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Mamayson RF, Lacanaria MGC. Effects of Cognitively Stimulating Activities on the Cognitive Functioning of Older People with Mild Cognitive Impairment: A Meta-analysis. ACTA MEDICA PHILIPPINA 2024; 58:14-23. [PMID: 38846164 PMCID: PMC11151131 DOI: 10.47895/amp.vi0.7162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background The number of individuals with mild cognitive impairment (MCI), or those people without dementia who are experiencing age-related cognitive decline, has increased in recent years. Conveniently, several interventions to delay cognitive decline exist, where cognitively stimulating activities (CSA) have been receiving too much attention. However, its beneficial effects have not been well established among older people with MCI due to conflicting findings. Objectives This study aimed to assess and summarize the available evidence on the effects of CSA on the overall cognitive functioning of older people with MCI. Specifically, it sought to answer the PICO question, "In older people with MCI, does engagement in cognitively stimulating activities improve cognitive function?" Methods A systematic review and meta-analysis of randomized controlled trials examining the effects of CSA on older people with MCI were conducted. Three studies met the inclusion criteria from the 1,328 records from BioMed Central, CINAHL, Cochrane Library, Health Source: Nursing/Academic Edition, MEDLINE, and PubMed databases and 156 articles from WorldCat, DSpace Saint Louis University, and Google Scholar databases and catalogs. Effect size values were inspected using the random-effects model. Data were summarized as standardized mean difference (SMD) with corresponding 95% confidence intervals in the forest plot. Results This meta-analysis which compared studies that employed similar methodologies, found that CSA has a significant, large effect in improving cognitive functioning among older people with MCI, evidenced by an SMD of 0.798 (95% CI = 0.510-1.085, p = 0.001). While its superiority over other interventions that improve cognitive function was not observed in this study, it was still found that using CSA was helpful in terms of its cost-effectiveness. Also, heterogeneity across studies was non-significant (Cochran's Q = 0.151, df = 2, p = 0.927, I2 = 0.00%). These results mean that clinical heterogeneity was absent even though a diverse range of CSA was employed. Additionally, methodological diversity was not present since there were no variations in the study design and minimal variability in the risk of bias assessment. Conclusion Overall, it is acknowledged that CSA are effective and practical, inexpensive, non-pharmacologic cognitive training approaches to delay cognitive decline among older people with MCI. However, interpreting this study's significant, large effect, and non-significant heterogeneity warrants caution.
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Hsiao CC, Lin CC, Cheng CG, Chang YH, Lin HC, Wu HC, Cheng CA. Self-Reported Beneficial Effects of Chinese Calligraphy Handwriting Training for Individuals with Mild Cognitive Impairment: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1031. [PMID: 36673790 PMCID: PMC9859373 DOI: 10.3390/ijerph20021031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Dementia is a common disease in aging populations. The treatment has mainly focused on memory decline prevention and behavior control. Nonpharmacological treatments, such as cognition training, physical exercise, and music therapy have been effective in slowing memory decline. Chinese calligraphy handwriting (CCH) through breath regulation and fine hand control involves high concentration levels, emotion regulation, and self-awareness. CCH is a mind and body activity that is culturally relevant to older Chinese adults. This study evaluated the beneficial effects of CCH on mild cognitive impairment. METHODS In 2018, we conducted 8 weeks of CCH training at the Tri-Service General Hospital. The participants were asked to copy a regular script. At the end of the course, they gave oral presentations and showed their work. Self-report questionnaires on emotion, memory, upper limb coordination, attention, and language were collected before and after training. RESULTS The five questionnaires showed significantly positive feelings after CCH training. The conditions of emotional stability, concentration, hand movement, memory, and speech improved. CONCLUSIONS CCH training stimulated the brain and improved cognition, psychological symptoms, and hand stability. It is inexpensive and worthwhile for elderly Chinese individuals with mild cognitive impairment to take time daily to practice calligraphy.
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Affiliation(s)
- Chih-Chun Hsiao
- Department of Nursing, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Yin-Han Chang
- Department of Psychology, National Taiwan University, Taipei 10621, Taiwan
| | - Hui-Chen Lin
- School of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Hsing-Chen Wu
- Graduate Institute of Vocational and Technological Education, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Yan RWK, Kwok CPC, Kwok JOT, Lee KKW, Lu H, Chu WCW, Kwok TCY, Lam LCW, Lee ATC. Increasing participation in habitual intellectual activities on modulating functional connectivity of default mode network among older adults at risk of dementia: study protocol of a randomized controlled trial. Trials 2022; 23:306. [PMID: 35422056 PMCID: PMC9009491 DOI: 10.1186/s13063-022-06271-3] [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: 10/14/2021] [Accepted: 04/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Active participation in intellectual leisure activities such as calligraphy helps prevent cognitive decline and dementia, but the underlying mechanisms are not fully understood. With disrupted functional connectivity (FC) of default mode network (DMN) associated with cognitive decline, we speculate that intellectual activities might optimize cognitive function through modulating FC of DMN. This two-arm single-blind randomized controlled trial aims to identify the effects of increasing practice of calligraphy on cognitive function and FC of DMN in people with subjective cognitive decline (SCD). METHODS One hundred twelve community-living Chinese aged 55 to 75 years old with SCD but without mild cognitive impairment or dementia and with prior practice of calligraphy as defined by 1 h of calligraphy per week will be recruited through elderly social centres in Hong Kong and randomized into either control or intervention group. The control group will continue with their usual practice of calligraphy, whereas the intervention group will double their practice of calligraphy. Measurement of cognitive outcomes and neuroimaging on resting-state FC will be performed at baseline and in 6 months. Repeated measures analysis of variance will be used to assess cognitive and FC changes, with time being the within-group factor, control/intervention as the between-group measure, and important covariates (age, sex, educational and occupational attainment, health, and other lifestyle factors) controlled for. DISCUSSION This study will shed light on the underlying neurocognitive mechanisms of how intellectual activities promotes cognitive maintenance. Our anticipated findings will provide evidence that reversing or slowing FC disruption by actively participating in intellectual activities is still possible for the at-risk individuals. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900024433 . Registered on 11 July 2019.
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Affiliation(s)
- Rachel W K Yan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Charlotte P C Kwok
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jessie O T Kwok
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Kaspar K W Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Hanna Lu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Winnie C W Chu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Timothy C Y Kwok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
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Lee CH, Lee YC. Effects of Different Finger Grips and Arm Positions on the Performance of Manipulating the Chinese Brush in Chinese Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910291. [PMID: 34639590 PMCID: PMC8507993 DOI: 10.3390/ijerph181910291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate the effects of finger grip and wrist position on Chinese calligraphy handwriting (CCH). Thirty participants were recruited in the study and asked to manipulate the Chinese brush using two finger grip methods (three-finger grip and five-finger grip) and two wrist positions (suspended wrist and raised wrist). Three experimental writing tasks were applied to investigate writing stability, agility, and hand–eye coordination, and to evaluate the completion time (s), area of error (cm2), and error times. Subjective responses (arm aching level, ease of grip, exertion level, and comfort) regarding the four combinations of Chinese brush manipulation were measured. The results indicated significantly better performance with the three-finger grip for the stability and agility tests, and with the five-finger grip for the hand–eye coordination task. Using the suspended wrist position for CCH allowed better agility and hand–eye coordination than the raised wrist position. In consideration of the results of the four operational combinations, the three-finger grip with a suspended wrist position demonstrated the best performance in both objective and subjective measurements. It is recommended for application in the early learning stage. These findings can be considered when teaching Chinese brushes for beginners of CCH in schools.
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Affiliation(s)
- Ching-Hung Lee
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Yu-Chi Lee
- School of Design, South China University of Technology, Guangzhou 510006, China
- Correspondence:
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Fong ZH, Tan SH, Mahendran R, Kua EH, Chee TT. Arts-based interventions to improve cognition in older persons with mild cognitive impairment: A systematic review of randomized controlled trials. Aging Ment Health 2021; 25:1605-1617. [PMID: 32643397 DOI: 10.1080/13607863.2020.1786802] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES As the global burden of dementia rises, the search for preventive measures such as interventions for mild cognitive impairment (MCI) remains a research priority. While arts-based interventions have demonstrated some success in improving cognitive functioning among older adults and those with dementia, its effectiveness for older persons with MCI remains unexplored. We conducted a systematic review to examine the effects of arts-based interventions on cognition in older persons with MCI. METHOD The following databases were searched in November 2019: PubMed, EMBASE, PsycINFO, and CINAHL Plus, supplemented by Google Scholar and ALOIS. Study inclusion criteria were older persons aged ≥ 60 with MCI; arts-based interventions such as dance, drama, music, or visual arts; and randomized controlled trial with cognitive outcome. Database search, study selection, and data extraction were conducted independently by 2 reviewers. RESULTS Eleven randomized controlled trials examining 13 interventions (817 participants) were identified, of which 4 involved visual arts, 4 dance/movement, 3 music, and 2 storytelling. Significant improvement on at least one cognitive outcome was reported in 10 of the 13 interventions. These included improvements in global cognition (6/7 interventions), learning and memory (5/9), complex attention (4/10), executive functioning (2/6), language (2/3), and perceptual-motor function (1/4). CONCLUSION This review found that arts-based interventions can potentially improve various aspects of cognitive functioning in older persons with MCI, although our confidence was dampened by methodological limitations such as the moderate-to-high risk of bias present in studies and heterogeneity in the way MCI was defined. Recommendations for future research are discussed.
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Affiliation(s)
- Zhi Hui Fong
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ser Hong Tan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore.,Academic Development Department, Duke-NUS Medical School, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
| | - Tji Tjian Chee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
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Promoting the Quality of Life of Elderly during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136813. [PMID: 34201928 PMCID: PMC8297320 DOI: 10.3390/ijerph18136813] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/28/2022]
Abstract
This study explored the technology learning model of the elderly in a senior learning center under the impact of the COVID-19 pandemic. Many senior learning centers were closed during the pandemic, and many of them adopted the mode of online education. However, problems such as decreased motivation and a lack of peer interaction still exist. To solve these problems, this study used the easy-to-implement calligraphy AR approach and E-book approach to conduct a quasi-experiment on the elderly of a calligraphy course offered by a senior learning center. The results show a higher learning motivation among the elderly who use calligraphy AR. The learning effectiveness and technology acceptance of the elderly in the E-book learning group were higher than those in the calligraphy AR group. The elderly mentioned that the E-book learning approach is more user-friendly. In general, in the face of the COVID-19 pandemic affecting the suspension of classes in senior centers, education through the development of technology has stimulated the growth of education in advanced learning centers. Through this kind of scientific and technological learning method, it will bring a whole new experience to the elderly. It can improve the stress relief methods, mental health, and quality of life of the elderly during the COVID-19 emergency shutdown, and provide a novel calligraphy technique learning experience for the elderly. Therefore, we believe that the calligraphy AR learning approach and the calligraphy E-book learning approach are practical and may promote quality of life and mental health of the elderly during the emergency closures due to COVID-19, providing elderly attendees with a novel calligraphy technology learning experience.
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Abstract
Current treatment paradigm in Alzheimer’s disease (AD) involves multiple approaches combining pharmacological and nonpharmacological intervention to mitigate the clinical symptoms, slow the progressive loss of cognitive and functional abilities, or modify the disease course. So far, beyond anti-cholinesterase inhibitors (AChEIs), donepezil, rivastigmine, galantamine, and antagonist of N-methyl-D-aspartic acid (NMDA) receptor, there are no newly approved medicines to treat AD. Under pharmacological treatment, the personal characteristic and the intra-individual therapeutic evaluations to examine various cognitive domains, behavioral and psychological problems, and global function should be considered when choosing any of AChEIs. The use of optimal dosage referring to the expected clinical outcomes and currently reported deficits from patient with AD has become an important issue in clinical treatment. Establishing and maintaining a strong therapeutic alliance to physician, patient, and caregiver is crucial and central to the comprehensive care in AD.
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Affiliation(s)
- Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Taiwan, China
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, China
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung City, Taiwan, China
| | - Rajka Liscic
- Department of Neurology, Johannes Kepler University Linz, Austria
| | - Jacqueline Dominguez
- Institute for Neurosciences, St. Luke’s Medical Center, Quezon City, Philippines
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A summary of the evidence and evaluation of the effectiveness of nonpharmacological interventions for mild cognitive impairment. FRONTIERS OF NURSING 2019. [DOI: 10.2478/fon-2019-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Objective
To summarize and evaluate the evidence of guidelines and systematic reviews (SRs) of nonpharmacological interventions for mild cognitive impairment (MCI) to support the development of future guidelines and clinical decisions for MCI patients.
Methods
Scottish Intercollegiate Guideline Network (SIGN), National Institute for Health and Clinical Excellence (NICE), American Academy of Neurology (AAN), Registered Nurses Association of Ontario (RNAO), Web of Science, PubMed, Cochrane Library, CNAHL, VIP, China National Knowledge Infrastructure (CNKI), and Wanfang Database were searched for relevant publications, including guidelines and SRs, from January 2014 to March 2019. Two authors independently screened articles, extracted data, and assessed the publications for adherence to the inclusion criteria. Appraisal of Guidelines for Research and Evaluation (AGREE II) was used to assess the quality of the guidelines, and Assessment of Multiple Systematic Reviews (AMSTAR 2) was used to assess the quality of SRs. In addition, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of outcomes.
Results
Thirty-two articles were retrieved, including 1 guideline and 31 SRs. Fourteen SRs of physical exercise for MCI, six articles describing cognitive interventions, four articles describing acupuncture, and seven articles assessing dietary interventions (including four articles employing a Mediterranean diet, one article using vitamin B supplementation, and two articles assessing the effects of tea, coffee, and caffeine) were included. The quality of the articles was very low for 4 (13%), low for 10 (32%), and moderate for 17 (55%).
Conclusions
Based on the evidence available to date, nonpharmacological interventions may improve the current cognitive function of persons with MCI. In particular, physical exercise, cognitive interventions, and acupuncture exerted promising effects. However, due to the limited number and quality of the included publications, additional high-quality reviews are needed to further confirm.
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Chu KY, Huang CY, Ouyang WC. Does Chinese calligraphy therapy reduce neuropsychiatric symptoms: a systematic review and meta-analysis. BMC Psychiatry 2018; 18:62. [PMID: 29514660 PMCID: PMC5842540 DOI: 10.1186/s12888-018-1611-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND There are currently no systematic reviews or meta-analyses of Chinese calligraphy therapy (CCT) to reduce neuropsychiatric symptoms. The aim of this systematic review and meta-analysis was to explore the efficacy of CCT for people with neuropsychiatric symptoms. METHODS We searched Chinese and English databases, including the Cochrane Central Register of Controlled Trials and Wanfang Data for relevant articles published between the earliest year available and December 2016. The search was limited to randomized controlled trials and controlled clinical studies and the associated keywords were "handwriting," "Chinese calligraphy," "Chinese calligraphy therapy," "Calligraphy exercise," and "Calligraphy training." The 21 articles that met these criteria were used in the analysis. The Joanna Briggs Institute critical appraisal checklist was used to assess methodological quality. RESULTS CCT significantly reduced psychosis (10 studies, 965 subjects, standardized mean difference [SMD] = - 0.17, 95% confidence intervals [CI] [- 0.30, - 0.40], Z = 2.60, p < 0.01), anxiety symptoms (9 studies, 579 subjects, SMD = - 0.78, 95% CI [- 0.95, - 0.61], Z = 8.98, p < 0.001), and depressive symptoms (7 studies, 456 subjects, SMD = - 0.69, 95% CI [- 0.88, - 0.50], Z = 7.11, p < 0.001). CCT also significantly improved cognitive function (2 studies, 55 subjects, MD = 2.17, 95% CI [- 0.03, 4.38], Z = 1.93, p = 0.05) and neurofeedback (3 studies, 148 subjects, SMD = - 1.09, 95% CI [- 1.44, - 0.73], Z = 6.01, p < 0.001). The therapy also significantly reduced the positive psychopathological expression of schizophrenia symptoms (4 studies, 287 subjects, SMD = - 0.35, 95% CI [- 0.59, - 0.12], Z = 2.96, p = 0.003) and reduced the negative symptoms of schizophrenia (4 studies, 276 subjects, SMD = - 1.39, 95% CI [- 1.65, - 1.12], Z = 10.23, p < 0.001). CONCLUSIONS CCT exerts a curative effect on neuropsychiatric symptoms, but the evidence remains insufficient. A large number of RCTs are needed to facilitate additional systematic reviews of evidence for CCT.
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Affiliation(s)
- Kuan-Yu Chu
- Taoyuan General Hospital, Taoyuan City, Taiwan. .,Department of Fine Art & Culture Creative Design, Hua-Fan University, New Taipei City, Taiwan. .,College of General studies, Yuan-Ze University, Taoyuan City, Taiwan.
| | - Chih-Yang Huang
- grid.445071.3Department of Fine Art & Culture Creative Design, Hua-Fan University, New Taipei City, Taiwan
| | - Wen-Chen Ouyang
- Jianan Psychiatric Center, Tainan City, Taiwan ,0000 0000 9476 5696grid.412019.fDepartment of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Chen W, He Y, Gao Y, Zhang C, Chen C, Bi S, Yang P, Wang Y, Wang W. Long-Term Experience of Chinese Calligraphic Handwriting Is Associated with Better Executive Functions and Stronger Resting-State Functional Connectivity in Related Brain Regions. PLoS One 2017; 12:e0170660. [PMID: 28129407 PMCID: PMC5271317 DOI: 10.1371/journal.pone.0170660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 12/26/2016] [Indexed: 11/18/2022] Open
Abstract
Chinese calligraphic handwriting (CCH) is a traditional art form that requires high levels of concentration and motor control. Previous research has linked short-term training in CCH to improvements in attention and memory. Little is known about the potential impacts of long-term CCH practice on a broader array of executive functions and their potential neural substrates. In this cross-sectional study, we recruited 36 practitioners with at least 5 years of CCH experience and 50 control subjects with no more than one month of CCH practice and investigated their differences in the three components of executive functions (i.e., shifting, updating, and inhibition). Valid resting-state fMRI data were collected from 31 CCH and 40 control participants. Compared with the controls, CCH individuals showed better updating (as measured by the Corsi Block Test) and inhibition (as measured by the Stroop Word-Color Test), but the two groups did not differ in shifting (as measured by a cue-target task). The CCH group showed stronger resting-state functional connectivity (RSFC) than the control group in brain areas involved in updating and inhibition. These results suggested that long-term CCH training may be associated with improvements in specific aspects of executive functions and strengthened neural networks in related brain regions.
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Affiliation(s)
- Wen Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Department of Psychology and Social Behavior, University of California, Irvine, California, United States of America
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yang Gao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Cuiping Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Chuansheng Chen
- Department of Psychology and Social Behavior, University of California, Irvine, California, United States of America
| | - Suyu Bi
- School of International Journalism and Communication, Beijing Foreign Studies University, Beijing, China
- School of Arts and Media, Beijing Normal University, Beijing, China
| | - Pin Yang
- Conservation Department, National Palace Museum, Beijing, China
| | - Yiwen Wang
- School of Arts and Media, Beijing Normal University, Beijing, China
- * E-mail: (WW); (YW)
| | - Wenjing Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- * E-mail: (WW); (YW)
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Tai SY, Hsu CL, Huang SW, Ma TC, Hsieh WC, Yang YH. Effects of multiple training modalities in patients with Alzheimer's disease: a pilot study. Neuropsychiatr Dis Treat 2016; 12:2843-2849. [PMID: 27843319 PMCID: PMC5098772 DOI: 10.2147/ndt.s116257] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This pilot study investigated the effects of multiple training modalities on cognition, neuropsychiatric symptoms, caregivers' burden, and quality of life in patients with Alzheimer's disease (AD). PATIENTS AND METHODS This intervention study was conducted in 24 patients with AD aged ≥65 years with a Clinical Dementia Rating (CDR) score of 0.5-1. The patients were assigned to receive multiple training modalities (1 hour for each training: Tai Chi, calligraphy, and drawing) over a 6-week period in either the experimental group (n=14) or the comparison group (n=10). A series of neuropsychological tests - namely the Traditional Chinese version Mini-Mental Status Examination, Cognitive Assessment Screening Instrument (CASI), Neuropsychiatric Inventory and the Neuropsychiatric Inventory Caregiver Distress Scale, and the Clinical Dementia Rating Sum of Boxes scale - were conducted at the baseline and after the intervention. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) and Zarit Caregiver Burden Scale were used to assess the quality of life and caregivers' burden, respectively. Independent sample t-test and paired sample t-test were used to analyze the data. RESULTS After the intervention, the experimental group reported higher scores in the orientation domain of CASI (P=0.007) and in the psychiatry domain of WHOQOL-BREF (P=0.042) compared with the comparison group. Caregivers' distress was significantly decreased in the experimental group (P=0.035) but not in the comparison group (P=0.430). CONCLUSION The multiple training modalities improved scores in the orientation domain of CASI and psychiatry domain of WHOQOL-BREF in patients with AD. Moreover, the intervention reduced caregivers' distress.
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Affiliation(s)
- Shu-Yu Tai
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University; Department of Family Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University; Research Center for Environmental Medicine, Kaohsiung Medical University
| | - Chia-Ling Hsu
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University
| | - Shu-Wan Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University
| | - Tzu-Chiao Ma
- Graduate Institute of Oral Health Sciences, Kaohsiung Medical University; Mentality Protection Center, Fo Guang Shan Compassion Foundation
| | - Wen-Chien Hsieh
- Department of Social Work, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University; Department of Sociology and Social Work, Kaohsiung Medical University
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University; Mentality Protection Center, Fo Guang Shan Compassion Foundation; Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University; Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
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Hikichi H, Kondo N, Kondo K, Aida J, Takeda T, Kawachi I. Effect of a community intervention programme promoting social interactions on functional disability prevention for older adults: propensity score matching and instrumental variable analyses, JAGES Taketoyo study. J Epidemiol Community Health 2015; 69:905-10. [PMID: 25888596 PMCID: PMC4552922 DOI: 10.1136/jech-2014-205345] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/05/2015] [Accepted: 03/26/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND The efficacy of promoting social interactions to improve the health of older adults is not fully established due to residual confounding and selection bias. METHODS The government of Taketoyo town, Aichi Prefecture, Japan, developed a resident-centred community intervention programme called 'community salons', providing opportunities for social interactions among local older residents. To evaluate the impact of the programme, we conducted questionnaire surveys for all older residents of Taketoyo. We carried out a baseline survey in July 2006 (prior to the introduction of the programme) and assessed the onset of functional disability during March 2012. We analysed the data of 2421 older people. In addition to the standard Cox proportional hazard regression, we conducted Cox regression with propensity score matching (PSM) and an instrumental variable (IV) analysis, using the number of community salons within a radius of 350 m from the participant's home as an instrument. RESULTS In the 5 years after the first salon was launched, the salon participants showed a 6.3% lower incidence of functional disability compared with non-participants. Even adjusting for sex, age, equivalent income, educational attainment, higher level activities of daily living and depression, the Cox adjusted HR for becoming disabled was 0.49 (95% CI 0.33 to 0.72). Similar results were observed using PSM (HR 0.52, 95% CI 0.33 to 0.83) and IV-Cox analysis (HR 0.50, 95% CI 0.34 to 0.74). CONCLUSIONS A community health promotion programme focused on increasing social interactions among older adults may be effective in preventing the onset of disability.
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Affiliation(s)
- Hiroyuki Hikichi
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Naoki Kondo
- School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
- Centor for Well-being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Density, Sendai, Japan
| | - Tokunori Takeda
- Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Rodakowski J, Saghafi E, Butters MA, Skidmore ER. Non-pharmacological interventions for adults with mild cognitive impairment and early stage dementia: An updated scoping review. Mol Aspects Med 2015; 43-44:38-53. [PMID: 26070444 DOI: 10.1016/j.mam.2015.06.003] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/06/2015] [Accepted: 06/06/2015] [Indexed: 02/07/2023]
Abstract
The purpose of this scoping review was to examine the science related to non-pharmacological interventions designed to slow decline for older adults with Mild Cognitive Impairment or early-stage dementia. We reviewed 32 unique randomized controlled trials that employed cognitive training (remediation or compensation approaches), physical exercise, or psychotherapeutic interventions that were published before November 2014. Evidence suggests that cognitive training focused on remediation and physical exercise interventions may promote small improvements in selected cognitive abilities. Cognitive training focused on compensation interventions and selected psychotherapeutic interventions may influence how cognitive changes impact daily living. However, confidence in these findings is limited due to methodological limitations. To better assess the value of non-pharmacological interventions for this population, we recommend: (1) adoption of universal criteria for "early stage cognitive decline" among studies, (2) adherence to guidelines for the conceptualization, operationalization, and implementation of complex interventions, (3) consistent characterization of the impact of interventions on daily life, and (4) long-term follow-up of clinical outcomes to assess maintenance and meaningfulness of reported effects over time.
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Affiliation(s)
- Juleen Rodakowski
- Department of Occupational Therapy, School of Health & Rehabilitation Sciences, University of Pittsburgh (Rodakowski, Skidmore), Pittsburgh, PA, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ester Saghafi
- Health Sciences Library System, University of Pittsburgh (Saghafi), Pittsburgh, PA, USA
| | - Meryl A Butters
- Department of Psychiatry, School of Medicine, University of Pittsburgh (Butters), Pittsburgh, PA, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, School of Health & Rehabilitation Sciences, University of Pittsburgh (Rodakowski, Skidmore), Pittsburgh, PA, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA.
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14
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Kao HSR, Zhu L, Chao AA, Chen HY, Liu ICY, Zhang M. Calligraphy and meditation for stress reduction: an experimental comparison. Psychol Res Behav Manag 2014; 7:47-52. [PMID: 24611024 PMCID: PMC3928403 DOI: 10.2147/prbm.s55743] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chinese calligraphic handwriting (CCH) has demonstrated a new role in health and therapy. Meanwhile, meditation is an traditional and effective method for coping with stress and staying healthy. This study compared the effectiveness of CCH and meditation as distinctive and parallel stress reduction interventions. METHODS Thirty graduate students and academic staff members in Taiwan who suffered from stress were selected by the General Health Questionnaire and randomly assigned to one of three treatment groups, ie, a CCH group, a meditation group, or a control group, for 8 consecutive weeks. Changes in physiological parameters were measured before, during, and after treatment. RESULTS CCH and meditation showed their strength in the respective indices of stress. There was a significant difference in respiratory rate, heart rate, and electromyographic scores between the groups. Comparing pre- and post-effects, a decrease in heart rate and an increase in skin temperature was seen in subjects who practiced CCH. Increased skin temperature and decreased respiratory rate were also seen in subjects who practiced meditation, along with reduced muscle tension and heart rate. CONCLUSION CCH and meditation have good effects in stress reduction. CCH is a particularly promising new approach to reducing stress.
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Affiliation(s)
- Henry SR Kao
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - Lin Zhu
- Department of Psychology, Renmin University of China, Beijing
| | - An An Chao
- International Society of Calligraphy Therapy, Hong Kong
| | - Hao Yi Chen
- Department of Business Administration, National Chengchi University, Taipei, Taiwan
| | - Ivy CY Liu
- Department of Psychology, Fu Jen Catholic University, Taipei, Taiwan
| | - Manlin Zhang
- Department of Psychology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
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15
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Zhu Z, Wang R, Kao HS, Zong Y, Liu Z, Tang S, Xu M, Liu IC, Lam SP. Effect of calligraphy training on hyperarousal symptoms for childhood survivors of the 2008 China earthquakes. Neuropsychiatr Dis Treat 2014; 10:977-85. [PMID: 24940061 PMCID: PMC4051712 DOI: 10.2147/ndt.s55016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study investigated the treatment effects of calligraphy therapy on childhood survivors of the 2008 Sichuan earthquakes in the People's Republic of China. METHODS In experiment 1, 129 children participated in a 30-day calligraphic training, and 81 children were controls. The Children's Revised Impact of Event Scale was adopted to assess behavioral effects. Experiment 2 involved 41 treatment subjects and 39 controls, with the same procedure as in experiment 1 except that salivary cortisol level was also measured as a physiological indicator. RESULTS After 30 days of calligraphy treatment, the arousal symptoms and salivary cortisol levels in the experimental group decreased from 5.72±0.31 and 13.34±2.88 to 4.98±0.31 and 9.99±2.81, respectively. In the control group, there was not a significant decrease from pretest to post-test. In addition, the arousal scores in posttest (4.98±4.39) were significantly lower than midtest (5.71±4.14) for girls; in contrast, for boys, posttest (4.90±4.24) showed little change compared with midtest (5.04±4.36), but both were significantly lower than pretest (6.42±4.59). CONCLUSIONS Calligraphy therapy was effective in reducing hyperarousal symptoms among child survivors.
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Affiliation(s)
- Zhuohong Zhu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Richu Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Henry Sr Kao
- Department of Psychology, University of Hong Kong, Hong Kong
| | - Yan Zong
- Sichuan Judicial and Police Officers Professional College, Deyang, Sichuan, People's Republic of China
| | - Zhengkui Liu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Shan Tang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Min Xu
- Department of Linguistics, University of Hong Kong, Hong Kong
| | - Ivy Cy Liu
- Department of Psychology, Fu Jen Catholic University, New Taipei, Taiwan
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Huckans M, Hutson L, Twamley E, Jak A, Kaye J, Storzbach D. Efficacy of cognitive rehabilitation therapies for mild cognitive impairment (MCI) in older adults: working toward a theoretical model and evidence-based interventions. Neuropsychol Rev 2013; 23:63-80. [PMID: 23471631 DOI: 10.1007/s11065-013-9230-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 02/15/2013] [Indexed: 02/04/2023]
Abstract
To evaluate the efficacy of cognitive rehabilitation therapies (CRTs) for mild cognitive impairment (MCI). Our review revealed a need for evidence-based treatments for MCI and a lack of a theoretical rehabilitation model to guide the development and evaluation of these interventions. We have thus proposed a theoretical rehabilitation model of MCI that yields key intervention targets-cognitive compromise, functional compromise, neuropsychiatric symptoms, and modifiable risk and protective factors known to be associated with MCI and dementia. Our model additionally defines specific cognitive rehabilitation approaches that may directly or indirectly target key outcomes-restorative cognitive training, compensatory cognitive training, lifestyle interventions, and psychotherapeutic techniques. Fourteen randomized controlled trials met inclusion criteria and were reviewed. Studies markedly varied in terms of intervention approaches and selected outcome measures and were frequently hampered by design limitations. The bulk of the evidence suggested that CRTs can change targeted behaviors in individuals with MCI and that CRTs are associated with improvements in objective cognitive performance, but the pattern of effects on specific cognitive domains was inconsistent across studies. Other important outcomes (i.e., daily functioning, quality of life, neuropsychiatric symptom severity) were infrequently assessed across studies. Few studies evaluated long-term outcomes or the impact of CRTs on conversion rates from MCI to dementia or normal cognition. Overall, results from trials are promising but inconclusive. Additional well-designed and adequately powered trials are warranted and required before CRTs for MCI can be considered evidence-based.
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Affiliation(s)
- Marilyn Huckans
- Research & Development Service, Portland VA Medical Center, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA.
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