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Jones L, Karageorghis CI, Ker T, Rushton CJ, Stephenson SR, Wheeldon IL. The exercise intensity-music-tempo preference relationship: A decennial revisit. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 74:102644. [PMID: 38608851 DOI: 10.1016/j.psychsport.2024.102644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/13/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
Tempo is a key determinant of the motivational effects of music during exercise and has been the focus of numerous empirical studies (e.g., Karageorghis & Jones, 2014). The present study sought to address the limitations of previous related work and revisit the relationship between exercise intensity and music-tempo preference using unfamiliar, non-lyrical music (to isolate the tempo manipulation). A within-within experimental design was employed to test hypotheses pertaining to the non-linear relationship and associated psychological outcomes (e.g., core affect and state attention). Twenty-four participants (Mage = 20.6 years, SD = 0.92 years) exercised at five intensities (10% of peak V̇O2 below ventilatory threshold [VT]; 5% of peak V̇O2 below VT, at VT, midway between VT and the respiratory compensation point [RCP], and at RCP) during which they were administered music tracks at four tempi (90 bpm, 110 bpm, 130 bpm and 150 bpm) and a no-music control. A music liking item, measures of core affect (valence and arousal), attentional focus and perceived exertion were recorded during the exercise bouts. Results indicated that unlike previous findings with familiar, lyrical music, there was no discernible relationship between exercise intensity and preference for music tempo. The most positive psychological outcomes were associated with fast-tempo music. In accord with previous findings, slow-tempo music attracted low liking scores and the least desirable psychological outcomes at every exercise intensity. The present findings have implications for the use of unfamiliar, non-lyrical music during exercise. Specifically, that such music should be ∼10 bpm faster than familiar, lyrical music.
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Affiliation(s)
- L Jones
- Academy of Sport and Physical Activity, Sheffield Hallam University, UK.
| | | | - T Ker
- Academy of Sport and Physical Activity, Sheffield Hallam University, UK
| | - C J Rushton
- Academy of Sport and Physical Activity, Sheffield Hallam University, UK
| | - S R Stephenson
- Academy of Sport and Physical Activity, Sheffield Hallam University, UK
| | - I L Wheeldon
- Academy of Sport and Physical Activity, Sheffield Hallam University, UK
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Lepping RJ, Hess BJ, Taylor JM, Hanson-Abromeit D, Williams KN. Inconsistent Music-Based Intervention Reporting in Dementia Studies: A Systematic Mapping Review. J Alzheimers Dis 2024:JAD240255. [PMID: 38995790 DOI: 10.3233/jad-240255] [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: 07/14/2024]
Abstract
Background Recent research has shown beneficial results for music-based interventions (MBIs) for persons living with Alzheimer's disease and related dementias (AD/ADRD), but reports often lack sufficient detail about the MBI methodology, which reduces replicability. A detailed checklist for best practices in how to report MBIs was created in 2011 by Robb and colleagues to remedy the lack of detail in MBI descriptions. The implementation of the checklist specifically in AD/ADRD research has not been established. Given the complexity of music and the variety of uses for research and health, specific MBI descriptions are necessary for rigorous replication and validation of study results. Objective This systematic mapping review utilized the "Checklist for Reporting Music-Based Interventions" to evaluate the current state of MBI descriptive specificity in AD/ADRD research. Methods Research articles testing MBIs and reviews of MBI efficacy published between January 2015 and August 2023 were scored using the checklist and the results were summarized. Results Forty-eight studies were screened, and reporting was inconsistent across the 11 checklist criteria. Ten out of 48 studies fully reported more than 5 of the 11 criteria. Only one of the 11 scoring criteria was at least partially reported across 47 of 48 studies. Conclusions Thorough reporting of intervention detail for MBIs remains limited in AD/ADRD MBI research. This impedes study validation, replication, and slows the progress of research and potential application of music in practice. Greater implementation of the reporting guidelines provided by Robb and colleagues would move the field of MBI research for AD/ADRD forward more quickly and efficiently.
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Affiliation(s)
- Rebecca J Lepping
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS USA
| | - Benjamin J Hess
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS USA
| | - Jasmine M Taylor
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS USA
| | - Deanna Hanson-Abromeit
- School of Music, Music Education and Music Therapy, University of Kansas, Lawrence, KS, USA
| | - Kristine N Williams
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, KS, USA
- School of Nursing, University of Kansas Medical Center, Kansas City, KS USA
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Declercq IJN, Leontjevas R, Verboon P, De Vriendt P, Gerritsen DL, van Hooren S. A bayesian network meta-analysis to explore modifying factors in randomized controlled trials: what works for whom to reduce depression in nursing home residents? BMC Geriatr 2024; 24:518. [PMID: 38872075 DOI: 10.1186/s12877-024-05117-8] [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: 12/22/2023] [Accepted: 05/29/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Reviews of depression interventions in nursing home residents resulted in positive findings. However, because of the heterogeneity of the studies, it remains unclear what works for whom. Considering moderator effects may contribute to a comprehensive understanding of depression treatment in residents. Therefore, this study aims to review depression interventions, examining moderator effects of (1) residents' factors, and (2) components specific of interventions. METHODS A Bayesian network meta-analysis of randomized controlled trials primarily aimed at reducing depressive symptoms among residents was conducted. First, intervention types, e.g., exercise interventions, were compared to care as usual. Second, meta-regression analyses were conducted for moderator effects of residents' factors (i.e., severity of depressive symptoms, physical dependency, and cognitive impairment) and components identified as specific to an intervention (e.g., music, creativity, positivity). RESULTS Our search across six databases resulted in 118 eligible studies: 16 on neurobiological interventions, 102 on non-pharmacological interventions. Compared to care as usual, cognitive interventions, such as cognitive behavioral therapy and goal-oriented therapy, showed the strongest effects (MD = -1.00, 95% CrI [-1.40 to -0.66]). Furthermore, the severity of depressive symptoms moderated the effect of interventions (ƅ = -0.63, CrI 95% [-1.04 to -0.22]), while none of fifteen identified intervention-specific components did. In residents with a depression diagnosis, there were larger effect sizes for interventions including daily structure, psychoeducation, healthy food, creativity, positivity, and an activating/encouraging environment, whereas interventions focusing on distraction and relaxation had larger effect sizes in those residents without. CONCLUSIONS By examining the moderator effects, we provided an integrative perspective on the observed variations in effects across different target groups, and components of depression interventions. This approach underscores the complex nature of interventions, emphasizing the need for continued transdisciplinary research, and the exploration of potential moderators. Future investigations should carefully assess residents' factors and choose interventions and their components accordingly.
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Affiliation(s)
- Ine J N Declercq
- Department of Primary and Community Care, Radboud University Medical Center, Gelderland, 6500 HBNijmegen, The Netherlands.
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands.
- Department of Gerontology and Frailty in Ageing (FRIA) and Mental Health and Wellbeing (MENT) Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Gelderland, 6500 HBNijmegen, The Netherlands
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Patricia De Vriendt
- Department of Gerontology and Frailty in Ageing (FRIA) and Mental Health and Wellbeing (MENT) Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Gelderland, 6500 HBNijmegen, The Netherlands
| | - Susan van Hooren
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
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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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You D, Hasley Bin Ramli S, Ibrahim R, Hibatullah Bin Romli M, Li Z, Chu Q, Yu X. A thematic review on therapeutic toys and games for the elderly with Alzheimer's disease. Disabil Rehabil Assist Technol 2024:1-13. [PMID: 38299880 DOI: 10.1080/17483107.2023.2299713] [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: 07/28/2023] [Accepted: 12/19/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE Alzheimer's disease (AD) is a common and devastating neurological ailment that affects millions of the elderly worldwide. Therapeutic toys and games have emerged as potential non-pharmacological interventions for AD. However, despite a growing number of documents on the subject, research on the future direction of therapeutic toys and games for AD remains scarce. To address this gap, this study aims to (1) map the future trends of therapeutic toys and games for AD and (2) identify the categories and design characteristics. MATERIALS AND METHODS Using a thematic review framework, a systematic literature search was conducted in two electronic databases (Scopus and WoS) using established criteria. Thematic analysis was done using ATLAS.ti 23 to identify prominent themes, patterns and trends. RESULTS A total of 180 documents were found. Twenty-five articles met the inclusion criteria. A thematic review of these 25 articles identified 13 initial codes, which were been clustered into four themes: detection and evaluation; intervention; toy/game category; and design characteristics. The word "Cognitive" appears most frequently in documents according to word cloud. CONCLUSIONS Therapeutic toys and games are used to detect and as an intervention for AD. Most of the current studies focused on specific cognitive functions. More research is needed about play therapy for neuropsychiatric symptoms. This thematic review also proposed a conceptual framework for designing toys and games tailored to the needs of the elderly with AD, offering valuable insights to future researchers focusing on this domain.
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Affiliation(s)
- Donggui You
- Industrial Design Department, Faculty of Design and Architecture, University Putra Malaysia, Serdang, Malaysia
- Department of Art Design & Creative Industries, Nanfang College, Guangzhou, China
| | - Saiful Hasley Bin Ramli
- Industrial Design Department, Faculty of Design and Architecture, University Putra Malaysia, Serdang, Malaysia
| | - Rahimah Ibrahim
- Department of Human Development & Family Studies, Faculty of Human Ecology, University Putra Malaysia, Serdang, Malaysia
| | - Muhammad Hibatullah Bin Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Science, University Putra Malaysia, Serdang, Malaysia
| | - Ziming Li
- Industrial Design Department, Faculty of Design and Architecture, University Putra Malaysia, Serdang, Malaysia
| | - Qingqing Chu
- Industrial Design Department, Faculty of Design and Architecture, University Putra Malaysia, Serdang, Malaysia
| | - Xinxin Yu
- Industrial Design Department, Faculty of Design and Architecture, University Putra Malaysia, Serdang, Malaysia
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Rossi E, Marrosu F, Saba L. Music Therapy as a Complementary Treatment in Patients with Dementia Associated to Alzheimer's Disease: A Systematic Review. J Alzheimers Dis 2024; 98:33-51. [PMID: 38427477 DOI: 10.3233/jad-230852] [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] [Indexed: 03/03/2024]
Abstract
Background Alzheimer's disease (AD) is a complex condition that affects various aspects of a patient's life. Music therapy may be considered a beneficial supplementary tool to traditional therapies, that not fully address the range of AD manifestations. Objective The purpose of this systematic review is to investigate whether music therapy can have a positive impact on AD patients and on which symptoms. Methods The main research databases employed have been PubMed and Cochrane, using the keywords "dementia", "music therapy", "Alzheimer", "fMRI", "music", and "EEG". Results After removing duplicates and irrelevant studies, 23 were screened using set criteria, resulting in the final inclusion of 15 studies. The total number of participants included in these studies has been of 1,196 patients. For the fMRI analysis the search resulted in 28 studies on PubMed, two of which were included in the research; the total number of participants was of 124 individuals. The studies conducted with EEG were found using PubMed. The initial search resulted in 15 studies, but after a more accurate evaluation only 2 have been included in the analysis. Conclusions Even though the data currently available is not sufficient to draw conclusions supported by robust statistical power, the impact of music therapy on AD neuropsychiatric symptoms deserves great interest. Further research should be ushered, possibly multicentric studies, led with neuroimaging and other recent techniques, which can eventually open views on the music role in improving the cognitive status in AD.
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Affiliation(s)
- Eleonora Rossi
- Department of Radiology, University of Cagliari, Cagliari, Italy
| | | | - Luca Saba
- Department of Radiology, University of Cagliari, Cagliari, Italy
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Parlak MM, Köse A, Güç M, Munis ÖB. Development of mobile compatible software for cognitive-communication disorder in individuals with Alzheimer's disease. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:234-254. [PMID: 37528064 DOI: 10.1111/1460-6984.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive neurodegenerative disease. Cognitive functions and communication skills worsen as the disease progresses, thereby reducing patients' independence levels. Therefore, recommending software that can be used at home may be a useful means of slowing down the cognitive and communicative decline in AD. AIMS To develop software that can be used at home to slow down the cognitive and communicative decline and increase independence in individuals with AD; and to examine the effect of this software on the cognitive communication skills of individuals with AD. METHODS & PROCEDURES The study was completed in four stages: the development of the application; the evaluation of the participants and their training for the application; their use of the application at home; and the re-evaluation of the participants. A total of 32 individuals who met the inclusion criteria were included in the study. These individuals were randomly divided into study and control groups, each consisting of a total of 16 participants, including six in the mild stage, six in the moderate stage, and four in the severe stages. The developed software was loaded on tablets and given to the participants in the study group. The participants in the control group only received their pharmacological treatment, while those in the study group received both their pharmacological treatment and used the developed application. All participants were evaluated with the Mini-Mental State Examination (MMSE) and Language Assessment Test for Aphasia (LATA) before and after application use. A survey was administered to the caregivers of the participants in the study group after the use of the application. OUTCOMES & RESULTS The results revealed a positive change in the cognitive-communication skills of the individuals in the study group, even if they were in the severe stage, according to the LATA and MMSE, as well as the survey. The application led to the greatest improvements in grammar on the LATA and orientation on the MMSE. No rapid cognitive decline was seen in individuals at all stages in the control group. CONCLUSIONS & IMPLICATIONS In this study, software was developed in Turkish that can be used in every stage of AD as part of a holistic cognitive-communication intervention programme offering alternative and supportive communication for individuals with AD, even those in the severe stage. Results prove the effectiveness of the developed software on the cognitive-communication skills of individuals with AD. WHAT THIS PAPER ADDS What is already known on the subject There are a few (as far as is known, three) applications developed in English for cognitive-communication disorders due to dementia. What this study adds to the existing literature In this study, for the first time in Turkish, mobile-compatible software has been developed for both cognitive and communication disorders that is specific to individuals with AD and can be used by individuals at all stages of the disease. The effects of the application we developed on the cognitive-communication skills of individuals with AD were shown in a randomised controlled trial. What are the potential or actual clinical implications of this work? Using the app can help people with all stages of AD keep their cognitive and communication skills and have a better prognosis in terms of cognitive-communication skills, especially grammar and orientation.
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Affiliation(s)
- Mümüne Merve Parlak
- Department of Speech and Language Therapy, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Murat Güç
- Computer Engineering and Software Development, D-Market Electronic Services and Trade Joint Stock Company (hepsiburada.com), Istanbul, Turkey
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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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Reynolds K, Chimoriya R, Chandio N, Tracey D, Pradhan A, Fahey P, Stormon N, Arora A. Effectiveness of sensory adaptive dental environments to reduce psychophysiology responses of dental anxiety and support positive behaviours in children and young adults with intellectual and developmental disabilities: a systematic review and meta-analyses. BMC Oral Health 2023; 23:769. [PMID: 37858057 PMCID: PMC10585952 DOI: 10.1186/s12903-023-03445-6] [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: 11/13/2022] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing difficulties, maladaptive behaviours and dental anxiety contribute to difficulties in receiving preventive and routine dental treatments. This study aimed to systematically review the evidence on the effectiveness of sensory adaptive dental environments (SADE) for children and young adults (up to the ages 24 years) with IDD to address cooperation and dental anxiety. METHODS This review was reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker were searched using appropriate terms to identify Randomised Control Trails (RCTs) that matched inclusion criteria. Screening was conducted by two reviewers after de-duplication based on titles and abstracts followed by full text retrieval. Quality of the included studies was assessed using Cochrane Risk of Bias (ROB)-2 for crossover trials and data extracted by two reviewers. The details of the interventions and effectiveness were compared and discussed narratively, and comparable outcomes were included to meta-analyses using R software. RESULTS A total of 622 articles were identified and five articles met eligibility for inclusion. Three studies used multi-sensory adaptations and one used single sensory adaptation of music. Narrative synthesis showed some evidence of SADE reducing magnitude and duration, although, questionable for reducing the number of maladaptive behaviours. Two studies demonstrated conflicting evidence of the effect of SADE on cooperation. Three studies demonstrated significant positive impact of SADE on psychophysiological outcomes. Despite an overall tendency to favour SADE, no statistically significant difference of maladaptive behaviours was found between SADE and regular dental environment (RDE) (Standardised mean change (SMC) = 0.51; 95% Confidence Interval (CI) -0.20 to 1.22; p = 0.161). SADE was superior to RDE (SMC -0.66; 95% CI -1.01 to -0.30; p = < 0.001) in reducing psychophysiological responses of dental anxiety. CONCLUSION Current evidence suggests that adapting visual, tactile, and auditory aspects of the dental environment in a single or multi-sensory approach demonstrates small positive effects on psychophysiological responses and maladaptive behaviours of dental anxiety for people with IDD. TRIAL REGISTRATION The title of this review was registered with PROSPERO (CRD42022322083).
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Affiliation(s)
- Kaitlyn Reynolds
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
| | - Ritesh Chimoriya
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW, 2144, Australia
| | - Navira Chandio
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Danielle Tracey
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
- Centre for Educational Research, Western Sydney University, Kingswood, NSW, 2747, Australia
| | - Archana Pradhan
- Sydney Dental School, The University of Sydney, Surry Hills, NSW, 2010, Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Nicole Stormon
- School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia.
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia.
- Discipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia.
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Ting B, Chen DTL, Hsu WT, Liang CS, Malau IA, Li WC, Lee SL, Jingling L, Su KP. Does Music Intervention Improve Anxiety in Dementia Patients? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2023; 12:5497. [PMID: 37685564 PMCID: PMC10488399 DOI: 10.3390/jcm12175497] [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: 06/07/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Music interventions (MIs) have been widely used to relieve anxiety in dementia in clinical settings. However, limited meta-analysis with randomized controlled trials (RCTs) on this topic has been conducted so far. A systematic search was conducted in four major databases (PubMed, EMBASE, Web of Science, and Cochrane Library) for data provided by RCTs from the inception to February 2023. The search strategy employed the terms "anxiety AND music AND dementia OR Alzheimer's disease". Thirteen RCTs (827 participants) were included. The results showed MI reduced anxiety significantly (SMD = -0.67, p < 0.001), especially for Alzheimer's disease (p = 0.007) and Mixed (p < 0.001)-type dementia. Moreover, significant improvements in agitation (p = 0.021) and depression (p < 0.001) in dementia were observed. Additionally, several psychological mechanisms which may be associated with MI were reviewed comprehensively. In conclusion, our findings support the efficacy of MI in alleviating anxiety symptoms in dementia patients. PROSPERO Registration (ID: CRD42021276646).
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Affiliation(s)
- Berne Ting
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung 40402, Taiwan;
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
| | - Daniel Tzu-Li Chen
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- M.D.-Ph.D. Program, College of Medicine, China Medical University, Taichung 40402, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Wei-Ti Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Anesthesiology, China Medical University Hospital, Taichung 40402, Taiwan
| | - Chih-Sung Liang
- Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Ikbal Andrian Malau
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Wei-Chih Li
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Sheau-Ling Lee
- National Health Research Institutes, Miaoli 35053, Taiwan;
| | - Li Jingling
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Kuan-Pin Su
- Mind–Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung 40402, Taiwan; (D.T.-L.C.); (I.A.M.); (W.-C.L.)
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 40402, Taiwan;
- An-Nan Hospital, China Medical University, Tainan 70965, Taiwan
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11
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Xu Y, Zheng F, Zhong Q, Zhu Y. Ketogenic Diet as a Promising Non-Drug Intervention for Alzheimer’s Disease: Mechanisms and Clinical Implications. J Alzheimers Dis 2023; 92:1173-1198. [PMID: 37038820 DOI: 10.3233/jad-230002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that is mainly characterized by cognitive deficits. Although many studies have been devoted to developing disease-modifying therapies, there has been no effective therapy until now. However, dietary interventions may be a potential strategy to treat AD. The ketogenic diet (KD) is a high-fat and low-carbohydrate diet with adequate protein. KD increases the levels of ketone bodies, providing an alternative energy source when there is not sufficient energy supply because of impaired glucose metabolism. Accumulating preclinical and clinical studies have shown that a KD is beneficial to AD. The potential underlying mechanisms include improved mitochondrial function, optimization of gut microbiota composition, and reduced neuroinflammation and oxidative stress. The review provides an update on clinical and preclinical research on the effects of KD or medium-chain triglyceride supplementation on symptoms and pathophysiology in AD. We also detail the potential mechanisms of KD, involving amyloid and tau proteins, neuroinflammation, gut microbiota, oxidative stress, and brain metabolism. We aimed to determine the function of the KD in AD and outline important aspects of the mechanism, providing a reference for the implementation of the KD as a potential therapeutic strategy for AD.
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Affiliation(s)
- Yunlong Xu
- Shenzhen Key Laboratory of Drug Addiction, Shenzhen Neher Neural Plasticity Laboratory, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS), Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
- Department of Neonatology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China
| | - Fuxiang Zheng
- Department of Clinical Laboratory, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China
| | - Qi Zhong
- Department of Neurology, Shenzhen Luohu People’s Hospital; The Third Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yingjie Zhu
- Shenzhen Key Laboratory of Drug Addiction, Shenzhen Neher Neural Plasticity Laboratory, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS), Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
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12
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Russo FA, Mallik A, Thomson Z, de Raadt St. James A, Dupuis K, Cohen D. Developing a music-based digital therapeutic to help manage the neuropsychiatric symptoms of dementia. Front Digit Health 2023; 5:1064115. [PMID: 36744277 PMCID: PMC9895844 DOI: 10.3389/fdgth.2023.1064115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
The greying of the world is leading to a rapid acceleration in both the healthcare costs and caregiver burden that are associated with dementia. There is an urgent need to develop new, easily scalable modalities of support. This perspective paper presents the theoretical background, rationale, and development plans for a music-based digital therapeutic to manage the neuropsychiatric symptoms of dementia, particularly agitation and anxiety. We begin by presenting the findings of a survey we conducted with key opinion leaders. The findings highlight the value of a music-based digital therapeutic for treating neuropsychiatric symptoms, particularly agitation and anxiety. We then consider the neural substrates of these neuropsychiatric symptoms before going on to evaluate randomized control trials on the efficacy of music-based interventions in their treatment. Finally, we present our development plans for the adaptation of an existing music-based digital therapeutic that was previously shown to be efficacious in the treatment of adult anxiety symptoms.
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Affiliation(s)
- Frank A. Russo
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada,LUCID Inc., Toronto, ON, Canada,Correspondence: Frank A. Russo
| | | | | | | | - Kate Dupuis
- Center for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Dan Cohen
- Right to Music, New York, NY, United States
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13
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Bloom PA, Bartlett E, Kathios N, Algharazi S, Siegelman M, Shen F, Beresford L, DiMaggio-Potter ME, Singh A, Bennett S, Natarajan N, Lee H, Sajid S, Joyce E, Fischman R, Hutchinson S, Pan S, Tottenham N, Aly M. Effects of familiar music exposure on deliberate retrieval of remote episodic and semantic memories in healthy aging adults. Memory 2023; 31:428-456. [PMID: 36651851 DOI: 10.1080/09658211.2023.2166078] [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: 01/19/2023]
Abstract
Familiar music facilitates memory retrieval in adults with dementia. However, mechanisms behind this effect, and its generality, are unclear because of a lack of parallel work in healthy aging. Exposure to familiar music enhances spontaneous recall of memories directly cued by the music, but it is unknown whether such effects extend to deliberate recall more generally - e.g., to memories not directly linked to the music being played. It is also unclear whether familiar music boosts recall of specific episodes versus more generalised semantic memories, or whether effects are driven by domain-general mechanisms (e.g., improved mood). In a registered report study, we examined effects of familiar music on deliberate recall in healthy adults ages 65-80 years (N = 75) by presenting familiar music from earlier in life, unfamiliar music, and non-musical audio clips across three sessions. After each clip, we assessed free recall of remote memories for pre-selected events. Contrary to our hypotheses, we found no effects of music exposure on recall of prompted events, though familiar music evoked spontaneous memories most often. These results suggest that effects of familiar music on recall may be limited to memories specifically evoked in response to the music (Preprint and registered report protocol at https://osf.io/kjnwd/).
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Affiliation(s)
| | - Ella Bartlett
- Barnard College of Columbia University, New York, NY, USA
| | | | | | | | - Fan Shen
- Columbia University, New York, NY, USA
| | | | | | | | - Sarah Bennett
- Teachers College, Columbia University, New York, NY, USA
| | | | | | | | - Erin Joyce
- Teachers College, Columbia University, New York, NY, USA
| | | | | | - Sophie Pan
- Barnard College of Columbia University, New York, NY, USA
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14
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Ro D, Lee J, Lee G, Shin S, Kim YH. Effect of interactive multitouch game-based cognitive intervention on cognitive function in older adults: A randomized controlled trial. Digit Health 2023; 9:20552076231176648. [PMID: 37256004 PMCID: PMC10226180 DOI: 10.1177/20552076231176648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 05/02/2023] [Indexed: 06/01/2023] Open
Abstract
Purpose This study investigated the effects of an interactive multitouch game-based cognitive intervention (ICI) on cognitive function in community-dwelling older adults. Methods Thirty-two older adults (19 women) between 65 and 84 years of age (mean age, 74.47 ± 4.30 years) without a history of neurological disease participated. They were randomized into two groups: intervention and control. The intervention group took part in ICI sessions using HAPPYTABLE® (Spring Soft Co. Ltd, Seoul, Korea) (ICI group), and the control group underwent a traditional paper-and-pencil-based cognitive intervention (TCI group). Both groups completed 10 intervention sessions over four consecutive weeks. Cognitive function was assessed before (pre-intervention) and after (post-intervention) intervention. Executive function was evaluated through the Color-Word Stroop Test (CWST) and Controlled Oral Word Association Test (COWAT). Memory was assessed through the Verbal Learning Test (VLT) and Rey Complex Figure Test (RCFT). Results The ICI and TCI groups showed significant improvements in some cognitive functions after the intervention. Both groups showed substantial improvements in VLT and RCFT (P < 0.05), reflecting memory function. Regarding the executive role, the ICI group showed significant post-intervention improvements in the conditions of the CWST incongruent (ICI 76.31 ± 23.82; P = 0.004) compared to the pre-intervention scores. ANCOVA with pre-intervention scores and gender as covariates revealed improved results in the ICI group compared with the VLT delayed (ICI 9.18 ± 1.68, TCI 7.56 ± 2.13; P = 0.015) and VLT recognition task (ICI 22.81 ± 1.22, TCI 21.38 ± 1.09; P = 0.035). Conclusions These findings revealed that both ICI and TCI helped increase cognitive performance in community-dwelling older persons; nevertheless, ICI showed better improvement in memory function than TCI. Thus, the ICI can be used to improve cognitive performance among older adults living in the community.
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Affiliation(s)
- Daeun Ro
- Department of Medical Device Management
& Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Physical and
Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jungsoo Lee
- Department of Medical IT Convergence
Engineering, Kumoh National Institute of
Technology, Gumi, Republic of Korea
| | - Gihyoun Lee
- Department of Physical and
Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and
Technology, SAIHST, Seoul, Republic of Korea
| | - Seyoung Shin
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of
Korea
| | - Yun-Hee Kim
- Department of Medical Device Management
& Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Physical and
Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and
Technology, SAIHST, Seoul, Republic of Korea
- Department of Rehabilitation, Haeundae
Sharing and Happiness Hospital, Pusan, Republic of Korea
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15
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Hakvoort L, Tönjes D. Music-mechanisms at the core of music therapy: Towards a format for a description of music therapy micro-interventions. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2070925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Laurien Hakvoort
- Department of Music therapy, ArtEZ University of the Arts, Enschede, The Netherlands
- Muzis, Private Practice for Music Therapy, Netherlands
| | - Djemida Tönjes
- Department of Music therapy, ArtEZ University of the Arts, Enschede, The Netherlands
- Zorggroep Noorderboog, Meppel, Netherlands
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16
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Machado BM, Castro CDSS. Use of multisensory stimulation in institutionalized older adults with moderate or severe dementia. Dement Neuropsychol 2022; 16:202-212. [PMID: 35720656 PMCID: PMC9173792 DOI: 10.1590/1980-5764-dn-2021-0022] [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: 05/12/2021] [Revised: 10/21/2021] [Accepted: 11/09/2021] [Indexed: 11/22/2022] Open
Abstract
The Multisensory Stimulation Program can help manage behavioral and psychological symptoms of dementia.
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Affiliation(s)
- Bento Miguel Machado
- Universidade de São Paulo, Programa de Pós Gradução Interunidades em Bioegenharia (EESC/FMRP/IQSC-USP), São Carlos SP, Brazil
| | - Carla da Silva Santana Castro
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ciências da Saúde, Ribeirão Preto SP, Brazil
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17
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Veal BM, Dobbs D, Lee S, Bugos JA, Pyfrom MP, Boddupalli S, Lengacher CA, Meng H. Feasibility and Acceptability of a Group Music Intervention in Memory Care Communities. J Appl Gerontol 2022; 41:1528-1538. [PMID: 35341380 DOI: 10.1177/07334648221079118] [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] Open
Abstract
Music-based interventions have been shown to reduce behavioral expressions among persons with dementia. The goal of this study was to examine the feasibility and acceptability of a group music intervention to reduce agitation. Two memory care communities were recruited to participate in this single-arm mixed-methods study. The group music intervention program included a total of 12 sessions delivered over 4 weeks. Agitation was assessed quantitatively at weeks 0, 2, and 4. Qualitative interviews of memory care staff were conducted post-intervention. Data were analyzed using linear mixed-effects models and qualitative content analysis. The study sample (N = 19) had a mean age of 82.74, and 73.7% were female. The great majority of participants completed the intervention and 63.2% experienced a reduction in agitation, suggesting that the intervention is feasible and acceptable in memory care and may be efficacious. Future research should evaluate the efficacy of the intervention in a randomized controlled trial.
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Affiliation(s)
- Britney M Veal
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | - Debra Dobbs
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | - Soomi Lee
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | - Jennifer A Bugos
- School of Music, College of the Arts, 7831University of South Florida, Tampa, FL, USA
| | - Mary P Pyfrom
- Department of Communication Sciences and Disorders, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
| | | | | | - Hongdao Meng
- School of Aging Studies, College of Behavioral and Community Sciences, 7831University of South Florida, Tampa, FL, USA
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18
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Exploring Factors Associated With Successful Nonpharmacological Interventions for People With Dementia. Dement Neurocogn Disord 2022; 21:1-16. [PMID: 35154336 PMCID: PMC8811205 DOI: 10.12779/dnd.2022.21.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/27/2022] Open
Abstract
Background and purpose Methods Results Conclusions
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19
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Delfa-Lobato L, Guàrdia-Olmos J, Feliu-Torruella M. Benefits of Cultural Activities on People With Cognitive Impairment: A Systematic Review. Front Psychol 2021; 12:762392. [PMID: 34899506 PMCID: PMC8656402 DOI: 10.3389/fpsyg.2021.762392] [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: 08/24/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Museums and cultural institutions are increasingly striving to respond to the interests and needs of the society that hosts them. This means, apart from other actions, that these institutions must be involved in the health and wellbeing of society, and the creation of cultural activities aimed at people with cognitive impairment, a group of individuals that is growing worldwide due to the aging of society and the increasing prevalence of dementia. The involved sectors are aware of the potential and benefits of activities for this population, even though there is much research to be conducted. To date, no systematic review has focused on the benefits of cultural activities for cognitively impaired people. This study aimed to explore the benefits of different modalities of cultural activities with evidence from 145 studies from various databases, which met the inclusion criteria. Significant improvements in general cognition, quality of life (QoL), emotional wellbeing, socialization, and communication were generally reported after interventions, with a reduction in depression symptoms. There was not enough evidence to prove memory, language, or daily functioning improvements attributable to cultural interventions. There were no significant reductions reported in apathy, sadness, agitation, or anxiety.
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Affiliation(s)
- Laia Delfa-Lobato
- Faculty of Geography and History, University of Barcelona, Barcelona, Spain
| | - Joan Guàrdia-Olmos
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- UB Institute of Complex Systems, University of Barcelona, Barcelona, Spain
| | - Maria Feliu-Torruella
- Department of Applied Didactics, Faculty of Education, University of Barcelona, Barcelona, Spain
- Institute of Research in Education (IRE), University of Barcelona, Barcelona, Spain
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20
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Sousa L, Neves MJ, Moura B, Schneider J, Fernandes L. Music-based interventions for people living with dementia, targeting behavioral and psychological symptoms: A scoping review. Int J Geriatr Psychiatry 2021; 36:1664-1690. [PMID: 34097789 DOI: 10.1002/gps.5568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/06/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Dementia care is a major public health issue worldwide. The management of behavioral and psychological symptoms (BPSD) is one of the hardest challenges in this context. Non-pharmacological strategies, like music-based interventions (Mbi), seem promising options, being considered low-risk, widely available and inclusive. This scoping review aimed at mapping all Mbi used in dementia care, targeting BPSD, and debriefing its components, structure and rationale. Music therapy and other therapeutic music activities were included. METHODS The Arksey and O'Malley framework, Cochrane recommendations and PRISMA checklist were followed. Embase, PubMed, PsycINFO, ASSIA and Humanities Index were searched from first records until the 31st of March 2020. Snowballing process and screening of relevant journals were also undertaken. A panel of experts critically guided the evidence synthesis. RESULTS Overall, 103 studies (34 RCT; 12 NRT; 40 Before/After studies and 17 Case Studies) met inclusion criteria. Basic elements of the Mbi, the rationale supporting its development and hypothesis tested were mostly underreported, thus hampering cross-study comparisons and generalizations. Despite this, available evidence indicates that: it is feasible to deliver Mbi to PwD at very different stages and in different settings - from community to the acute setting - even for non-music therapists; positive or neutral effects in BPSD are often reported but not without exception; individualization seems a critical factor mediating Mbi effects. CONCLUSIONS Detailed intervention and research reporting are essential to interpretation, replication and translation into practice. Ten years after the publication of specific reporting guidelines, this goal is not yet fully achieved in music in dementia care.
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Affiliation(s)
- Lídia Sousa
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Geriatrics & Mental Health Group, CINTESIS - Center for Health Technologies and Services Research, Porto, Portugal
| | - Maria J Neves
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Unidade de Saúde Familiar Espinho, ACeS Grande Porto VIII, Portugal
| | - Bárbara Moura
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Justine Schneider
- School of Sociology & Social Policy, University of Nottingham, Nottingham, UK
| | - Lia Fernandes
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.,Geriatrics & Mental Health Group, CINTESIS - Center for Health Technologies and Services Research, Porto, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar Universitário de S. João, Porto, Portugal
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21
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Gaviola MA, Higgins I, Dilworth S, Holliday E, Inder KJ. Individualised music for people living with dementia and the experiences and perceptions of residential aged care staff: A qualitative study. Australas J Ageing 2021; 41:e8-e15. [PMID: 34351677 DOI: 10.1111/ajag.12987] [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: 09/16/2020] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore the experiences and perceptions of staff regarding the use of individualised music for people with dementia living in residential aged care. METHODS A qualitative descriptive methodology was used. Methods included a focus group and face-to-face interviews, open-ended responses to a pre-post survey and relevant clinical notes about older participants' responses. Qualitative content analysis was used to analyse data. RESULTS There were four themes: (1) transcendental reminiscing, the calm, the joy and the elation; (2) optimism, excitement and the snowball effect; (3) pitching in for older person, it is not rocket science and the hurdles; and (4) music beyond the intervention. CONCLUSIONS Overall, the individualised music was a generally positive experience. While some older participants reported discomfort with the use of headphones, staff concerns related to care and accessibility of music equipment.
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Affiliation(s)
- Minah Amor Gaviola
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Isabel Higgins
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Sophie Dilworth
- Hunter Aged Care Assessment Team, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Kerry J Inder
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
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22
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Lineweaver TT, Bergeson TR, Ladd K, Johnson H, Braid D, Ott M, Hay DP, Plewes J, Hinds M, LaPradd ML, Bolander H, Vitelli S, Lain M, Brimmer T. The Effects of Individualized Music Listening on Affective, Behavioral, Cognitive, and Sundowning Symptoms of Dementia in Long-Term Care Residents. J Aging Health 2021; 34:130-143. [PMID: 34346261 DOI: 10.1177/08982643211033407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to replicate music's positive effects on dementia-related symptoms, determine whether a 6-month intervention would lead to greater positive outcomes than typical 3- to 4-month interventions, and examine changes in sundowning symptoms after music listening. METHODS 282 nursing home residents with dementia listened to personalized music playlists 1-3 times weekly for 30 minutes across 6 months. Standardized assessments of affect, behavior, and cognition and direct observations of sundowning symptoms comprised the outcomes. RESULTS Results documented significant improvements in residents' general neuropsychiatric symptoms, agitation, and depression across the first 3 months, but no additional improvements across the subsequent 3 months. Seven sundowning symptoms significantly improved following music listening, with some (e.g., disengagement) being more amenable to music than others (e.g., aggression). DISCUSSION Results support short-term individualized music listening as an effective non-pharmacological approach for improving dementia-related symptoms in nursing home residents and suggest new applications of music-related interventions.
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Affiliation(s)
| | | | | | | | | | - Monica Ott
- Indiana University, Indianapolis, IN, USA
| | | | | | - Mary Hinds
- 4065Butler University, Indianapolis, IN, USA
| | - Michelle L LaPradd
- 10668Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | | | | | - Mikala Lain
- 4065Butler University, Indianapolis, IN, USA
| | - Tim Brimmer
- 4065Butler University, Indianapolis, IN, USA
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23
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Music and Nursing Home Residents with Dementia: A Literature Review. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.03.011] [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]
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24
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Petrovsky DV, Ramesh P, McPhillips MV, Hodgson NA. Effects of music interventions on sleep in older adults: A systematic review. Geriatr Nurs 2021; 42:869-879. [PMID: 34090233 PMCID: PMC8316320 DOI: 10.1016/j.gerinurse.2021.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/21/2022]
Abstract
Sleep disruption is common among older adults. Non-pharmacological interventions involving music has emerged as a promising approach to address sleep disruption. The purpose of this systematic review was to examine the effects of music interventions on sleep outcomes among older adults (age ≥ 50). We searched five databases through May 2020 and found 16 eligible studies focused on two types of music interventions: music listening (n = 11) and multi-component (n = 5). We found mixed evidence in the efficacy of music interventions to improve sleep outcomes in older adults, which included sleep quality, objective and subjective sleep characteristics. Music listening interventions contained relaxing music with research teams personalizing music choice based on participants' preferences. Multi-component interventions included listening to music in addition to one other approach, such as massage, tai chi, and nature scenes. Future higher-quality studies should provide a detailed description of music interventions and tailor music selections to older adults' preferences.
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Affiliation(s)
- Darina V Petrovsky
- University of Pennsylvania School of Nursing, Claire M. Fagin Hall, 418 Curie Blvd., Philadelphia, Pennsylvania, USA 19104-4217 USA.
| | - Pranav Ramesh
- Irvington High School, 41800 Blacow Rd, Fremont, CA 94538 USA
| | | | - Nancy A Hodgson
- University of Pennsylvania School of Nursing, Claire M. Fagin Hall, 418 Curie Blvd., Philadelphia, Pennsylvania, USA 19104-4217 USA
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Ibenthal E, Kehmann M, Backhaus C. Effectiveness of personalized music systems to influence neuropsychiatric symptoms associated with dementia: A quasi-experimental study. Explore (NY) 2021; 18:319-326. [PMID: 33781719 DOI: 10.1016/j.explore.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 12/21/2022]
Abstract
CONTEXT Studies have shown that music can improve the neuropsychiatric symptoms in people with dementia. Personalized music has the greatest impact. However, people with dementia in residential care rarely listen to personalized music; in doing so, they themselves as well as their caregivers pass up the positive effects associated with it. As a result, customizable music systems have been developed that allow people with dementia to listen to their favorite music. AIM To determine the effectiveness of personalized music systems on the neuropsychiatric symptoms of people with dementia in residential care and the perceived distress of caregivers. METHOD 14 residents heard personalized music during personal care for eight weeks. Outcomes were derived from pre-post-follow up assessments of residents' neuropsychiatric symptoms and caregivers' distress using the Neuropsychiatric Inventory Questionnaire (NPI-Q). The frequency of the music systems' usage was recorded in log files. A control group of 14 residents received standard care. RESULTS Caregivers used the music systems among the residents with varying frequency. During the intervention, an increasing trend of the severity value of apathy was observed, while the severity values of delusions and nighttime disturbances tended to decrease. However, the trends did not reach statistical significance. Caregivers' perceived distress was not affected. CONCLUSION A practicable solution for providing personalized music to people with dementia in residential care was tested. Possible positive effects were observed for delusions and nighttime disturbances in people with dementia, but a larger study will be required to verify these observations.
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Affiliation(s)
- Elisabeth Ibenthal
- Münster University of Applied Sciences, Bürgerkamp 3, 48565 Steinfurt, Germany.
| | - Maximilian Kehmann
- Münster University of Applied Sciences, Bürgerkamp 3, 48565 Steinfurt, Germany
| | - Claus Backhaus
- Münster University of Applied Sciences, Bürgerkamp 3, 48565 Steinfurt, Germany
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Pinto JO, Dores AR, Geraldo A, Peixoto B, Barbosa F. Sensory stimulation programs in dementia: a systematic review of methods and effectiveness. Expert Rev Neurother 2020; 20:1229-1247. [PMID: 32940543 DOI: 10.1080/14737175.2020.1825942] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Dementia is characterized by the presence of cognitive decline and can lead to sensory-perceptual alterations, compromising the functionality in activities of daily living. The main objective of this work is to review the characteristics of sensory stimulation programs in dementia and its effectiveness. AREAS COVERED Studies were identified through a literature search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane Collaboration Guidelines. Twenty studies were included in this review. The studies used multisensory stimulation at different stages of dementia. The results show a lack of consensus regarding frequency, duration, and number of sessions, as well as the duration of the interventions and assessment instruments used to evaluate the results. Multisensory stimulation, particularly Snoezelen, was the most widely used approach. Vision, hearing, touch, and smell were the most frequently stimulated senses. Most studies comprised pre- and post-intervention assessment, but few studies performed follow-up assessment. The interventions that revealed positive results in dementia were Snoezelen, multisensory environment other than Snoezelen, and Multi-sensory Behavior Therapy. EXPERT OPINION This review weakly supports sensory stimulation in dementia, providing useful information for rehabilitation and future investigations.
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Affiliation(s)
- Joana O Pinto
- Faculty of Psychology and Education Sciences, University of Porto , Porto, Portugal
| | - Artemisa R Dores
- Faculty of Psychology and Education Sciences, University of Porto , Porto, Portugal.,School of Health, Polytechnic Institute of Porto , Porto, Portugal
| | - Andreia Geraldo
- Faculty of Psychology and Education Sciences, University of Porto , Porto, Portugal
| | - Bruno Peixoto
- Department of Social and Behaviour Sciences, CESPU, University Institute of Health Sciences , Gandra, Portugal.,Center for Health Technology and Services Research (CINTESIS), NeuroGen research group , Porto, Portugal
| | - Fernando Barbosa
- Faculty of Psychology and Education Sciences, University of Porto , Porto, Portugal
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Diehl K, Kratzer A, Graessel E. The MAKS-s study: multicomponent non-pharmacological intervention for people with severe dementia in inpatient care - study protocol of a randomised controlled trial. BMC Geriatr 2020; 20:405. [PMID: 33059610 PMCID: PMC7559466 DOI: 10.1186/s12877-020-01807-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/30/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nursing homes accommodate a large number of people with severe dementia. More than 80% of residents with dementia suffer from behavioural and psychological symptoms, that can have consequences on the perceived burden of the formal caregivers. Internationally, the number of studies on non-pharmacological interventions for people with severe dementia is very small. One way to reduce these symptoms is to meet the needs of people with severe dementia. The non-pharmacological group intervention MAKS-s, which we will investigate in this study, is intended to reduce the behavioural and psychological symptoms and to improve the quality of life of such people. Additionally, we will investigate the effects on the burden carried by formal caregivers. METHODS With the present study, we will investigate the effectiveness of a multicomponent non-pharmacological intervention for people with severe dementia living in nursing homes (primary target group). A power analysis indicated that 144 dementia participants should initially be included. In addition, a secondary target group (nursing home staff) will be examined with respect to their dementia-related stress experiences. The study will be conducted as a cluster randomised controlled trail in Germany with a 6-month intervention phase. The nursing homes in the waitlist control group will provide "care as usual." The primary endpoints of the study will be the behavioural and psychological symptoms of dementia and the quality of life of people with severe dementia. The total duration of the study will be 18 months. Data will be collected by using observer rating scales. DISCUSSION The project has some outstanding quality features. The external validity is high, because it is situated in a naturalistic setting in nursing homes and is being carried out with available nursing employees. Due to this fact, a permanent implementation also seems to be possible. Since the participating nursing homes are disseminated across several German federal states and rural and urban regions, the results should be transferable to the entire population. TRIAL REGISTRATION ISRCTN15722923 (Registration date: 07 August 2019).
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Affiliation(s)
- Kristina Diehl
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - André Kratzer
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Elmar Graessel
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
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28
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Lam HL, Li WTV, Laher I, Wong RY. Effects of Music Therapy on Patients with Dementia-A Systematic Review. Geriatrics (Basel) 2020; 5:geriatrics5040062. [PMID: 32992767 PMCID: PMC7709645 DOI: 10.3390/geriatrics5040062] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 01/10/2023] Open
Abstract
Dementia is an increasingly common syndrome and while pharmacotherapy is available, its potential benefit is limited, especially in non-cognitive outcomes. Non-pharmacotherapy such as music therapy is potentially associated with improved outcomes. We assessed the effects of music therapy on patients with dementia to evaluate its potential benefits on dementia. Two independent reviewers searched MEDLINE, EMBASE, CINAHL, CENTRAL, and ClinicalTrials.gov databases for clinical trials, using the keywords "music therapy" and "dementia". Study outcomes included cognitive function, behavioral and psychological symptoms of dementia (BPSD), and quality of life. A total of 82 studies were included, of which 43 were interventional clinical trials, and 39 were systematic reviews or meta-analyses. Significant improvements in verbal fluency occurred after music therapy, with significant reductions in anxiety, depression, and apathy. There were no significant improvements in cognition or daily functioning, and the results on quality of life and agitation were ambiguous. Limitations of studies included low patient numbers, lack of standardized music therapy, and high heterogeneity in outcomes. More large-scale clinical trials would allow for clearer conclusions on the benefits of music therapy in patients with dementia.
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Affiliation(s)
- Hei Long Lam
- Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (H.L.L.); (W.T.V.L.)
| | - Wai Tak Victor Li
- Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (H.L.L.); (W.T.V.L.)
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Roger Y. Wong
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Correspondence: ; Tel.: +1-604-875-4826
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Bauer ACM, Andringa G. The Potential of Immersive Virtual Reality for Cognitive Training in Elderly. Gerontology 2020; 66:614-623. [PMID: 32906122 DOI: 10.1159/000509830] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/17/2020] [Indexed: 11/19/2022] Open
Abstract
The number of elderly is growing rapidly, including those that struggle with cognitive decline and, consequently, activities of daily living. Developing interventions that slow down cognitive decline would greatly benefit the autonomy of these elderly, as well as their caretakers. Virtual reality (VR) is an immersive and interactive human-computer interface with real-time simulation that is suggested to be a promising tool to improve cognitive functioning. This literature review discusses the features of immersive VR, including its opportunities and limitations, that are of special relevance for improving cognition in elderly. First, the high flexibility of VR allows for personalized and safe training of potentially harmful situations and isolated aspects of tasks. Second, VR's dynamic and real-time feedback on performance provides a labor-extensive tool for caretakers in elderly care. Third, the acquisition of high resolution data enables the exposure of subtle changes over time, relevant for detecting the nature and extent of cognitive changes in elderly, including those with dementia. Fourth, immersive VR has been related to cybersickness. Finally, VR is immersive and enables the perception and expression of emotions, motor behaviors, and multiple senses. Aged subjects are found to have sparing of emotional learning and show increased reliance on multisensory integration for learning. Moreover, they experience high levels of flow, motivation, and presence in VR setups. Despite the clear potential of immersive VR, the studies available are small scale and have not been replicated. The digital illiteracy of elderly and healthcare personnel form an additional barrier for implementation. Hence, while replication of outcomes and standardization of VR interventions is required before it can be used in standard care, VR may provide a particularly effective tool for training cognition in elderly.
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Affiliation(s)
- Anna Cornelia Maria Bauer
- Department of Science, University College Roosevelt, Utrecht University, Middelburg, The Netherlands
| | - Gerda Andringa
- Department of Science, University College Roosevelt, Utrecht University, Middelburg, The Netherlands, .,Academic Workplace for the Elderly in Zeeland, Middelburg, The Netherlands,
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Seyyedrasooli A, Ghojazadehm M, Goljaryan S, Hosseini MS, Esmaeilnezhad M. The Effect of Sensory Stimulation on Quality of Life of the Elderly and their Self-efficacy for Coping with the Fear of Falling. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:407-413. [PMID: 33344212 PMCID: PMC7737834 DOI: 10.4103/ijnmr.ijnmr_172_19] [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] [Received: 09/14/2019] [Revised: 08/31/2019] [Accepted: 07/11/2020] [Indexed: 12/03/2022]
Abstract
BACKGROUND Aging causes major changes that affect the performance of all senses, and as a result, a critical change in the quality of life is expected. Falling and the fear of falling is one of the major health risks that affect the quality of life among elderly, threatening their independent living. This study was conducted to determine the role of sensory stimulation on the quality of life and self-efficacy in coping with fear in the elderly population. MATERIALS AND METHODS During this randomized controlled trial, 80 elderly volunteers from healthcare centers were divided into four intervention groups (music, photo album, aromatherapy, and hand massage) and one control group. Data collection was performed using the Older People's Quality of Life Questionnaire and Falls Efficacy Scale-International tools. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software program, version 16.0. RESULTS Comparing the scores of the quality of life and self-efficacy questionnaires, no statistically significant difference was reported among the groups (p < 0.05). CONCLUSIONS Sensory stimulation seems to have no impressive effect on the improvement of self-efficacy in coping with the fear of falling and the quality of life in the older population.
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Affiliation(s)
- Alehe Seyyedrasooli
- Master science of faculty of medical & surgical nursing, Tabriz University of Medical Sciences, Tabriz, Iran, Iran
| | - Morteza Ghojazadehm
- MPH, PhD, Associated professor, Research Center for Evidence based-medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran, Iran
| | - Sakineh Goljaryan
- Assistant professor, physiotherapy Department, School of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran, Iran
| | - Mohammad-Salar Hosseini
- Medical student, member of student research center, Tabriz University of Medical Sciences, Tabriz, Iran, Iran
| | - Mahdieh Esmaeilnezhad
- Master science of medical surgical nursing, Tabriz University of Medical Sciences, Tabriz, Iran, Iran
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Pradarelli JC, Yule S, Lipsitz SR, Panda N, Craig M, Lowery KW, Ashley SW, Gee DW, Waters PM, Knight J, Smink DS. Surgical Coaching for Operative Performance Enhancement (SCOPE): skill ratings and impact on surgeons’ practice. Surg Endosc 2020; 35:3829-3839. [DOI: 10.1007/s00464-020-07776-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/01/2020] [Indexed: 01/03/2023]
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Use of Music Therapy to Improve Cognition in Older Adults With Dementia: An Integrative Review. Res Theory Nurs Pract 2020; 33:183-195. [PMID: 31123162 DOI: 10.1891/1541-6577.33.2.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Dementia is considered a public health priority due to physical, psychological, economic, and social repercussions in older adults, their families, and caregivers. To address this issue, healthcare providers can use music therapy as a complementary therapy. This manuscript was elaborated to analyze and synthesize the current evidence of the use of music therapy to improve cognition in older adults with dementia. METHODS Using the Whittemore and Knafl (2005) method, databases searched were PubMed, CINAHL, Ovid, EBSCO, ProQuest, and PsycINFO, using the terms such as "Music Therapy," "Acoustic Stimulation," "Music," "Cognition," "Memory," "Attention," "Aged," and "Dementia." Studies that met the eligibility criteria were screened by title, abstract and full text. Quality of the studies were evaluated using critical appraisal tools and Cochrane "Risk of Bias" tool. RESULTS A total of 211 articles were screened by title and abstract, but only 28 articles met the inclusion criteria and were full text screened. Of the 28 articles, only five studies were analyzed and synthesized as they focused specifically on music therapy and cognition. Three of the studies showed that active and active-passive approaches of music therapy produce significant effect on cognition in older adults with dementia. The common characteristic was the participation of music therapists or music teachers who delivered the music therapy sessions that resulted in improved cognition. IMPLICATIONS FOR PRACTICE As a safe, inexpensive intervention, it should be considered as a complementary therapy to positively impact cognition in older adults with different types of dementia and levels of severity.
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Bakerjian D, Bettega K, Cachu AM, Azzis L, Taylor S. The Impact of Music and Memory on Resident Level Outcomes in California Nursing Homes. J Am Med Dir Assoc 2020; 21:1045-1050.e2. [PMID: 32146039 DOI: 10.1016/j.jamda.2020.01.103] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/14/2020] [Accepted: 01/19/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To study the effects of a nonpharmacologic intervention, Music and Memory (M&M), on residents with dementia and/or behavioral problems living in nursing homes (NHs). DESIGN This was a prospective, mixed-methods cohort study. SETTING AND PARTICIPANTS In total, 4107 residents in 265 California NHs and that reported data at least twice during the 3-year study period were enrolled. MEASURES We used a quarterly rolling enrollment process; participants provided data at baseline and quarterly via an online survey that included select resident level data from the Minimum Data Set (psychotropic drug use, cognition, behaviors, mood, pain, and falls), experience with the M&M program, and resident use of music. NHs were eligible if they were Medicare- and Medicaid-certified and had 15 residents with a diagnosis of dementia or cognitive impairment or exhibited significant behavioral symptoms. RESULTS M&M was associated with reductions in psychotropic medication use, reduced behaviors, and improved mood. The odds of antipsychotic use declined by about 11%, of antianxiety medications by 17%, and antidepressants by 9% per quarter. Aggressive behaviors, depressive symptoms, pain, and falls also declined significantly over time. The odds of residents exhibiting aggressive behaviors declined by 20% per quarter, depressive symptoms by 16%, reported pain by 17%, and falls by 8%. CONCLUSIONS AND IMPLICATIONS This is the largest study of M&M to date. We found clinically and statistically significant reductions in psychotropic medications and improved behaviors in residents using M&M. Although the study showed positive results overall, the lack of a control group was a significant limitation that precluded determining how much more improvement participating residents experienced compared with nonparticipants. Future studies should include a control group so that better conclusions can be drawn regarding the effectiveness of the M&M program.
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Affiliation(s)
- Debra Bakerjian
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA.
| | - Kristen Bettega
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
| | - Ana Marin Cachu
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
| | - Leslie Azzis
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
| | - Sandra Taylor
- Clinical and Translational Science Center, University of California, Davis, Sacramento, CA
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Froggatt K, Best A, Bunn F, Burnside G, Coast J, Dunleavy L, Goodman C, Hardwick B, Jackson C, Kinley J, Davidson Lund A, Lynch J, Mitchell P, Myring G, Patel S, Algorta GP, Preston N, Scott D, Silvera K, Walshe C. A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT. Health Technol Assess 2020; 24:1-140. [PMID: 31971506 PMCID: PMC7008353 DOI: 10.3310/hta24060] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND People with advanced dementia who live and die in nursing homes experience variable quality of life, care and dying. There is a need to identify appropriate, cost-effective interventions that facilitate high-quality end-of-life care provision. OBJECTIVES To establish the feasibility and acceptability to staff and family of conducting a cluster randomised controlled trial of the Namaste Care intervention for people with advanced dementia in nursing homes. DESIGN The study had three phases: (1) realist review and (2) intervention refinement to inform the design of (3) a feasibility cluster randomised controlled trial with a process evaluation and economic analysis. Clusters (nursing homes) were randomised in a 3 : 1 ratio to intervention or control (usual care). The nature of the intervention meant that blinding was not possible. SETTING Nursing homes in England providing care for people with dementia. PARTICIPANTS Residents with advanced dementia (assessed as having a Functional Assessment Staging Test score of 6 or 7), their informal carers and nursing home staff. INTERVENTION Namaste Care is a complex group intervention that provides structured personalised care in a dedicated space, focusing on enhancements to the physical environment, comfort management and sensory engagement. MAIN OUTCOME MEASURES The two contender primary outcome measures were Comfort Assessment in Dying - End of Life Care in Dementia for quality of dying (dementia) and Quality of Life in Late Stage Dementia for quality of life. The secondary outcomes were as follows: person with dementia, sleep/activity (actigraphy), neuropsychiatric symptoms, agitation and pain; informal carers, satisfaction with care at the end of life; staff members, person-centred care assessment, satisfaction with care at the end of life and readiness for change; and other data - health economic outcomes, medication/service use and intervention activity. RESULTS Phase 1 (realist review; 86 papers) identified that a key intervention component was the activities enabling the development of moments of connection. In phase 2, refinement of the intervention enabled the production of a user-friendly 16-page A4 booklet. In phase 3, eight nursing homes were recruited. Two homes withdrew before the intervention commenced; four intervention and two control homes completed the study. Residents with advanced dementia (n = 32) were recruited in intervention (n = 18) and control (n = 14) homes. Informal carers (total, n = 12: intervention, n = 5; control, n = 7) and 97 staff from eight sites (intervention, n = 75; control, n = 22) were recruited over a 6-month period. Recruitment is feasible. Completion rates of the primary outcome questionnaires were high at baseline (100%) and at 4 weeks (96.8%). The Quality of Life in Late Stage Dementia was more responsive to change over 24 weeks. Even where economic data were missing, these could be collected in a full trial. The intervention was acceptable; the dose varied depending on the staffing and physical environment of each care home. Staff and informal carers reported changes for the person with dementia in two ways: increased social engagement and greater calm. No adverse events related to the intervention were reported. CONCLUSIONS A subsequent definitive trial is feasible if there are amendments to the recruitment process, outcome measure choice and intervention specification. FUTURE WORK In a full trial, consideration is needed of the appropriate outcome measure that is sensitive to different participant responses, and of clear implementation principles for this person-centred intervention in a nursing home context. TRIAL REGISTRATION Current Controlled Trials ISRCTN14948133. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 6. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Katherine Froggatt
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Ashley Best
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Frances Bunn
- Department of Health and Human Sciences, University of Hertfordshire, Hatfield, UK
| | - Girvan Burnside
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Joanna Coast
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lesley Dunleavy
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Claire Goodman
- Department of Health and Human Sciences, University of Hertfordshire, Hatfield, UK
| | - Ben Hardwick
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Clare Jackson
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | | | | | - Jennifer Lynch
- Department of Health and Human Sciences, University of Hertfordshire, Hatfield, UK
| | - Paul Mitchell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gareth Myring
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Shakil Patel
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, UK
| | - Guillermo Perez Algorta
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Nancy Preston
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | | | - Kate Silvera
- Clinical Trials Research Centre, University of Liverpool, Liverpool, UK
| | - Catherine Walshe
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Cheng C, Baker GB, Dursun SM. Use of multisensory stimulation interventions in the treatment of major neurocognitive disorders. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1699738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Catherine Cheng
- Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Glen B. Baker
- Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Serdar M. Dursun
- Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Edmonton, Canada
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Liang JH, Lin L, Wang YQ, Jia RX, Qu XY, Li J, Li JY, Qian S, Qian YX, Wang S, Gao Z, Cheng XX, Xu Y. Non-pharmacological therapeutic strategy options for patients with dementia based on cognitive function-A Bayesian network meta-analysis of randomized controlled trials. Ageing Res Rev 2019; 56:100965. [PMID: 31678652 DOI: 10.1016/j.arr.2019.100965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/17/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022]
Abstract
Dementia represents one of the most common neurodegenerative disorders in older adults. However, it is still unclear whether non-pharmacological therapies (NPTs) are effective or not and which treatment should be preferred. We applied a series of search strategies to identify eligible randomized controlled trials on 1st October, 2018, investigating the effects of NPTs of dementia in the older persons. Pairwise and network meta-analyses were sequentially performed. A total of 31 trials were included, which enrolled 1895 participants and 7 NPTs. Compared with control group, all the NPTs included were statistically beneficial to cognitive function, and our study indicated Comprehensive Therapy(CT) [the surface under the cumulative ranking curve (SUCRA = 92.42%)] might be the best choice for dementia patients. Our study suggests CT might be the optimal NPT for improving the cognitive function of dementia patients. However, the above conclusions need to be further analyzed.
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Wang LN, Tao H, Wang M, Yu HW, Su H, Wu B. Efficacy of path-oriented psychological self-help interventions to improve mental health of empty-nest older adults in the Community of China. BMC Psychiatry 2019; 19:365. [PMID: 31752762 PMCID: PMC6868724 DOI: 10.1186/s12888-019-2327-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/17/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND China has the world's largest aging population and the number of empty-nest older adults is on the rise. In comparison to the aging population in general, empty-nest older adults have a lower level of subjective well-being and poorer mental health status due to a lack of emotional support from their children. The aim of this study is to conduct an empirical study to evaluate the efficacy of the 'Path-oriented Psychological Self-help Intervention' (P-oPSI) led by nurses on the mental health of empty-nest older adults in the community, to provide a scientific foundation for improving their quality of life. METHODS A Quasi-Experimental controlled intervention study was conducted from 2015 to 2017. A total of 76 empty-nest older adults from 2 districts were recruited using a convenience sampling and assigned to 2 groups based on their residential communities in the city of Chifeng in the Inner Mongolia Autonomous Region, China. The wait list control group participated in a mental health lecture to gain knowledge and learn techniques of mental health promotion. The intervention group additionally received 1 month of training in a nurse-led 'P-oPSI' for a month. Both groups were followed-up for 3 months. Mental health status, coping styles, and psychological self-help ability of the participating empty nest older adults were assessed at the baseline, 1 month, and 3-months follow up, respectively. Two-way analysis of variance and a simple effect test were used to analyse the differences of the two groups. RESULTS The P-oPSI yielded a greater benefit for the mental health status, coping styles, and psychological self-help ability of the participants in the intervention group. Combined with a simple effect test, the scores of the mental health status, positive coping style, and psychological self-help ability of those in the intervention group significantly increased at 1 month after the baseline (F mental health status = 7.59, F positive coping style = 7.24, F psychological self-help ability = 7.07); and the sustainable effect of this program lasted for 3 months after the intervention (F mental health status = 13.24, F positive coping style = 10.42, F psychological self-help ability = 10.45), which reached statistical significance (P < 0.01). CONCLUSIONS The P-oPSI program significantly improved the level of mental health of empty-nest older adults in China. This intervention provides a new approach of self-management to improve mental health of older adults in community settings. TRIAL REGISTRATION chictr.org.cn: ChiCTR1900025552. Retrospectively registered 1 September 2019.
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Affiliation(s)
- Li-Na Wang
- School of Medicine, Huzhou University, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
| | - Hong Tao
- AdventHealth Whole-Person Research, Orlando, FL 32804 USA
| | - Mi Wang
- School of Nursing, Binzhou Polytechnic, Binzhou, 256600 Shandong China
| | - Hong-Wei Yu
- School of Medicine, Huzhou University, Huzhou Central Hospital, Huzhou, 313000 Zhejiang China
| | - Hong Su
- 0000 0001 2204 9268grid.410736.7School of Nursing, Harbin Medical University, DaQing Campus, Daqing, 163319 China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, USA.
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Silva R, Abrunheiro S, Cardoso D, Costa P, Couto F, Agrenha C, Apóstolo J. Effectiveness of multisensory stimulation in managing neuropsychiatric symptoms in older adults with major neurocognitive disorder: a systematic review. ACTA ACUST UNITED AC 2019; 16:1663-1708. [PMID: 30113550 DOI: 10.11124/jbisrir-2017-003483] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of the review was to synthesize the effectiveness of multisensory stimulation in managing neuropsychiatric symptoms (NPS) in older adults with major neurocognitive disorder (NCD). INTRODUCTION Major neurocognitive disorder is characterized by changes in specific cognitive domains with a progressive deterioration in cognitive ability and capacity for independent living. Most older adults with this condition have one or more concomitant symptoms known as NPS. Evidence shows that nonpharmacological therapies have been effective in controlling these symptoms, with multisensory stimulation attracting further investigation. INCLUSION CRITERIA The review considered studies on older adults aged 65 years or over with major NCD. The intervention of interest was multisensory stimulation, and the comparator was usual care (e.g. no occupational therapy, no cognitive training, and no art therapy, but with possible control of activities such as looking at photographs or doing quizzes), or another intervention (e.g. occupational therapy, cognitive training and art therapy). Primary outcomes were NPS (agitation, aggression, motor disturbances, mood liability, anxiety, apathy, night-time behaviour, eating disorders, delusion and hallucination). Secondary outcomes were quality of life, functional status in activities of daily living, cognitive status and caregiver burden. Experimental study designs were considered. METHODS A broad range of keywords and a three-step search strategy were used to identify potentially eligible published and unpublished studies from January 1990 to June 2016 in major healthcare-related online databases. Studies in English, Spanish and Portuguese were included. Two independent reviewers assessed the methodological quality of eight included studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists for Randomized Controlled Trials and Quasi-Experimental Studies. Data were extracted using the standardized data extraction tool from the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI) and included details about the interventions, populations, study methods and outcomes of interest. Significant differences were found between participants, interventions, outcome measures (clinical heterogeneity), and designs (methodological heterogeneity). For these reasons, a meta-analysis could not be performed. Therefore, the results have been described in a narrative format. RESULTS Eight studies (seven randomized controlled trials and one quasi-experimental study) were included, with a total sample of 238 participants (pre-intervention). Four studies confirmed the effectiveness of multisensory stimulation in domains such as physically nonaggressive behavior, verbally agitated behavior and agitation. However, these effects did not always persist in the long-term. Six studies showed poorly consistent results on the effects of multisensory stimulation in improving mood, with only one displaying significant effects. Similarly, despite poor results, two studies showed benefits concerning anxiety. Participants reported significantly decreased levels of anxiety over the course of the intervention, and this improvement persisted in the long-term. In regard to functional status in activities of daily living, two studies reported an improvement in the short-term. Moreover, the effectiveness in cognitive domains such as memory and attention to surroundings also showed inconsistent results across the seven studies that analyzed this outcome. Two studies reflected an improvement during the intervention, but also reported a gradual decline in the long-term. Only one study observed significantly better results during the intervention that persisted until the follow-up assessment. Apathy, night-time behavior, eating disorders, delusion and hallucination were NPS that were not explored in the studies that met the criteria to be included in this review. CONCLUSIONS These findings suggest that multisensory stimulation could be an effective intervention for managing NPS in older adults with major NCD in a mild to severe stage, particularly for managing behavioral symptoms such as agitation. This research provides an indication of the likely effect of the multisensory stimulation on NPS such as agitation and anxiety, as well on cognitive status.
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Affiliation(s)
- Rosa Silva
- Universidade Católica Portuguesa, Nursing School, Porto, Portugal.,Portugal Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence.,Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Sérgio Abrunheiro
- Neurology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Daniela Cardoso
- Portugal Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence.,Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Paulo Costa
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Filipa Couto
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Cátia Agrenha
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - João Apóstolo
- Portugal Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence.,Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, D’Amico F, Turnone B, Laporta D, Scordamaglia A, Pinto K. Smartphone-Based Interventions to Foster Simple Activity and Personal Satisfaction in People With Advanced Alzheimer's Disease. Am J Alzheimers Dis Other Demen 2019; 34:478-485. [PMID: 31014071 PMCID: PMC10653363 DOI: 10.1177/1533317519844144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study assessed a smartphone-based program to promote practical and mildly demanding arm responses and personal satisfaction and increase physical exertion (heart rates) in people with advanced Alzheimer's disease. METHODS The program relied on a Samsung Galaxy A3 smartphone with Android 6.0 operating system. Two groups of 10 and 11 participants, respectively, were assigned different responses (ie, placing cards into an elevated box and moving bottles with water from a table into a container). Responses activated the smartphone, which produced brief periods of preferred stimulation. Lack of responding led the smartphone to produce a verbal prompt. RESULTS All participants had significant increases in independent response frequencies, level of personal satisfaction, and heart rates during program sessions as opposed to baseline or control sessions. CONCLUSION A smartphone-based program may help people with advanced Alzheimer's disease increase independent occupation with possible benefits in terms of satisfaction and physical condition.
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Affiliation(s)
| | | | | | - Jeff Sigafoos
- Victoria University of Wellington, Wellington, New Zealand
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Abstract
Importance Worldwide, 47 million people live with dementia and, by 2050, the number is expected to increase to 131 million. Observations Dementia is an acquired loss of cognition in multiple cognitive domains sufficiently severe to affect social or occupational function. In the United States, Alzheimer disease, one cause of dementia, affects 5.8 million people. Dementia is commonly associated with more than 1 neuropathology, usually Alzheimer disease with cerebrovascular pathology. Diagnosing dementia requires a history evaluating for cognitive decline and impairment in daily activities, with corroboration from a close friend or family member, in addition to a thorough mental status examination by a clinician to delineate impairments in memory, language, attention, visuospatial cognition such as spatial orientation, executive function, and mood. Brief cognitive impairment screening questionnaires can assist in initiating and organizing the cognitive assessment. However, if the assessment is inconclusive (eg, symptoms present, but normal examination findings), neuropsychological testing can help determine whether dementia is present. Physical examination may help identify the etiology of dementia. For example, focal neurologic abnormalities suggest stroke. Brain neuroimaging may demonstrate structural changes including, but not limited to, focal atrophy, infarcts, and tumor, that may not be identified on physical examination. Additional evaluation with cerebrospinal fluid assays or genetic testing may be considered in atypical dementia cases, such as age of onset younger than 65 years, rapid symptom onset, and/or impairment in multiple cognitive domains but not episodic memory. For treatment, patients may benefit from nonpharmacologic approaches, including cognitively engaging activities such as reading, physical exercise such as walking, and socialization such as family gatherings. Pharmacologic approaches can provide modest symptomatic relief. For Alzheimer disease, this includes an acetylcholinesterase inhibitor such as donepezil for mild to severe dementia, and memantine (used alone or as an add-on therapy) for moderate to severe dementia. Rivastigmine can be used to treat symptomatic Parkinson disease dementia. Conclusions and Relevance Alzheimer disease currently affects 5.8 million persons in the United States and is a common cause of dementia, which is usually accompanied by other neuropathology, often cerebrovascular disease such as brain infarcts. Causes of dementia can be diagnosed by medical history, cognitive and physical examination, laboratory testing, and brain imaging. Management should include both nonpharmacologic and pharmacologic approaches, although efficacy of available treatments remains limited.
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Affiliation(s)
- Zoe Arvanitakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Dept of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Raj C. Shah
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Dept of Family Medicine, Rush University Medical Center, Chicago, IL
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Dept of Neurological Sciences, Rush University Medical Center, Chicago, IL
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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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Weise L, Töpfer NF, Deux J, Wilz G. Feasibility and effects of individualized recorded music for people with dementia: A pilot RCT study. NORDIC JOURNAL OF MUSIC THERAPY 2019. [DOI: 10.1080/08098131.2019.1661507] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Lisette Weise
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
| | - Nils F. Töpfer
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
| | - Juliane Deux
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
| | - Gabriele Wilz
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
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Dowson B, McDermott O, Schneider J. What indicators have been used to evaluate the impact of music on the health and wellbeing of people with dementia? A review using meta-narrative methods. Maturitas 2019; 127:26-34. [DOI: 10.1016/j.maturitas.2019.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/17/2019] [Accepted: 06/03/2019] [Indexed: 01/17/2023]
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Accessible Digital Musical Instruments—A Review of Musical Interfaces in Inclusive Music Practice. MULTIMODAL TECHNOLOGIES AND INTERACTION 2019. [DOI: 10.3390/mti3030057] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Current advancements in music technology enable the creation of customized Digital Musical Instruments (DMIs). This paper presents a systematic review of Accessible Digital Musical Instruments (ADMIs) in inclusive music practice. History of research concerned with facilitating inclusion in music-making is outlined, and current state of developments and trends in the field are discussed. Although the use of music technology in music therapy contexts has attracted more attention in recent years, the topic has been relatively unexplored in Computer Music literature. This review investigates a total of 113 publications focusing on ADMIs. Based on the 83 instruments in this dataset, ten control interface types were identified: tangible controllers, touchless controllers, Brain–Computer Music Interfaces (BCMIs), adapted instruments, wearable controllers or prosthetic devices, mouth-operated controllers, audio controllers, gaze controllers, touchscreen controllers and mouse-controlled interfaces. The majority of the AMDIs were tangible or physical controllers. Although the haptic modality could potentially play an important role in musical interaction for many user groups, relatively few of the ADMIs (14.5%) incorporated vibrotactile feedback. Aspects judged to be important for successful ADMI design were instrument adaptability and customization, user participation, iterative prototyping, and interdisciplinary development teams.
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Maseda A, Cibeira N, Lorenzo-López L, González-Abraldes I, Buján A, de Labra C, Millán-Calenti JC. Multisensory Stimulation and Individualized Music Sessions on Older Adults with Severe Dementia: Effects on Mood, Behavior, and Biomedical Parameters. J Alzheimers Dis 2019; 63:1415-1425. [PMID: 29843244 DOI: 10.3233/jad-180109] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Multisensory stimulation and individualized music have shown to be good in handling the psychological and behavioral symptoms in people with severe dementia. OBJECTIVE Explore the effects of two nonpharmacological interventions, multisensory stimulation environment (MSSE) in a Snoezelen room and individualized music sessions, on mood, behavior, and biomedical parameters of institutionalized elderly patients with severe dementia. METHODS Randomized trial of 21 patients aged ≥65 years randomly assigned to two groups (MSSE and individualized music). Interventions administered in two-weekly sessions lasted 30 minutes for a period of 12 weeks. Main outcomes were recorded before, during, and at the end of the intervention. RESULTS Both groups had immediate positive effects on mood and behavior. Participants were more happy/more content (p < 0.001), talked more spontaneously (p = 0.009), related to people better (p = 0.002), were more attentive to/focused on their environment (p < 0.001), enjoyed themselves (p = 0.003), were less bored/inactive (p = 0.004), and more relaxed/content (p = 0.003). The MSSE group performed a better visual follow-up of the stimuli (p = 0.044), and the music group were more relaxed and happy (p = 0.003). A decrease in heart rate (p = 0.013) and an increase in oxygen saturation (p = 0.011) were observed from before to after interventions in both groups, with no significant differences between them. CONCLUSIONS Both interventions seem to be effective at managing mood and behavioral disturbances in the short term and at improving physiological rates, highlighting the efficacy of nonpharmacological treatments in patients with severe dementia.
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Affiliation(s)
- Ana Maseda
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Coruña, Spain
| | - Nuria Cibeira
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Coruña, Spain
| | - Laura Lorenzo-López
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Coruña, Spain
| | - Isabel González-Abraldes
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Coruña, Spain
| | - Ana Buján
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Coruña, Spain
| | - Carmen de Labra
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Coruña, Spain
| | - José Carlos Millán-Calenti
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Coruña, Spain
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Abstract
Background:
Due to the increase in life expectancies and the number of aging population
worldwide, there is a rise of aging diseases, out of which the most common is dementia. Therefore,
researchers all over the world look for another alternative ways that can improve cognitive
competency and neuropsychiatric disorders of these people in order to assist them in maintaining the
quality of their life and reducing the overall economic burden. One of the alternative approache
seems to be non-pharmacological therapies, which are non-invasive, with minimum side effects and
definitely less costly, such as a music therapy (MT).
Objective:
The purpose of this review study is to discuss benefits and limitations of music therapy in
the management of dementia.
Method:
This was done by conducting a literature review of available sources found in the Web of
Science, Scopus and MEDLINE.
Results:
The findings show that MT may be a promising non-invasive strategy with a long history
of use, relatively favorable acceptance among patients with dementia, and its efficacy especially in
the treatment of psycho-behavioral symptoms of dementia.
Conclusion:
However, more research should be conducted in the area of cognitive functioning, as
well as on the mechanism of MT for dementia patients.
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Affiliation(s)
- Blanka Klímová
- Department of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Kuča
- Faculty of Education, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Martin Vališ
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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Volicer L. Review of Programs for Persons Facing Death with Dementia. Healthcare (Basel) 2019; 7:E62. [PMID: 30991668 PMCID: PMC6628090 DOI: 10.3390/healthcare7020062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Persons with advanced dementia cannot initiate activities because of the executive dysfunction. The lack of activities was identified as one of the most important factors contributing to behavioral problems of these persons. The unmet needs were boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activities. There is a need for activities designed specifically for residents with advanced dementia. OBJECTIVE A description of patient's needs and of programs that intend to maintain quality of life for people with dementia and facing death. DATA SOURCES A literature review of programs used for persons with advanced dementia and residing in long-term facilities, using the PubMed data base and collateral sources. RESULTS Since palliative care is appropriate for persons with advanced dementia, attention has to be paid to three following important aspects of care: Medical issues, behavioral symptoms, and meaningful activities. Medical interventions should be limited to those which have more benefits than burdens, behavioral symptoms should be distinguished according to the context in which they occur, and treated by non-pharmacological interventions that involve meaningful activities. This review describes four programs that may promote the quality of life in persons with advanced dementia and facing death. They are designed for persons with advanced dementia, taking into account their functional impairments. Most of these programs involve short infrequent sessions. In contrast, Namaste Care is a daily extended program of enhanced nursing care that can provide quality of life until the last breath. CONCLUSIONS It is possible to maintain quality life for people with advanced dementia if a special program of activities is available.
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Affiliation(s)
- Ladislav Volicer
- School of Aging Studies, University of South Florida, Tampa, FL 34639, USA.
- The 3rd Medical Faculty, Charles University, 11000 Prague, Czech Republic.
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Gaviola MA, Inder KJ, Dilworth S, Holliday EG, Higgins I. Impact of individualised music listening intervention on persons with dementia: A systematic review of randomised controlled trials. Australas J Ageing 2019; 39:10-20. [PMID: 30912616 DOI: 10.1111/ajag.12642] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To summarise the evidence regarding the impact of individualised music listening on persons with dementia. METHODS Six electronic databases (CINAHL, Medline, ProQuest, PsycINFO, Music Periodicals and Cochrane) were searched up to July 2018 for randomised controlled trials (RCTs) evaluating the efficacy of individualised music listening compared to other music and non-music-based interventions. RESULTS Four studies were included. Results showed evidence of a positive impact of individualised music listening on behavioural and psychological symptoms of dementia (BPSDs) including agitation, anxiety and depression and physiological outcomes. Evidence for other outcomes such as cognitive function and quality of life was limited. CONCLUSIONS The limited evidence suggests individualised music listening has comparable efficacy to more resource-intensive interventions. However, there was a small number of RCTs and some outcomes were evaluated by a single study. This limits the conclusions drawn, warranting more RCTs evaluating other outcomes beyond the BPSDs.
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Affiliation(s)
- Minah Amor Gaviola
- School of Nursing & Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kerry J Inder
- School of Nursing & Midwifery, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Sophie Dilworth
- Hunter Aged Care Assessment Team, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Elizabeth G Holliday
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Isabel Higgins
- School of Nursing & Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
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Lancioni G, Singh N, O’Reilly M, Sigafoos J, D’Amico F, Laporta D, Scordamaglia A, Pinto K. Tablet-based intervention to foster music-related hand responses and positive engagement in people with advanced Alzheimer’s disease. JOURNAL OF ENABLING TECHNOLOGIES 2019. [DOI: 10.1108/jet-06-2018-0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeMusic stimulation is considered beneficial for people with advanced Alzheimer’s disease. The purpose of this paper is to assess a tablet-based program to promote music-related hand responses and positive engagement (e.g. singing or moving the body with the music) in people with advanced Alzheimer’s disease.Design/methodology/approachThe program was implemented with 20 participants according to a non-concurrent multiple baseline design across participants. The participants were provided with a tablet whose screen worked as a sensor. During the intervention, sensor activations by hand responses led the tablet to present 10 s segments of preferred songs; an absence of sensor activation led the tablet to produce a prompt.FindingsThe participants’ mean frequencies of hand responses (i.e. sensor activations) per 5 min session increased from mostly zero during baseline to between about 9 and 20 during the intervention. The mean percentages of observation intervals with participants’ positive engagement increased from 0 to 12 during the baseline to between 13 and 55 during the intervention. The differences between baseline and intervention data were statistically significant for all participants.Originality/valueA tablet-based program, such as that used in this study, may help people with advanced Alzheimer’s disease develop specific music-related responses and positive engagement.
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Dunphy K, Baker FA, Dumaresq E, Carroll-Haskins K, Eickholt J, Ercole M, Kaimal G, Meyer K, Sajnani N, Shamir OY, Wosch T. Creative Arts Interventions to Address Depression in Older Adults: A Systematic Review of Outcomes, Processes, and Mechanisms. Front Psychol 2019; 9:2655. [PMID: 30671000 PMCID: PMC6331422 DOI: 10.3389/fpsyg.2018.02655] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 12/10/2018] [Indexed: 01/26/2023] Open
Abstract
Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama, and music modalities, are utilized internationally to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama, and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g., increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g., enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g., creative expression, aesthetic pleasure), cognitive (e.g., stimulation of memory), and social (e.g., increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research includes stronger focus on testing of processes and mechanisms.
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Affiliation(s)
- Kim Dunphy
- Creative Arts and Music Therapy Research Unit, University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A. Baker
- Creative Arts and Music Therapy Research Unit, University of Melbourne, Melbourne, VIC, Australia
| | - Ella Dumaresq
- Creative Arts and Music Therapy Research Unit, University of Melbourne, Melbourne, VIC, Australia
| | - Katrina Carroll-Haskins
- Health, Arts, Learning & Evaluation Lab, Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Jasmin Eickholt
- Creative Arts and Music Therapy Research Unit, University of Melbourne, Melbourne, VIC, Australia
- Music Therapy Lab, Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Maya Ercole
- Creative Arts and Music Therapy Research Unit, University of Melbourne, Melbourne, VIC, Australia
| | - Girija Kaimal
- Health, Arts, Learning & Evaluation Lab, Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Kirsten Meyer
- Creative Arts and Music Therapy Research Unit, University of Melbourne, Melbourne, VIC, Australia
| | - Nisha Sajnani
- Theatre and Health Lab, Department of Music and Performing Arts Professions, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, United States
| | - Opher Y. Shamir
- Theatre and Health Lab, Department of Music and Performing Arts Professions, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, United States
| | - Thomas Wosch
- Music Therapy Lab, Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
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