological Symptoms of Dementia: The RECage Project. J Alzheimers Dis 2021; 80:1613-1627. [PMID: 33720887 PMCID: PMC8203243 DOI: 10.3233/jad-201215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Behavioral and psychological symptoms of dementia (BPSD) are quite challenging problems during the dementia course. Special Care Units for people with dementia (PwD) and BPSD (SCU-B) are residential medical structures, where BPSD patients are temporarily admitted, in case of unmanageable behavioral disturbances at home. OBJECTIVE RECage (REspectful Caring for AGitated Elderly) aspires to assess the short and long-term effectiveness of SCU-Bs toward alleviating BPSD and improving the quality of life (QoL) of PwD and their caregivers. METHODS RECage is a three-year, prospective study enrolling 500 PwD. Particularly, 250 community-dwelling PwDs presenting with severe BPSD will be recruited by five clinical centers across Europe, endowed with a SCU-B, for a short period of time; a second similar group of 250 PwD will be followed by six other no-SCU-B centers solely via outpatient visits. RECage's endpoints include short and long-term SCU-B clinical efficacy, QoL of patients and caregivers, cost-effectiveness of the SCU-B, psychotropic drug consumption, caregivers' attitude toward dementia, and time to nursing home placement. RESULTS PwD admitted in SCU-Bs are expected to have diminished rates of BPSD and better QoL and their caregivers are also expected to have better QoL and improved attitude towards dementia, compared to those followed in no-SCU-Bs. Also, the cost of care and the psychotropic drug consumption are expected to be lower. Finally, PwD followed in no-SCU-Bs are expected to have earlier admission to nursing homes. CONCLUSION The cohort study results will refine the SCU-B model, issuing recommendations for implementation of SCU-Bs in the countries where they are scarce or non-existent.
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Affiliation(s)
- Eleni Poptsi
- Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Makedonia, Hellas
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Makedonia, Hellas.,1st Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), Macedonia, Hellas
| | - Sverre Bergh
- Research centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Bruno Mario Cesana
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics"Giulio A. Maccacaro" Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Alfonso Ciccone
- Department of Neurology with Neurosurgical Activity "Carlo Poma" Hospital, ASST di Mantova, Mantua, Italy
| | - Andrea Fabbo
- Direttore UOC di Geriatria-Disturbi Cognitivi e Demenze, Dipartimento Cure Primarie AUSL, Modena, Italy
| | - Giovanni B Frisoni
- Memory Clinic, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sara Lavolpe
- Department of Neurology and CDCD Centre Humanitas Gavazzeni, Bergamo, Italy
| | - Anna Giulia Guazzarini
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Italy
| | - Jacques Hugon
- Center of Cognitive Neurology Université de Paris, Paris, France
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25
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Sikkes SA, Tang Y, Jutten RJ, Wesselman LM, Turkstra LS, Brodaty H, Clare L, Cassidy-Eagle E, Cox KL, Chételat G, Dautricourt S, Dhana K, Dodge H, Dröes RM, Hampstead BM, Holland T, Lampit A, Laver K, Lutz A, Lautenschlager NT, McCurry SM, Meiland FJM, Morris MC, Mueller KD, Peters R, Ridel G, Spector A, van der Steen JT, Tamplin J, Thompson Z, Bahar-Fuchs A. Toward a theory-based specification of non-pharmacological treatments in aging and dementia: Focused reviews and methodological recommendations. Alzheimers Dement 2021; 17:255-270. [PMID: 33215876 PMCID: PMC7970750 DOI: 10.1002/alz.12188] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/28/2020] [Accepted: 05/03/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Non-pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks methodological rigor and continues to produce mixed results. METHODS In the current position paper, experts in NPT research have specified treatment targets, aims, and ingredients using an umbrella framework, the Rehabilitation Treatment Specification System. RESULTS Experts provided a snapshot and an authoritative summary of the evidence for different NPTs based on the best synthesis efforts, identified main gaps in knowledge and relevant barriers, and provided directions for future research. Experts in trial methodology provide best practice principles and recommendations for those working in this area, underscoring the importance of prespecified protocols. DISCUSSION We conclude that the evidence strongly supports various NPTs in relation to their primary targets, and discuss opportunities and challenges associated with a unifying theoretical framework to guide future efforts in this area.
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Affiliation(s)
- Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Yi Tang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Linda M.P. Wesselman
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Lyn S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Henry Brodaty
- Centre for Healthy Brain Ageing and Dementia Centre for Research Collaboration, School of Psychiatry, UNSW, Sydney, Australia
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Erin Cassidy-Eagle
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Kay L. Cox
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Sophie Dautricourt
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Klodian Dhana
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Hiroko Dodge
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
- Department of Neurology, University of Michigan,Ann Arbor, Michigan, USA
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Center, VUmc, Amsterdam, the Netherlands
| | - Benjamin M. Hampstead
- Department of Psychiatry, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Thomas Holland
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Laver
- Department of Rehabilitation, Aged and Extended Care, College of Medicine and Public Health Flinders University, Adelaide, Australia
| | - Antoine Lutz
- Lyon Neuroscience Research Center INSERM U1028, CNRS UMR5292, Lyon University, Lyon, France
| | - Nicola T. Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Melbourne, Australia
| | - Susan M. McCurry
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Franka J. M. Meiland
- Department of Psychiatry, Amsterdam University Medical Center, VUmc, Amsterdam, the Netherlands
| | - Martha Clare Morris
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ruth Peters
- Department of Psychology, University of New South Wales, Randwick, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | | | - Aimee Spector
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Victoria, Australia
| | - Zara Thompson
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Victoria, Australia
| | - Alex Bahar-Fuchs
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Research on Ageing, Health, and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
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Karacsony S, Abela MRL. Stimulating sense memories for people living with dementia using the Namaste Care programme: What works, how and why? J Clin Nurs 2021; 31:1921-1932. [PMID: 33462888 DOI: 10.1111/jocn.15665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/18/2020] [Accepted: 12/31/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sensory-based program for people with advanced dementia aim to address unmet needs and to improve behaviours, mood or cognition. Pleasurable, involuntary sense memories stimulated by sensory-based program are difficult to evaluate because it is not possible to ask what people with dementia remember about their past, or what sense memories are being evoked. Notwithstanding the challenges in identifying what sense memories people with dementia experience, nurses and caregivers should recognise the potential value of sense memories for pleasure and happiness and provide optimum conditions to stimulate the senses. AIMS AND OBJECTIVES To examine the potential for involuntary sense memories to be activated by sensory stimulation, with a focus on the effects of the Namaste Care programme. DESIGN This is a discursive paper applying a content analysis to the qualitative findings of studies reporting on the Namaste Care programme to critically evaluate the topic of involuntary sense memories for people living with advanced dementia. METHODS A literature review and content analysis of qualitative findings on the Namaste Care programme was performed. Findings are reported in line with the COREQ checklist. RESULTS Eleven studies met the inclusion criteria. Codes were grouped into four categories representing enhanced mood, pleasure, happiness and comfort capturing the effects of the sensory stimulation observed or perceived by nurses and family caregivers. Descriptions provide some evidence of sensory memories activated by stimulation of some senses but not all. CONCLUSION Involuntary sense memories contribute to well-being of people living with advanced dementia. Caregivers, including nurses, need to be aware that involuntary sense memories that do not rely on cognitive processes can be triggered by sensory stimulation and have the potential to enhance mood and bestow pleasure, happiness and comfort over and above the "activity" of the sensory programme. RELEVANCE TO CLINICAL PRACTICE By integrating the documented experiential findings and conceptual understandings of sense memory, this paper contributes to advancing the understanding of the value of involuntary sense memories for people living with dementia that nurses and caregivers need to be aware of and, in turn, provide the optimum conditions for memory of the senses to be activated. A sensory-based programme, such as Namaste Care, provides optimum conditions at low cost to activate sense memories.
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Affiliation(s)
- Sara Karacsony
- School of Nursing, College of Health and Medicine, University of Tasmania, Sydney, Australia
| | - Melissa R L Abela
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Australia
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Vocally disruptive behaviour in nursing home residents in Ireland: a descriptive study. Ir J Psychol Med 2020:1-11. [PMID: 33323141 DOI: 10.1017/ipm.2020.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Vocally disruptive behaviour (VDB) is relatively common in nursing home residents but difficult to treat. There is limited study on prevalence and treatment of VDB. We hypothesise that VDB is a result of complex interaction between patient factors and environmental contributors. METHODS Residents of nursing homes in south Dublin were the target population for this study. Inclusion criteria were that the residents were 65 years or over and exhibited VDB significant enough for consideration in the resident's care plan. Information on typology and frequency of VDB, Interventions employed and their efficacy, diagnoses, Cohen-Mansfield Agitation Inventory scores, Mini-Mental State Examination scores, and Barthel Index scores were obtained. RESULTS Eight percent of nursing home residents were reported to display VDB, most commonly screaming (in 39.4% of vocally disruptive residents). VDB was associated with physical agitation and dementia; together, these two factors accounted for almost two-thirds of the variation in VDB between residents. One-to-one attention, engaging in conversation, redirecting behaviour, and use of psychotropic medication were reported by nurses as the most useful interventions. Analgesics were the medications most commonly used (65.7%) followed by quetiapine (62.9%), and these were reportedly effective in 82.6% and 77.2% of residents respectively. CONCLUSIONS VDB is common, challenging, and difficult to manage. The study of VDB is limited by a variety of factors that both contribute to this behaviour and make its treatment challenging. Issues relating to capacity and ethics make it difficult to conduct randomised controlled trials of treatments for VDB in the population affected.
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Liang S, Chau JPC, Lo SHS, Zhao J, Choi KC. Effects of nonpharmacological delirium-prevention interventions on critically ill patients' clinical, psychological, and family outcomes: A systematic review and meta-analysis. Aust Crit Care 2020; 34:378-387. [PMID: 33250403 DOI: 10.1016/j.aucc.2020.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/24/2020] [Accepted: 10/09/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Delirium is common in critically ill patients and may lead to severe complications, such as falls and injuries. Nonpharmacological interventions have been widely suggested to prevent delirium, yet the effects remain uncertain. OBJECTIVES The aim of the study was to determine the effects of nonpharmacological interventions on preventing delirium and improving critically ill patients' clinical, psychological, and family outcomes. METHODS Ten databases were searched from their inception to September 2020. Two reviewers assessed the methodological quality and extracted details of the included studies. The data were narratively or statistically pooled where appropriate. Dichotomous variables are presented as odds ratio (OR), and continuous variables are presented as mean difference (MD). The Grading of Recommendations Assessment, Development, and Evaluation criteria were used to assess the quality of evidence for each review outcome. RESULTS Thirty-four studies (10 randomised controlled trials, eight controlled clinical trials, and 16 before-and-after studies) were included in the analysis. Low-certainty evidence indicated that nonpharmacological interventions reduced delirium incidence (OR = 0.43, 95% confidence interval [CI] [0.33, 0.55]), delirium duration (MD = -1.43 days, 95% CI [-1.94, 0.92]), and length of stay in the intensive care unit (MD = -1.24 days, 95% CI [-2.05, -0.43]). Moderate-certainty evidence demonstrated no effect on mortality. Narrative synthesis further implied improvements in patients' psychological recovery (two studies, very low-certainty evidence) and families' satisfaction with care (two studies, very low-certainty evidence) through nonpharmacological interventions. As for effective intervention types, moderate-certainty evidence demonstrates that early mobilisation (OR = 0.33, 95% CI [0.24, 0.46], five studies, 859 participants, I2 = 24%), family participation (OR = 0.25, 95% CI [0.18, 0.34], four studies, 997 participants, I2 = 21%), and use of multicomponent interventions (OR = 0.48, 95% CI [0.34, 0.69], 13 studies, 3172 participants, I2 = 77%) are associated with reduced incidence of delirium. CONCLUSIONS Healthcare professionals are recommended to apply early mobilisation, family participation, or multicomponent interventions in clinical practice to prevent delirium. Further studies investigating the effects of nonpharmacological interventions on patients' psychological and family outcomes are warranted.
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Affiliation(s)
- Surui Liang
- The Nethersole School of Nursing, 6/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, 8/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.
| | - Suzanne Hoi Shan Lo
- The Nethersole School of Nursing, 8/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region
| | - Jie Zhao
- The Nethersole School of Nursing, 6/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region
| | - Kai Chow Choi
- The Nethersole School of Nursing, 7/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region
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Satoh M, Ogawa JI, Tokita T, Matsumoto Y, Nakao K, Tabei KI, Kato N, Tomimoto H. The Effects of a 5-Year Physical Exercise Intervention with Music in Community- Dwelling Normal Elderly People: The Mihama-Kiho Follow-Up Project. J Alzheimers Dis 2020; 78:1493-1507. [PMID: 33185595 DOI: 10.3233/jad-200480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We previously reported the enhanced effects of physical exercise when combined with music (ExM) on cognitive function in community-dwelling normal elderly people compared to exercise alone. Following that study, participants voluntarily continued the ExM classes for 5 years. OBJECTIVE To identify the effects of a 5-year ExM intervention on cognitive function in normal elderly people. METHODS Fifty-four subjects continued the ExM classes once a week for 5 years (ExM group). Thirty-three subjects retired from the ExM class during the 5 years (Retired group). Twenty-one subjects never participated in any intervention over the 5 years (No-exercise group). Cognitive function and ADLs were assessed using neuropsychological batteries and the functional independence measure (FIM), respectively. The voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used to investigate medial temporal lobe atrophy. RESULTS Analyses of the raw scores after the 5-year intervention showed significant differences between the ExM and No-exercise groups in their MMSE scores, Raven's colored progressive matrices (RCPM) time, logical memory (LM)-I, as well as the total and physical exercise sub-scores of the FIM. Analysis of subjects aged 70- 79 years at the beginning of this project showed significantly quicker performance on the RCPM in the ExM compared to No-exercise groups. The correlation coefficients between the total number of ExM sessions attended and the degree of changes in physical, neuropsychological, and VSRAD scores were significant for RCPM performance time and LM-I scores. CONCLUSION Long-term ExM intervention reinforces multifaceted cognitive function in normal elderly people, and is especially beneficial for psychomotor speed.
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Affiliation(s)
- Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | | | - Tomoko Tokita
- Department of Health and Welfare, Mihama Town Hall, Mihama, Mie, Japan
| | | | - Koji Nakao
- Department of Neurosurgery, Kinan Hospital, Mihama, Mie, Japan
| | - Ken-Ichi Tabei
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | - Natsuko Kato
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan.,Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
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Sandvoll AM, Grov EK, Simonsen M. Nursing home residents' ADL status, institution-dwelling and association with outdoor activity: a cross-sectional study. PeerJ 2020; 8:e10202. [PMID: 33133784 PMCID: PMC7580574 DOI: 10.7717/peerj.10202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 09/27/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction The Norwegian regulations for nursing homes consider access to meaningful activities to be an indicator for the quality of nursing homes. Activities of daily living (ADL) provide important basic self-care skills for nursing home residents. Due to the physical changes caused by ageing and comorbidities, nursing home residents may experience functional decline over time, which may affect their ability to perform meaningful ADL, such as outdoor activity, which is considered a valuable and meaningful activity in Norwegian culture. This study aimed to investigate the association between ADL status, institution-dwelling and outdoor activity among nursing home residents. Methods This cross-sectional study included 784 residents aged >67 years living in 21 nursing homes in 15 Norwegian municipalities between November 2016 and May 2018. The Barthel Index was used to assess the nursing home residents' ADL status. Other variables collected were age, gender, body weight and height, visits per month, institution, ward, and participation in weekly outdoor activities. Descriptive statistics were used to provide an overview of the residents' characteristics. A Poisson regression model was used to test the association between the outdoor activity level as the dependent variable and ADL score, institution, and other control variables as independent variables. Results More than half (57%) of the nursing home residents in this sample did not go outdoors. More than 50% of the residents had an ADL score <10, which indicates low performance status. Further, we found that residents' ADL status, institution, ward, and number of visits had an impact on how often the residents went outdoors. Discussion The nursing home residents in this study rarely went outdoors, which is interesting because Norwegians appreciate this activity. Differences in the number of visits might explain why some residents went outdoors more often than other residents did. Our findings also highlight that the institutions impact the outdoor activity. How the institutions are organized and how important this activity is considered to be in the institutions determine how often the activity is performed. Conclusion The low frequency of the outdoor activities might be explained by a low ADL score. More than 50% of the residents had an ADL score <10, which indicates low performance status. Despite regulations for nursing home quality in Norway, this result suggests that organizational differences matter, which is an important implication for further research, health policy and practice.
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Affiliation(s)
- Anne Marie Sandvoll
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Ellen Karine Grov
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Morten Simonsen
- Department of Environmental Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
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Strøm BS, Engedal K. Ethical aspects in dementia care - The use of psychosocial interventions. Nurs Ethics 2020; 28:435-443. [PMID: 34032153 DOI: 10.1177/0969733020952121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of psychosocial interventions for people with dementia is common and recommended because they focus on the underlying problem and well-being of the person. The promotion of well-being is a relevant dimension in person-centred care, where the aim is to confirm the person's 'personhood'. Most literature about ethics in dementia care instructs us on how and when to include people with dementia in our research. Little is written about the ethical aspects regarding the use of psychosocial interventions in daily care. In clinical practise, several challenges arise about the use of psychosocial interventions. Those include questions about the person's ability to participate in decision-making and how we know what is best for them. Furthermore, we must consider what kinds of psychosocial interventions are best for everybody, or if intervention causes discomfort for the person. This article emphasizes the necessity to consider the ethical aspects of the implementation of psychosocial interventions while taking into consideration the persons individual needs. A particular ethical challenge arises when a person with dementia is unable to express themselves verbally. Therefore, it is essential that the staff know the history and preferences of each person with dementia. The ethical aspects of psychosocial interventions for people with dementia will be discussed using Beauchamp and Childress four ethical principles: respect for autonomy, beneficence, non-maleficence and justice. The person-centred approach proposed by Kitwood's and Brooker.
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Affiliation(s)
| | - Knut Engedal
- Vestfold Hospital HF, Norway; Oslo University Hospital, Norway
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Dixon E, Lazar A. The Role of Sensory Changes in Everyday Technology use by People with Mild to Moderate Dementia. ASSETS. ANNUAL ACM CONFERENCE ON ASSISTIVE TECHNOLOGIES 2020; 2020:41. [PMID: 34308427 PMCID: PMC8299872 DOI: 10.1145/3373625.3417000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Technology design for dementia primarily focuses on cognitive needs. This includes providing task support, accommodating memory changes, and simplifying interfaces by reducing complexity. However, research has demonstrated that dementia affects not only the cognitive abilities of people with dementia, but also their sensory and motor abilities. This work provides a first step towards understanding the interaction between sensory changes and technology use by people with dementia through interviews with people with mild to moderate dementia and practitioners. Our analysis yields an understanding of strategies to use technology to overcome sensory changes associated with dementia as well as barriers to using certain technologies. We present new directions for the design of technologies for people with mild to moderate dementia, including intentional sensory stimulation to facilitate comprehension, as well as opportunities to leverage advances in technology design from other disabilities for dementia.
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Affiliation(s)
- Emma Dixon
- Information Studies, University of Maryland, College Park, Maryland, US
| | - Amanda Lazar
- Information Studies, University of Maryland, College Park, Maryland, US
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Kouzuki M, Kitao S, Kaju T, Urakami K. Evaluation of the effect of aroma oil as a bath salt on cognitive function. Psychogeriatrics 2020; 20:163-171. [PMID: 31578055 PMCID: PMC7079117 DOI: 10.1111/psyg.12481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/03/2019] [Accepted: 08/24/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Aromatherapy is a non-pharmacological therapy for the improvement of dementia symptoms. This study aimed to assess the effects of aroma oil as a bath salt on cognitive function, olfactory function and sleep quality. METHODS This was a randomised controlled trial. Overall, 49 patients were able to provide consent, and 35 were finally analysed (Alzheimer's disease: 10, mild cognitive impairment: 25). The patients were randomly assigned to use 0.1%, 0.5% or 1% aroma bath salt. During daily bathing, bath salt was added to the bath water, and the subjects remained in the bathroom for ≥10 min. The intervention period was 24 weeks, and the observation periods were 4 weeks before and after using the aroma bath salt. We performed the Touch Panel-type Dementia Assessment Scale (TDAS), the Odour Stick Identification Test for Japanese (OSIT-J) and the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) five times during the before and after observation periods and after the 12-week intervention. RESULTS There were no significant changes in the TDAS, OSIT-J and PSQI-J scores before and after the intervention in all groups. Moreover, there were no significant differences in the TDAS, OSIT-J and PSQI-J scores between the groups before and after the intervention. In the correlation analysis of changes in the TDAS and other tests during the intervention period, significant associations between TDAS and sleep latency and sleep disturbances, which are sub-items of PSQI-J, were observed in the use of 0.1% aroma bath salt group. CONCLUSIONS The use of aroma bath salt was not associated with improvement in cognitive function, olfactory function or sleep quality. However, sleep-related aspects were associated with changes in cognitive function before and after use of aroma bath salt, which suggested that there is a link between improvements in sleep and that in cognitive function.
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Affiliation(s)
- Minoru Kouzuki
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Satoshi Kitao
- Fuji Sangyo Co., Ltd., 1301, Tamura-cho, Marugame, Kagawa, Japan
| | - Takeshi Kaju
- Fuji Sangyo Co., Ltd., 1301, Tamura-cho, Marugame, Kagawa, Japan
| | - Katsuya Urakami
- Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, Yonago, Japan
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Ekra EMR, Dale B. Systematic Use of Song and Music in Dementia Care: Health Care Providers' Experiences. J Multidiscip Healthc 2020; 13:143-151. [PMID: 32103974 PMCID: PMC7023855 DOI: 10.2147/jmdh.s231440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/23/2020] [Indexed: 01/17/2023] Open
Abstract
Background and Aim Using song and music in a systematic way in residential dementia care may have several positive impacts on the patients, as well as the care providers. The aim of this study was to explore how health care providers experienced taking responsibility for conducting a song and music program in dementia care in nursing homes. Methods An explorative, qualitative study design was used. Focus groups were formed by 17 health care providers from 3 different nursing homes. These providers had experience implementing and using the “Gjenklang” (“reverberation”) song and music program especially developed for people with dementia. Focus group interviews were transcribed verbatim, and systematic text condensation was used for analysing the data. Results Three categories with associated subcategories emerged from the analysis process. The categories were 1) the music program increased the staff’s consciousness and awareness; 2) the music program evoked the patients’ emotions and reactions; and 3) maintaining enthusiasm over time. Conclusion The general opinion among the participants was that using the song and music program in a systematic and planned way had many benefits and positive impacts on the patients, as well as the staff. However, it was challenging to make it a part of the daily routine. Thus, it is important that the leaders of the units take responsibility to ensure continuity and maintain engagement among the staff over time.
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Affiliation(s)
- Else Mari Ruberg Ekra
- Institute of Health and Nursing Science, University of Agder, Grimstad NO-4898, Norway
| | - Bjørg Dale
- Centre of Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad NO-4898, Norway
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Strøm BS, Engedal K, Rokstad AM. Engagement in Everyday Activities among People Living in Indian Nursing Homes: The Association with Person-Centredness. Dement Geriatr Cogn Dis Extra 2020; 10:13-26. [PMID: 32158463 PMCID: PMC7011750 DOI: 10.1159/000505396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 12/10/2019] [Indexed: 02/03/2023] Open
Abstract
Introduction It has been reported that residents living in nursing homes are often inactive and lonely and are offered a limited number of activities. However, high engagement in activities has been reported to improve residents' quality of life and engagement in personalized activities can even reduce agitation and enhance positive mood. Information regarding occupational patterns and purpose in life is well established in Western countries. However, we know next to nothing about how people living in Indian nursing homes spend their days. Objective To explore the participation in everyday activities among older people in Indian nursing homes and the extent to which engagement in activities is associated with person-centred care. Methods The study was conducted in 6 nursing homes in India, comprising 147 residents. In all, 23 nursing staff took part and completed a 26-item questionnaire about resident activities based on the Multi-Dimensional Dementia Assessment Scale and the Person-Directed Care Questionnaire. Person-centredness was measured with the Person-Centred Care Assessment Tool. Results We found low participation in everyday activities among the residents. Participation in religious activities was the most frequent, whereas the least used activities were excursions, participating in cultural activities, taking part in educational programmes, visiting a restaurant and going to the cinema. A significant positive association was found between person-centred care and participation in religious activities, engagement in an activity programme and physical activity. Conclusions The most frequently attended activity was religious activities. Person-centred care was associated with participation in religious activities, engagement in an activity programme, physical activity, spending time in the garden and playing and listening to music.
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Affiliation(s)
| | - Knut Engedal
- Norwegian Advisory Unit for Aging and Health, Vestfold Hospital HF, Tønsberg, Norway.,Department of Geriatrics, Oslo University Hospital, Tønsberg, Norway
| | - Anne Marie Rokstad
- Norwegian Advisory Unit for Aging and Health, Vestfold Hospital HF, Tønsberg, Norway.,Faculty of Health Science and Social Care, Molde University College, Molde, Norway
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Kang HS, Makimoto K, Konno R, Koh IS. Review of outcome measures in PARO robot intervention studies for dementia care. Geriatr Nurs 2019; 41:207-214. [PMID: 31668459 DOI: 10.1016/j.gerinurse.2019.09.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
Abstract
The aim of this study was to describe interventions for PARO, as well as the outcomes evaluated and found following use of PARO, and to identify outcome measures in PARO intervention studies for older adults with dementia. Multiple databases (Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane, and Scopus) were searched and eight studies were included in the systematic review. The review demonstrated that interventions using PARO can be beneficial for improving QOL, affect, social interaction, and reducing NPS and psychotropic or pain medication use. This study identified three domains of outcome measures used to assess the effects of interventions using the PARO robot: quality of life, biological and physiological conditions, and medical treatment.
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Affiliation(s)
- Hee Sun Kang
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Rd, Dongjak-Gu, Seoul 156-756, South Korea.
| | - Kiyoko Makimoto
- School of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Rie Konno
- Kansai University of International Studies, Hyogo, Japan
| | - In Soon Koh
- Department of Nursing, Andong Science College, South Korea.
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Keszycki RM, Fisher DW, Dong H. The Hyperactivity-Impulsivity-Irritiability-Disinhibition-Aggression-Agitation Domain in Alzheimer's Disease: Current Management and Future Directions. Front Pharmacol 2019; 10:1109. [PMID: 31611794 PMCID: PMC6777414 DOI: 10.3389/fphar.2019.01109] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/29/2019] [Indexed: 12/14/2022] Open
Abstract
Behavioral and psychological symptoms of dementia (BPSD) afflict the vast majority of patients with dementia, especially those with Alzheimer's disease (AD). In clinical settings, patients with BPSD most often do not present with just one symptom. Rather, clusters of symptoms commonly co-occur and can, thus, be grouped into behavioral domains that may ultimately be the result of disruptions in overarching neural circuits. One major BPSD domain routinely identified across patients with AD is the hyperactivity-impulsivity-irritiability-disinhibition-aggression-agitation (HIDA) domain. The HIDA domain represents one of the most difficult sets of symptoms to manage in AD and accounts for much of the burden for caregivers and hospital staff. Although many studies recommend non-pharmacological treatments for HIDA domain symptoms as first-line, they demonstrate little consensus as to what these treatments should be and are often difficult to implement clinically. Certain symptoms within the HIDA domain also do not respond adequately to these treatments, putting patients at risk and necessitating adjunct pharmacological intervention. In this review, we summarize the current literature regarding non-pharmacological and pharmacological interventions for the HIDA domain and provide suggestions for improving treatment. As epigenetic changes due to both aging and AD cause dysfunction in drug-targeted receptors, we propose that HIDA domain treatments could be enhanced by adjunct strategies that modify these epigenetic alterations and, thus, increase efficacy and reduce side effects. To improve the implementation of non-pharmacological approaches in clinical settings, we suggest that issues regarding inadequate resources and guidance for implementation should be addressed. Finally, we propose that increased monitoring of symptom and treatment progression via novel sensor technology and the "DICE" (describe, investigate, create, and evaluate) approach may enhance both pharmacological and non-pharmacological interventions for the HIDA domain.
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Affiliation(s)
- Rachel M. Keszycki
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Daniel W. Fisher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA, United States
| | - Hongxin Dong
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Bray J, Brooker DJ, Garabedian C. What is the evidence for the activities of Namaste Care? A rapid assessment review. DEMENTIA 2019; 20:247-272. [DOI: 10.1177/1471301219878299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives To assess the quality of research evidence for the different activity components for the psycho-social Namaste Care intervention for care home residents with advanced dementia. Design Namaste Care is a multi-component intervention delivered on a daily basis to people living with advanced dementia or people at end of life with dementia. A significant part of its operationalisation within care homes is the delivery of a number of activities delivered by trained in-house Namaste Care workers to a group of residents with similar high dependency needs. The Namaste Care workers focus on touch, music, nature, sensory experience, aromas and interactions with objects delivered in a way to enhance feelings of enjoyment and wellbeing. This review evaluated the evidence for using these activities with people living with advanced dementia. A systematic search of peer-reviewed research articles was conducted between November 2016 and September 2018 using search terms of activities used in Namaste Care. The quality of each accepted article was rated using the Rapid Evidence Assessment scale. Results The initial literature search returned 1341 results: 127 articles including 42 reviews were included. The majority of activity interventions yielded between 10 and 20 peer-reviewed papers. The use of smells and aromas, interacting with animals and dolls, the use of various forms of music (e.g. background music, singing, personalised music), nature, lighting, various forms of touch/massage and sensory interventions (including Snoezelen) all appear to have proven efficacy with people living with advanced dementia. Conclusions There is generally a limited number of research papers and reviews in this area, but overall there is a good evidence base for including these activities within Namaste Care for people living with advanced dementia.
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Affiliation(s)
- Jennifer Bray
- Association for Dementia Studies, University of Worcester, UK
| | - Dawn J Brooker
- Association for Dementia Studies, University of Worcester, UK
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Smith-Carrier TA, Béres L, Johnson K, Blake C, Howard J. Digging into the experiences of therapeutic gardening for people with dementia: An interpretative phenomenological analysis. DEMENTIA 2019; 20:130-147. [PMID: 31426675 DOI: 10.1177/1471301219869121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Gardening programmes aim to promote improved engagement and quality of life in persons with dementia. Although a substantial literature has amassed documenting the overall positive outcomes associated with therapeutic gardening and horticulture for persons with dementia, little is known about the specific aspects of the gardening process that engender these benefits, and how and why they are important. The purpose of this research was to explore, using interpretative phenomenological analysis, the experiences of therapeutic gardening for persons with dementia, and their perspectives on the senses and emotions elicited in the gardening process that promote well-being. The themes that emerged in our analysis are to varying degrees substantiated in the literature: the usefulness of activating the senses, particularly those of touch and smell; the significance of being occupied in meaningful, productive work; the importance of cultivating a sense of curiosity, wonder, and learning; the positive gains derived from socialization in a group context; the peace and hope derived from being 'in the moment'; and the positive mental and physical well-being derived from participating in the outdoor garden. Our findings support the integration of therapeutic gardening as a valuable practice for people with dementia.
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Affiliation(s)
| | - Laura Béres
- School of Social Work, King's University College at Western University, London, Ontario, Canada
| | | | | | - Jennifer Howard
- Arthur Labatt Family School of Nursing, London, Ontario, Canada
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[Quality of life of nursing home residents with dementia before, during and after playing with a magic table]. Tijdschr Gerontol Geriatr 2019; 49:72-80. [PMID: 29235073 DOI: 10.1007/s12439-017-0243-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The 'Active Cues Magic Table' is a new game concept within nursing home care. It consists of light animations projected on a dining table and responding to movements of the players. The aim of this exploratory, quasi-experimental study was to examine the quality of life of nursing home residents with moderately severe or severe dementia before, during and after playing with this magic table. Quality of life was assessed with the Qualidem and the DS-DAT. Of the 34 nursing home residents included, 62% were female and mean age was 86.5 years (standard deviation 6.2). The Qualidem showed a small to moderate improvement in 'negative affect', 'restless tense behavior' and 'positive self-image' up to the week after playing (p ≤ 0.04). The DS-DAT showed a moderate improvement up to one hour after playing compared to a quarter of an hour before playing (p < 0.001). In conclusion, the quality of life of nursing home residents with moderately severe or severe dementia seems to improve up to the week after playing with the magic table. However, future research is needed to confirm the results of this exploratory study and to examine whether the improvements can truly be ascribed to the magic table.
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Language disintegration: communication ability in elderly immigrants with dementia. Lancet Public Health 2018; 3:e563. [PMID: 30522682 DOI: 10.1016/s2468-2667(18)30184-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/04/2018] [Indexed: 11/23/2022]
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Mendelevich EG. Alzheimer's disease: some pharmacological and non-pharmacological approaches to correcting neuropsychiatric disorders. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2018. [DOI: 10.14412/2074-2711-2018-3-129-134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Today, there is no reliable pharmacological correction of dementia, despite its high prevalence worldwide. The clinical presentation of Alzheimer's disease at one or another stage is accompanied by neuropsychiatric disorders (NPDs) in addition to cognitive defect. The intensity and range of NPDs are different. The possibilities of drug therapy for NPDs are demonstrated. The role of akatinol memantine in correcting a number of psychological and behavioral disorders is highlighted. Biological, psychological, social, and environmental factors are identified among those that contribute to or provoke the development of NPDs. Knowledge of the triggers of mental disorders makes it possible to prevent and thereby reduce or eliminate NPDs. Special emphasis is laid on the patient-caregiver relationship. In recent years, non-pharmacological interventions have been increasingly used as priority-line therapy for NPDs. There are data on main methods for non-pharmacological correction and on the efficiency of their application.
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Affiliation(s)
- E. G. Mendelevich
- Kazan State Medical University, Kazan, Republic of Tatarstan, Russia 49, Butlerov St., Kazan, Republic of Tatarstan
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Fossøy AB, Grov EK, Sandvoll AM. Magiske augneblikk; erfaringar med kulturprosjekt foreldre. TIDSSKRIFT FOR OMSORGSFORSKNING 2018. [DOI: 10.18261/issn.2387-5984-2018-02-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Positive Interactive Engagement (PIE): A pilot qualitative case study evaluation of a person-centred dementia care programme based on Montessori principles. DEMENTIA 2018; 19:975-991. [DOI: 10.1177/1471301218792144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Altered behaviour associated with dementia can present a number of challenges in the provision of care within both community and residential aged care settings. This paper presents a qualitative case study investigation of the implementation of the Positive Interactive Engagement programme within a residential aged care setting. The Positive Interactive Engagement programme incorporates non-pharmacological sensory techniques that have been informed by a person-centred, Montessori approach. Face-to-face semi-structured interviews with workers at a residential aged care facility in South Australia yielded seven case studies. Data were thematically analysed both within and between cases. Our data indicate the programme demonstrates underlying Montessori principles and supports participant behaviour change, with a noted reduction in ‘disruptive’ behaviours and increased social connection amongst participants. Programme staff report increased job satisfaction. The Positive Interactive Engagement programme offers a model that demonstrates encouraging outcomes, and further research would be useful in ascertaining whether these outcomes translate to quantifiable improvements in the quality of life for people with dementia in a residential aged care setting.
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The Adult Sensory Profile™ in Care Homes Targeting People Diagnosed with Dementia: A Qualitative Study from the Care Provider Perspective. Rehabil Res Pract 2018; 2018:5091643. [PMID: 30155306 PMCID: PMC6098864 DOI: 10.1155/2018/5091643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/08/2018] [Accepted: 07/26/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction The background of this study is the pilot testing of the Adolescent /Adult Sensory Profile (A/ASP) in dementia units at municipal nursing homes. Based on the results from therapists' A/ASP assessment, recommendations are made according to individual needs and forwarded to the health care providers. This study looks into the health care providers' perspective on the usability of these recommendations. Aim The aim of this qualitative study is to explore the health care providers' perspective on the usability of recommendations derived from the A/ASP during a pilot testing of the profile in dementia units for people living with severe dementia. Methods Participant observations and informal and formal interviews with health care providers at five municipal dementia units during the pilot testing of the A/ASP. Results In the health care provider perspective, the A/ASP is a relevant and useful tool to use when behavioural challenges among residents living with dementia occur. However, in their opinion, it requires time, adjustment, and further education if recommendations are to be fully implemented in everyday practice at the dementia units.
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Strøm BS, Šaltytė Benth J, Engedal K. Impact of the Sonas Programme on Communication over a Period of 24 Weeks in People with Moderate-to-Severe Dementia. Dement Geriatr Cogn Dis Extra 2018; 8:238-247. [PMID: 30022997 PMCID: PMC6047560 DOI: 10.1159/000489041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/07/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives The primary aim was to examine how communication abilities changed over time among nursing home residents with moderate-to-severe dementia who were attending the Sonas programme and to explore whether changes in communication abilities were related to cognitive ability. Method A longitudinal secondary descriptive study method was employed, where 56 people with moderate-to-severe dementia attended a 45-min Sonas group session twice a week for 24 weeks. The Threadgold Communication Tool (TCT) was completed every 4 weeks. Results The impact of the Sonas programme on communication showed a significant non-linear trend in the TCT, with an increase in communication abilities during the first 16 weeks, regardless of the level of the residents' cognitive abilities. Thereafter it levelled out. No interaction was found between time and the frequency of attendances at Sonas sessions. Both verbal and non-verbal communication increased from the baseline, with non-verbal communication increasing quickly and verbal communication increasing marginally. Conclusion Communication abilities increased with the time of the intervention, but the peak was achieved after 16 weeks, after which the effect levelled out. This suggest that the Sonas programme should be used for a period of at least 16 weeks before evaluating its effect.
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Affiliation(s)
| | | | - Knut Engedal
- Norwegian Advisory Unit for Aging and Health, Vestfold Hospital HF and Department of Geriatrics, Oslo University Hospital, Tønsberg, Norway
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Chiu HY, Chen PY, Chen YT, Huang HC. Reality orientation therapy benefits cognition in older people with dementia: A meta-analysis. Int J Nurs Stud 2018; 86:20-28. [PMID: 29960104 DOI: 10.1016/j.ijnurstu.2018.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND/AIMS To investigate the effect of reality orientation therapy on cognition, behavioral problems, and depressive symptoms in older people with dementia. DESIGN Meta-analysis of randomized controlled trials (RCTs). DATA SOURCE Various electronic databases were searched to select eligible articles, which included CINAHL, Embase, Pubmed, ProQuest, PsycINFO, the Cochrane Central Register of Controlled Trials, Google Scholar and Chinese electronic databases comprising Chinese Electronic Periodical Services and China Knowledge Resource Integrated. REVIEW METHODS Two reviewers independently extracted data and evaluated the methodological quality of the included articles. All analyses were performed using a random-effects model. Moderator analyses were conducted to identify the superior subgroup of intervention details that benefited from reality orientation therapy. RESULTS There was an overall random effect of reality orientation therapy of improving cognitive functions (n = 11, g = 0.39, 95% confidence interval [CI] = 0.25, 0.53); however, reality orientation therapy did not ameliorate behavioral problems (n = 5, g= -0.18, 95% CI= -0.36, 0.00) and depressive symptoms (n = 5, g= -0.17, 95% CI= -0.39, 0.05). A subgroup analysis revealed that studies of reality orientation therapy alone had a greater improvement in cognitive functions compared to those studies adopting reality orientation therapy combined with other types of techniques, but the difference in effect sizes between the two approaches was not significant (g = 0.51 vs. 0.35, p = 0.333). CONCLUSIONS Reality orientation therapy can be considered routine care for the maintenance and improvement of cognitive functions in older populations with dementia. Health professionals and caregivers can be further educated and trained to regularly perform reality orientation therapy to improve the cognition of older people with dementia.
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Affiliation(s)
- Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Pin-Yuan Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital in Keelung Branch, Keelung, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ting Chen
- School of Nursing, College of Medicine, Chang Gung University, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Van Deun B, Van den Noortgate N, Cinthia S, Van Bladel A, Dirk C. Paratonia in Flemish Nursing Homes: Current State of Practice. Am J Alzheimers Dis Other Demen 2018; 33:205-214. [PMID: 29468898 PMCID: PMC10852473 DOI: 10.1177/1533317518760594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Paratonia is a major underlying motor problem impeding functionality and locomotion in dementia. Despite its undeniable impact on patient's quality of life and daily care, there is a lack of evidence-based therapy on patients with this condition. METHODS We surveyed physiotherapists working in nursing homes in Flanders (Belgium) concerning the use and perceived effect of therapeutic strategies and positioning methods/aids. RESULTS Positioning and soft passive mobilization were the most applied and positively appraised therapeutic interventions. Highest ratings for positioning were found for C-shaped positioning cushions and multi-position wheelchair. According to the respondents, key points for paratonia approach were relaxation, positioning, active movement stimulation, and-to some extent-passive mobilization. Indispensable for any success however is multidisciplinary cooperation. CONCLUSION These findings might provide an inspirational path for research to verify possible (evidence based) beneficial treatments that could be applied to improve current and future treatment of patients with paratonia.
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Affiliation(s)
- Bieke Van Deun
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | | | - Saucedo Cinthia
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Anke Van Bladel
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Cambier Dirk
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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Onega LL, Pierce TW, Epperly L. Bright Light Therapy to Treat Depression in Individuals with Mild/Moderate or Severe Dementia. Issues Ment Health Nurs 2018; 39:370-373. [PMID: 29509051 DOI: 10.1080/01612840.2018.1437648] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This secondary analysis examined whether the benefits of bright light therapy on depression are greater in persons with mild/moderate or severe dementia. Exploratory analyses were also conducted to determine if bright light treatment targets different depressive symptom clusters based on dementia severity. Analyses using total scores from the instruments, Depressive Symptom Assessment for Older Adults and the Cornell Scale for Depression in Dementia, showed that bright light exposure is an equally effective intervention for depression in persons with both mild/moderate and severe dementia. Analyses of individual depressive subscales revealed that for disagreeable behavior and sleep impairment, bright light therapy appears to have greater benefits in persons with severe dementia than for those with mild/moderate dementia. Overall, this investigation supports the use of bright light therapy to treat depression regardless of dementia severity.
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Affiliation(s)
- Lisa L Onega
- a Associate Dean of Academics and Professor of Nursing , West Virginia University , Robert C. Byrd Health Sciences Center, Morgantown , West Virginia , USA
| | - Thomas W Pierce
- b Professor of Psychology, Radford University , Department of Psychology , Radford , Virginia , USA
| | - Lora Epperly
- c Director of Business Development and Care Innovations , Commonwealth Care of Roanoke, Inc. , Roanoke , Virginia , USA
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Raggi A, Tasca D, Ferri R. A brief essay on non-pharmacological treatment of Alzheimer's disease. Rev Neurosci 2018; 28:587-597. [PMID: 28422708 DOI: 10.1515/revneuro-2017-0002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/11/2017] [Indexed: 12/27/2022]
Abstract
Current pharmacological therapies for Alzheimer's disease (AD) do not modify its course and are not always beneficial. Therefore, the optimization of quality of life represents the best possible outcome achievable in all stages of the disease. Cognitive and behavioural rehabilitation represents the main therapeutic approach for this purpose, also in order to mitigate indirectly the burden of distress of family caregivers. The aim of this mini-review is to go through this theme by discussing cognitive activation, virtual reality and neuromodulation techniques. The practices summarized in this essay are not alternative but, often, complementary therapies to standardized pharmacological treatment. The present mini-review has found encouraging results but also the need for more conclusive evidence for all types of non-invasive/non-pharmacological treatment of AD.
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