1
|
Venegas-Sanabria LC, Cavero-Redondo I, Lorenzo-Garcia P, Sánchez-Vanegas G, Álvarez-Bueno C. Efficacy of Nonpharmacological Interventions in Cognitive Impairment: Systematic Review And Network Meta-Analysis. Am J Geriatr Psychiatry 2024:S1064-7481(24)00385-3. [PMID: 39034265 DOI: 10.1016/j.jagp.2024.06.012] [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] [Received: 02/01/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION There is currently no known cure for cognitive impairment, which highlights the need to explore other ways of managing this condition. This topic has recently become an area of active research. However, the availability of nonpharmacological options poses a challenge when trying to determine the best treatment for improving cognitive function. METHODS We conducted a systematic review and a Bayesian network meta-analysis to compare the effects of nonpharmacological interventions on global cognition in patients with mild cognitive impairment and dementia. The nonpharmacological interventions were classified as aerobic exercise, strength exercise, multicomponent physical exercise, other physical exercises, tai chi, mind-body exercises, traditional cognitive rehabilitation, computer-based cognitive rehabilitation, occupational therapy, music therapy, physical-cognitive rehabilitation, and reminiscence therapy. RESULTS Physical-cognitive rehabilitation emerged as the most effective nonpharmacological intervention for enhancing global cognition in patients with unspecified cognitive impairment and dementia, whereas occupational therapy focused on dual-task interventions was found to be the most effective nonpharmacological intervention for mild cognitive impairment. CONCLUSION These results underscore the importance of adopting a dual approach to managing cognitive impairment, integrating both cognitive and physical rehabilitation within the same intervention.
Collapse
Affiliation(s)
- Luis Carlos Venegas-Sanabria
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain; Escuela de Medicina y Ciencias de la Salud (LCVS, GSV), Universidad del Rosario, Bogotá, Colombia; Hospital Universitario Mayor-Méderi (LCVS, GSV), Bogotá, Colombia.
| | - Iván Cavero-Redondo
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain; Rehabilitation in Health Research Center (CIRES) (ICR), Universidad de Las Américas, Santiago, Chile; Facultad de Enfermería de Cuenca (ICR), Cuenca, Spain
| | - Patricia Lorenzo-Garcia
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain
| | - Guillermo Sánchez-Vanegas
- Escuela de Medicina y Ciencias de la Salud (LCVS, GSV), Universidad del Rosario, Bogotá, Colombia; Hospital Universitario Mayor-Méderi (LCVS, GSV), Bogotá, Colombia
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Camino de Pozuelo s/n (LCVS, ICR, PLG, CAB), Universidad de Castilla-La Mancha , Cuenca, Spain; Universidad Politécnica y Artística del Paraguay (CAB), Asunción, Paraguay
| |
Collapse
|
2
|
Tuohy D, Kingston L, Carey E, Graham M, Dore L, Doody O. A scoping review on the psychosocial interventions used in day care service for people living with dementia. PLoS One 2023; 18:e0295507. [PMID: 38079409 PMCID: PMC10712883 DOI: 10.1371/journal.pone.0295507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Adult Day care centres provide an important aspect of care provision through all phases of the dementia illness from diagnosis to the end of life (Dabelko HI 2008) supporting the well-being of both older people living with dementia and their care partners. Services within adult day care settings are designed to provide biopsychosocial health benefits to participants as well as care partner respite. OBJECTIVE To examine research studies, literature reviews and grey literature and identify and map the literature on psychosocial interventions used in day care services for older people living with dementia and chart their use, evaluation and outcomes. The research review question is "what are the psychosocial interventions used in day care service for older people living with dementia?" Psychosocial interventions are important non-pharmacological interventions which support people's wellbeing. METHODS Inclusion/Exclusion criteria were identified and guided the search strategy. Participants were people aged 60 years and over living with dementia attending day care services. The use of psychosocial interventions for this cohort was the focus of the review. Databases were searched (Cochrane Reviews, CINAHL, Embase, Medline EBSCO, Medline Ovid, Medline PubMed, PsycINFO, Scopus, Open Grey, Lenus and WHO Global Index Medicus databases) using keywords/terms with Boolean operators from 2011 to 2023. Rayyan was used to extract and manage the data. RESULTS The findings present a narrative and charting of the data from the 45 papers that met the review criteria, and this data is mapped onto the five objectives. Within this review, interventions were grouped into five broad types: nature (n = 6 papers), memory/cognitive (n = 11 papers), social (n = 17 papers), animal (n = 4 papers), or physical/sensory (n = 7 papers) based interventions. CONCLUSIONS This review has illustrated the wide variety in the types, range and facilitation of psychosocial interventions within adult day care services. This review highlights the potential benefits of these interventions. However, findings must be considered in the context that many were provided as brief intervention studies with little evidence of continuation after the study and further research is required given the complex and diverse range of interventions. Results will be of interest to practitioners planning to implement or evaluate psychosocial interventions used in day care services for older people living with dementia.
Collapse
Affiliation(s)
- Dympna Tuohy
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liz Kingston
- Department of Nursing and Midwifery, Health Research Institute, Health Implementation Science and Technology Cluster, University of Limerick, Limerick, Ireland
| | - Eileen Carey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Margaret Graham
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Liz Dore
- Research Services Department, Glucksman Library, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| |
Collapse
|
3
|
Luo G, Zhang J, Song Z, Wang Y, Wang X, Qu H, Wang F, Liu C, Gao F. Effectiveness of non-pharmacological therapies on cognitive function in patients with dementia-A network meta-analysis of randomized controlled trials. Front Aging Neurosci 2023; 15:1131744. [PMID: 36967820 PMCID: PMC10035791 DOI: 10.3389/fnagi.2023.1131744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Objective Non-pharmacological therapies (NPTs) have received increasing attention from researchers as a category of treatment to improve cognitive impairment in patients with dementia because of their fewer side effects. In this study, photobiomodulation (PBM), enriched environment (EE), exercise therapy (ET), computerized cognitive training (CCT), and cognitive stimulation therapy (CST) were selected to compare the effects of NPTs that improve dementia by quantifying information from randomized controlled trials (RCTs). Methods We did a systematic review and network meta-analysis. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure Database, Wan Fang Database, Chinese Biomedical Literature Database, Web of Science, and VIP Database from the time of database creation to 1 August 2022. Two investigators independently screened the literature, extracted information, and assessed the RCTs' quality with the Cochrane Collaboration Network Risk of Bias 2.0. Network meta-analysis was performed using R language (X64 version 4.1.3) and STATA 17.0. Results We identified 1,268 citations and of these included 38 trials comprising 3,412 participants. For improving dementia, the results of the network meta-analysis showed that compared with the control group (CON), PBM (SMD = 0.90, 95% CI: 0.43-1.37), EE (SMD = 0.71, 95% CI: 0.02-1.41), ET (SMD = 0.42, 95% CI: 0.16-0.68), and CST (SMD = 0.36, 95% CI: 0.11-0.62) were significantly different (P < 0.05); There was no significant difference in CCT (SMD = 0.41, 95% CI: -0.07-0.88) (P > 0.05). The ranked results showed that PBM has more potential to be the best intervention (P = 0.90). In addition, there was a significant difference between PBM and CST in improving cognitive function (SMD = 0.54, 95% CI: 0.00; 1.08, P < 0.05). Conclusion In this study, NPTs have excellent potential to improve cognition in people with dementia, and PBM may have more significant benefits in improving cognition than the other four NPTs. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022363746.
Collapse
Affiliation(s)
- Guangxin Luo
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Junqiu Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Zeyi Song
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, China
| | - Ying Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xiaojing Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Haifeng Qu
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, China
| | - Fang Wang
- Department of Psychology, The Fourth People’s Hospital of Wuhu, Wuhu, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People’s Hospital of Anhui Medical University, Anqing, China
| | - Fujia Gao
- School of Public Health, North China University of Science and Technology, Tangshan, China
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, School of Public Health, North China University of Science and Technology, Tangshan, China
| |
Collapse
|
4
|
Woods B, Rai HK, Elliott E, Aguirre E, Orrell M, Spector A. Cognitive stimulation to improve cognitive functioning in people with dementia. Hippokratia 2023. [DOI: 10.1002/14651858.cd005562.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Bob Woods
- Dementia Services Development Centre Wales; Bangor University; Bangor UK
| | - Harleen Kaur Rai
- Department of Psychiatry and Applied Psychology; Institute of Mental Health, University of Nottingham; Nottingham UK
| | - Emma Elliott
- Institute of Cardiovascular and Medical Sciences; University of Glasgow; Glasgow UK
| | | | - Martin Orrell
- Institute of Mental Health; University of Nottingham; Nottingham UK
| | - Aimee Spector
- Research Department of Clinical, Educational and Health Psychology; University College London; London UK
| |
Collapse
|
5
|
Lo CKF, Yung EA, Tsang KT. Investigation of Play Intervention for Dementia (PID) Activities in Addressing Cognitive Domains Reflected in Hong Kong Montreal Cognitive Assessment (HK-MoCA). Gerontol Geriatr Med 2022; 8:23337214221130161. [PMID: 36275408 PMCID: PMC9580081 DOI: 10.1177/23337214221130161] [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: 07/10/2022] [Revised: 08/14/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background/Objectives: Yee Hong Play Intervention for Dementia (PID) is a community program strengthening East Asians >65 years with dementia in their daily functional activities. We analyzed how PID activities align with Hong Kong Montreal Cognitive Assessment. Methods: Utilizing observation sheets procured from documentation notes from the twice-weekly PID sessions, cognitive domains were identified. Mean time duration and activity frequencies were compared between high and low competency client groups. Results: Independent of competency group, activities predominantly targeted attention/concentration (23.8% HC, 16.4% LC), and hand-eye coordination (19.1% HC, 28.7% LC). Less focused domains were delayed recall (3.1-4.7%) and naming (1.3-1.5%). Conclusions: Yee Hong PID tested innovative cognitive domains not currently covered in HK-MoCA screening assessment, emphasizing attention/concentration-oriented activities and none assessing orientation and language domains. Additionally, presence of new domains such as hand-eye coordination and fine motor dexterity suggested that strict adherence with standardized screening tools (e.g., MoCA) may not be ideal. Likely, facilitators have developed innovative measures to assess individual competency to strengthen resilience in our geriatric population.
Collapse
Affiliation(s)
- Calvin Ka-Fung Lo
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada,Calvin Ka-Fung Lo, Department of Pathology and Laboratory Medicine, University of British Columbia, 317 – 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Eric Andrew Yung
- School of Public Health Sciences, University of Waterloo, ON, Canada
| | - Ka Tat Tsang
- Factor-Inwentash Faculty of Social Work, University of Toronto, ON, Canada
| |
Collapse
|
6
|
Zheng J, Yu P, Chen X. An Evaluation of the Effects of Active Game Play on Cognition, Quality of Life and Depression for Older People with Dementia. Clin Gerontol 2022; 45:1034-1043. [PMID: 34666621 DOI: 10.1080/07317115.2021.1980170] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This pilot study was intended to evaluate the effects of active game play on cognition, quality of life, and depression for older people with dementia. METHODS Thirty-eight older people with dementia were recruited. Eighteen people received eight-week active game play using Xbox 360 Kinect. Twenty people received their usual care. The Mini Mental State Examination, Quality of Life-Alzheimer's Disease and Cornell Scale for Depression in Dementia were used to measure the outcomes. RESULTS The results showed that there was no significant improvement on the mean scores of Mini Mental State Examination (P = .252), however, the active game play increased the mean score of Quality of Life-Alzheimer's Disease (P = .005), and reduced the mean score of Cornell Scale for Depression in Dementia (P = .001) in comparison with the usual care group. CONCLUSIONS The study demonstrated that the active game play was effective in improving quality of life and alleviating depression in older people with dementia. CLINICAL IMPLICATIONS Findings highlight the potential for gaming as a non-pharmacological interventions for older people with dementia.
Collapse
Affiliation(s)
- Jiaying Zheng
- Nursing Department, Qianjiang College, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ping Yu
- School of Computing and Information Technology, University of Wollongong, Wollongong, Australia
| | - Xueping Chen
- Nursing Department, Qianjiang College, Hangzhou Normal University, Hangzhou, Zhejiang, China
| |
Collapse
|
7
|
Lee JLC, Ho RTH. Creating Exercise Spaces in Parks for Older Adults With Fitness, Rehabilitation, and Play Elements: A Review and Perspective. Gerontol Geriatr Med 2022; 8:23337214221083404. [PMID: 35295288 PMCID: PMC8918966 DOI: 10.1177/23337214221083404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/02/2022] [Indexed: 12/03/2022] Open
Abstract
Parks usually create a protective playground space for children to perform physical activity like jumping, running, and climbing. Specific spaces have rarely been created for older adults to perform physical activity in public parks. Now that park designs increasingly include outdoor exercise spaces for older adults, yet the important elements or considerations when designing this space remain unclear. Here, we present the emerging importance of and evidence for creating well-designed activity spaces for senior citizens in public parks in the era of population aging.
Collapse
Affiliation(s)
- Janet Lok Chun Lee
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong
| | - Rainbow Tin Hung Ho
- Department of Social Work and Social Administration and Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| |
Collapse
|
8
|
Li BY. Co-Composing an Aesthetic Self Through Play: Towards a Transformative Framework for Dementia Care. THE GERONTOLOGIST 2021; 62:464-474. [PMID: 33605400 DOI: 10.1093/geront/gnab021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Aging and deterioration mark a new phase in many older adults' life, highlighting the importance of creativity and imagination. This article introduces the implementation of an innovative program, Play Intervention for Dementia (PID), at a nursing home in Hong Kong, with emphasis on its contribution to the conceptual framework for understanding selfhood of older adults with dementia. RESEARCH DESIGN AND METHODS As a community-based participatory action research (CBPAR) project, this study democratized knowledge production by integrating voices of practitioners with diverse backgrounds through video-based methods. RESULTS Play, as an activity replete with free expressions and impulsive interactions, is an ideal realm for exploring and establishing selfhood with older adults with dementia. It has been found that "aesthetic self", an alternative self emerging from immediate aesthetic experience and carrying transformative power within the caring relationship, is a necessary element of self-construction in life with dementia. DISCUSSION AND IMPLICATIONS Integrating theories and practice, this framework provides a new lens for understanding and responding to selfhood, disease, and life.
Collapse
Affiliation(s)
- Bing Yu Li
- Department of Sociology, Law School, Shenzhen University, Shenzhen, China
| |
Collapse
|