Effects of a cognitive-enhancement group training program on daily living activities, cognition, and depression in the demented elderly

"Upgrading self-esteem: Effectiveness of cognitive enhancement package among psychiatric inpatients."

OBJECTIVE

To assess and compare the self-esteem before and after administration of cognitive enhancement package among psychiatric inpatients.

DESIGN & METHOD

Quantitative approach, Non-Equivalent control group pre-test and post-test design under quasi experimental research design was used for study. Total 60 psychiatric inpatients whose scores came out to be 25 and less in Rosenberg Self-esteem scale were enrolled in the study. Samples were selected by using purposive sampling method. Total four sessions of intervention were provided with 80 to 100 min for overall tasks. Interventions comprised of total three sub-tasks and each task was followed by daily assessment of progression with the help of self-care activities checklist for self-care activities, Ferrara Group Experience scale for group interaction and Mini-Mental Status Examination for cognitive functioning. Post-test was taken on fifth day of intervention.

RESULTS

The results showed that mean score of self-esteem (14.17 ± 2.00), self-care activities (3.83 ± 2.34) and group interaction (20.83 ± 7.42) along with cognitive functioning (18.23 ± 6.07) in pre-test were in lower level comparatively than in post-test after administration of Cognitive Enhancement Package which is self-esteem(20.17 ± 3.24), self-care activities (6.82 ± 2.31), group interaction (37.90 ± 5.71) and cognitive functioning (24.80 ± 4.12) at the 0.05 level of significance (p ≤ 0.05). However, the score remained same or decreased in case of comparison group who only received routine hospital care.

CONCLUSION

All in all, present study concluded that different innovative psychological approaches like Cognitive Enhancement Package can be incorporated along with usual psychopharmacology in order to promote the overall wellbeing and better rehabilitation for the psychiatric inpatients.

Cognitive Intervention with Musical Stimuli Using Digital Devices on Mild Cognitive Impairment: A Pilot Study

The effect of music therapy on cognitive function has been widely reported; however, its clinical implications remain controversial. Performing therapeutic musical activities in groups using individualized instruments can help overcome the issues of engagement and compliance. We aimed to evaluate the effect of a cognitive intervention with musical stimuli using digital devices on mild cognitive impairment (MCI). In this prospective study, 24 patients with MCI (intervention group, 12; and control group, 12) were enrolled. We developed an electronic device with musical instruments and the Song-based Cognitive Stimulation Therapy protocol (SongCST). Patients in the intervention group underwent a 10-week cognitive intervention involving musical stimuli generated by our device. Effect of the intervention on cognitive function was evaluated by the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Montreal Cognitive Assessment-Korean (MOCA-K), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB). In the intervention group, MMSE-DS and MOCA-K scores improved significantly after the 10-week intervention. The changes in MOCA-K and CDR-SB scores were significantly different between the intervention and control groups. Our study showed that music therapy with digital devices has a positive effect on the executive function and overall disease severity in patients with MCI. Our study can facilitate individualization of music therapy using digital devices in groups.

Promoting functional independence in people with Alzheimer's disease: Outcomes of a home-based occupational therapy intervention in Spain

Nonpharmacologic therapies such as occupational therapy (OT) are promising for people with Alzheimer's disease (AD). However, more research is needed to better understand the effectiveness of home-based OT programs. This pilot study aimed to assess the effects of a home-based, high-intensity and multicomponent OT intervention on the activities of daily living of people with AD in Spain. The secondary objective was to examine its impact on the cognitive functions. A multiple-baseline intrasubject design was used. Twenty-one community-dwelling older adults with mild AD (mean age 78.6 years) and their primary caregivers participated in a 12-week home-based OT program. This intervention was replicated for 8 weeks after a 1.5-month intervention withdrawal period. The intervention followed a holistic, biopsychosocial and client-centred approach and consisted of the following components: meaningful activities/tasks, cognitive stimulation, activation of psychomotor and sensory skills, home modification, caregiver counselling and training in daily living skills. Functional independence was the primary outcome (Barthel Index). The cognitive functions were assessed by the Loewenstein Occupational Therapy Cognitive Assessment-Geriatric (LOTCA-G). Data were analysed using nonparametric tests. Main results showed that after completing the OT program, 6.5 months after the moment of inclusion, the level of functional independence improved significantly and the effect size was large. Moreover, there was a significant moderate-to-substantial improvement in several cognitive functions after each of the two intervention periods: place orientation, time orientation and attention/concentration. In summary, the findings give a great deal of information as a basis for further research. This study provides evidence that an intensive home-based OT intervention has a positive influence on daily activities and some cognitive functions, suggesting that this program may be beneficial as a nonpharmacological supplementary tool in health and social care for people with AD living in the community.

The effects of occupation-centered activity program on fall-related factors and quality of life in patients with dementia

[Purpose] The purpose of this study was to investigate the effects of an occupation-centered activity program for dementia patients living in a local community, and examined the effects of the occupation-centered activity program on their cognitive functions, fall-related factors, and quality of life. [Subjects and Methods] Thirty subjects were divided into two groups: the experiment group (n=15) and the control group (n=15). The occupation-centered activity program was then applied to dementia patients for 60 minutes, 5 times/week for 12 weeks. To identify their cognitive functions before and after the intervention occupation-centered activity program, Mini-Mental State Examination-Korea (MMSE-K) and the Global Deterioration Scale (GDS) were used. To assess fall-related factors, Korean Falls Efficacy Scale for the Elderly (FES-K) was used and leg strength, agility, and balance of the participants was measured. To examine quality of life, the Korean version of Quality of Life-Alzheimer's Disease Scale (KQOL-AD) was used. [Results] The results of the intervention showed that although cognitive function improved in both the experimental and control groups, fall-related factors and the quality of life significantly improved only in the experimental group. [Conclusion] This indicates that the occupation-centered activity program had a positive effect on dementia patients' cognitive functions, fall-related factors, and quality of life.

The effects of a combined physical activity, recreation, and art and craft program on ADL, cognition, and depression in the elderly

[Purpose] To determine the effects of a combined physical activity, arts and crafts, and recreational program on the activities of daily living (ADL), cognitive function, and depression in the elderly. [Subjects and Methods] Twenty-eight elderly persons aged 65 years or older who live in P City, South Korea participated in a program combining arts and crafts and physical and recreational activities, twice weekly for eight weeks (a total of 16 sessions). The subjects' ADL, cognitive function, and depression were measured before and after the program using the following assessment instruments: the FIM, MMSE-K, and BDI, respectively. [Results] The results showed that, after the program intervention, ADL were remarkably improved for both men and women, cognitive function increased considerably, and depression levels significantly decreased, especially for elderly women. [Conclusion] The results of the present study indicate that a program combining physical and recreational activities, as well as arts and crafts, had positive effects on the health of the elderly and provide evidence for managing their health.

The Influence of Speech-Language-Hearing Therapy Duration on the Degree of Improvement in Poststroke Language Impairment

Background. The relevance of speech-language-hearing therapy (ST) duration to language impairment remains unclear. Objective. To determine the effect of ST duration on improvement in language impairment as a stroke sequela and to compare the findings with those for occupational therapy (OT) and physical therapy (PT). Methods. Data regarding patients with stroke sequelae who were registered in the Japanese Association of Rehabilitation Medicine database were analyzed. Propensity scores for ST, OT, and PT duration were calculated using logistic regression, followed by inverse probability weighting in generalized estimating equations to examine the odds ratio for improvement in the Functional Independence Measures scores for comprehension, expression, and memory. Analyses stratified by age and dementia severity were also conducted. Results. Compared with short-duration ST, long-duration ST was significantly associated with improved scores for comprehension and expression in the overall study population and in some groups, with higher benefit especially for younger participants (<64 years) and those with more severe dementia. A significant but less pronounced effect was also observed for OT and PT. Conclusion. Long-duration ST is more effective than long-duration OT or PT for improving language impairment occurring as stroke sequela. However, these effects are limited by age and severity of dementia.

The contributions of occupational science to the readiness of long duration deep space exploration

BACKGROUND

This study introduces the contributions of occupational science (OS) to the preparation and support of astronauts during long duration space exploration. Given the hostile environment of space, it is not surprising that there is grave deterioration of both physical and mental health when off Earth. However, OS, through occupational therapy (OT), can identify strategies that maintain health and minimize disruptions in task performance for mission success.

OBJECTIVE

To determine the gaps in NASA's preparation of astronauts for long duration space exploration and the viable contributions of OT. Because occupational therapists are trained to address deficits and modify environments to support meaningful engagement in occupations, the OT practitioner is well suited to address the disabling conditions astronauts experience in space.

METHODS

A literature review revealing the challenges of deep space travel on humans was completed. A survey was also sent to (N = 170) occupational therapists worldwide to identify opinions about the profession's involvement in deep space exploration.

RESULTS

Ninety-seven percent (N = 163) of the participants believed that OS can inform long duration space travel. Approximately ninety-eight percent (N = 166) of respondents believed that OT interventions can be used on space travelers during long duration space flights.

CONCLUSION

OT interventions can be implemented in any phase of space flight to increase the likelihood of mission success and astronaut safety and well-being.

Association between handgrip strength and cognitive impairment in elderly Koreans: a population-based cross-sectional study

[Purpose] The purpose of this study was to investigate the association between handgrip strength and mild cognitive impairment in elderly adults. [Subjects] Study participants included 2,982 adults (1,366 males and 1,616 females), aged 65 years or older. [Methods] This population-based cross-sectional study used the baseline database from the Korean Longitudinal Study of Ageing. [Results] The odds ratio for mild cognitive impairment showed a significant linear decrease in relation to the quartile of handgrip strength, independent of potential covariates, in both men and women. Moreover, after excluding incident cases of mild cognitive impairment, the results showed that greater handgrip strength was associated with higher cognitive function scores in the elderly. [Conclusion] The findings presented here suggest that handgrip strength is associated with a risk of mild cognitive impairment in the Korean elderly. Moreover, greater handgrip strength is associated with higher cognitive function in cognitively normal elderly individuals.

Effects of combined fine motor skill and cognitive therapy to cognition, degree of dementia, depression, and activities of daily living in the elderly with Alzheimer's disease

[Purpose] This study evaluated the effects of combined fine motor skill and cognitive therapies on cognition, depression, and activities of daily living in elderly patients with Alzheimer's disease (AD). [Subjects and Methods] Twenty-six participants comprised 2 groups. The experimental group (n=13) received combined fine motor skill and cognitive therapy, and the control group (n=13) received only general medical care. [Results] The experimental group showed improvements in cognition, degree of dementia, depression, and activities of daily living compared to the control group. However, there were no significant differences between the two groups. [Conclusion] These results suggest that combined fine motor skill and cognitive therapy improves cognition, degree of dementia, depression, and daily living in elderly patients with AD. These therapies would therefore be effective as general medical care strategies.