"Art, Colors, and Emotions" Treatment (ACE-t): A Pilot Study on the Efficacy of an Art-Based Intervention for People With Alzheimer's Disease

Cognitive therapies and their impact on neuropsychiatric symptoms in mild cognitive impairment or dementia: a scoping review

To date, the impact of cognitive therapies on patients with dementia and mild cognitive impairment (MCI) has been studied in terms of cognition, quality of life and activities of daily living rather than in the context of neuropsychiatric symptoms (NPS). The objective of this scoping review was to collect evidence that different cognitive therapies affect the NPS of patients with MCI and dementia. A bibliographic search was conducted in the PUBMED, EMBASE, ISI WOS and SCOPUS databases through February 2025. After the elimination of duplicates, a total of 1,854 publications were identified. Among these, 42 articles were included in the analysis. These articles were reviewed by title and abstract, and then the full text was reviewed by two independent researchers with subsequent decisions about conflicts made in consultation with a third researcher. A sample of 4,089 participants was collected. All participants had undergone cognitive training interventions, cognitive rehabilitation, cognitive stimulation, art therapy, reminiscence therapy or psychobehavioural therapy and were evaluated for NPS. Depression was the most commonly analysed symptom (70% of the articles). The types of interventions that improved NPS the most were art therapy and reminiscence therapy (76 and 71% of the articles), whereas cognitive training (43%) was the least effective. While all types of therapy seemed to support the improvement of NPS, art therapy and reminiscence therapy were the most effective, especially for patients with MCI or dementia. However, studies that comprehensively evaluate the effects of cognitive therapy on NPS other than depression are lacking.

Structural and functional neuroplasticity in music and dance-based rehabilitation: a systematic review

BACKGROUND

Music- and dance-based rehabilitation has gained prominence in promoting social engagement and improving motor, cognitive, and mood domains in individuals affected by different neurological disorders.

AIM

This systematic review aims to synthesize existing evidence from randomized controlled trials (RCTs) investigating neuroimaging-based structural and functional neuroplasticity following music- and dance-based interventions among people with neurological disorders.

METHODS

Literature research was performed using PubMed (MEDLINE), Scopus, and Web of Science (WOS). A multidimensional approach was employed to assess the efficacy of music- and dance-based interventions, integrating neuroimaging and clinical assessments.

RESULTS

Out of a total of 2247 papers reviewed, 20 RCTs met the inclusion criteria for this review, with a total of 718 subjects. Among them, 88% underwent a neuroimaging investigation to evaluate structural or functional neuroplasticity. Six studies involved dance-based interventions, while 14 examined music-based rehabilitation. These interventions targeted cognitive, motor, and mood impairments in people at risk of dementia or with neurological disorders including Huntington's Disease, stroke, traumatic brain injury, spinal cord injury, and disorder of consciousness.

DISCUSSION

Overall, the selected studies demonstrated significant effects on behavioral and neuroimaging outcomes, showing structural and functional changes in critical areas for perception and memory in patients at risk of dementia, as well as in regions essential for language processing, emotional regulation, and motor control in patients with acute and chronic stroke. Nevertheless, several biases were identified, specifically related to neuroimaging biomarkers, such as a lack of baseline and between-group comparisons and a lack of prior registration of neuroimaging biomarkers investigated. The protocol of this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO), with registration number CRD42024574754.

The effect of art therapy on cognitive status and psychological well-being in elderly people in institutional care

BACKGROUND

Cognitive decline seen in old age manifests itself as a decrease in reasoning ability that is not related to intelligence. This situation, together with many other problems, can affect the psychological well-being of the elderly. Especially the elderly living in institutional care constitute a special group that needs to be protected. It is important that the psychotherapy interventions to be carried out with this group are determined according to the characteristics of the group. The aim of this study is to determine the effect of art therapy on cognitive status and psychological well-being in the elderly living in institutional care.

METHODS

This single-blind randomised controlled study was conducted with 42 elderly individuals living in three nursing homes in Türkiye. In the study, the sample group was assigned to the experimental (n = 21) and control (n = 21) groups by simple randomisation. Art therapy intervention was applied to the elderly individuals in the experimental group, and no special intervention was applied to the control group. The sociodemographic information form, standardised mini mental test (MMT) and Psychological Well-being Scale for the Elderly (PWBS) were used as data collection tools in the study.

RESULTS

It was found that there was a statistically significant difference between the pre-test and post-test total scores of the PWBS and MMT in favour of the post-test (P < 0.001). In the study, the effect of the art therapy intervention applied to the elderly individuals in the experimental group was evaluated and it was determined that the difference between the PWBS (η 2 $$ {\eta}^2 $$  = 0.75) and MMT (η 2 $$ {\eta}^2 $$  = 0.52) scores had a medium effect level.

CONCLUSIONS

The results showed that art therapy has a positive effect on the psychological well-being and cognitive status of the elderly in institutional care and can be used as a moderate developmental intervention.

Visual art therapy and its effects in older people with mild cognitive impairment: A systematic review

INTRODUCTION

Mild cognitive impairment (MCI) is a known risk factor for the development of dementia. The potential benefits on cognition from non-pharmacological measures such as art-based interventions are of increasing interest. This systematic review examines the evidence for the impact of one form of art-based intervention, visual art therapy (VAT), on the cognition and psychological wellbeing of older people with MCI.

METHODS

Randomised controlled and quasi-experimental trials evaluating the efficacy of VAT in older persons aged over 60 years with MCI were included. A search was performed on electronic databases: MEDLINE, CINAHL, Embase and PsycINFO. Joanna Briggs Institute critical appraisal and extraction tools were utilised for risk of bias assessment and data extraction, respectively. A narrative descriptive approach was used to outline the findings.

RESULTS

Seven studies were identified from 4311 articles screened. Improvement in cognition was reported in five studies, with two of these reporting sustained improvement at 6-9 months, while the remaining three studies showed improvement only at the immediate post-intervention period. A positive impact was reported in four of six studies that examined the effect of VAT on participant psychological wellbeing. The overall methodological quality of the studies ranged from moderate in four of five RCTs, to high in the quasi-experimental studies and one RCT. However, the low study power in the context of small sample sizes limits the applicability of these studies to the population of interest.

CONCLUSIONS

VAT is potentially an effective non-pharmacological intervention that may enhance cognition and provide benefits for psychological wellbeing in older persons with MCI. Given the limited studies available, with the majority emerging over the last 5 years, further research is required to confirm these reported benefits, as well as to determine whether VAT impacts on the progression of cognitive decline in MCI.

A digital health home intervention for people within the Alzheimer's disease continuum: results from the Ability-TelerehABILITation pilot randomized controlled trial

PURPOSE

This study tested the efficacy of digital-health home intervention for people within the Alzheimer's disease (AD)-continuum.

METHODS

Thirty people within the AD continuum were randomly assigned to a telerehabilitation (ABILITY; 6 males, M_age=78.2 ± 3.95) or treatment as usual (TAU; 8 males, M_age=77.13 ± 6.38), performing cognitive and physical activities at home for six weeks. The ABILITY intervention additionally included a digital platform enabling communication between the hospital and the patient's home. Efficiency, such as adherence, perceived fit of demands and skills, usability, and effectiveness measures, including neuropsychological level, neuropsychiatric symptoms, and autonomy in daily living, were collected before (T0), after the treatment (T1), and at the 1-year-follow-up (T2).

RESULTS

The ABILITY program was efficient, with a higher adherence (81% vs. 62%), a higher perceived fit of demands and skills than TAU (p<.05), and a good level of technology usability. In terms of effectiveness, a treatment effect (ABILITY > TAU) emerged on the global cognitive level, especially in language, executive functions, and memory domains. Moreover, a treatment carry-over effect (1-year follow-up) was observed in global cognitive functions (especially language) (ABILITY > TAU), behavioral symptoms, and caregiver distress (TAU > ABILITY).

CONCLUSIONS

Our preliminary findings suggest that ABILITY is a promising eHealth intervention to improve at-home treatment adherence and to preserve cognitive and behavioral abilities.

The key role of depression and supramarginal gyrus in frailty: a cross-sectional study

Background

The age-related decrease in reserve and resistance to stressors is recognized as frailty, one of the most significant challenges identified in recent years. Despite a well-acknowledged association of frailty with cognitive impairment, depression, and gray matter morphology, no clear data are available regarding the nature of this relationship. This cross-sectional study aims to disentangle the role of the behavioral, neuropsychological, and neural components as predictors or moderators of frailty.

Methods

Ninety-six older adults (mean age = 75.49 ± 6.62) were consecutively enrolled and underwent a clinical and MRI (3 T) evaluation to assess frailty, physical activity, global cognitive level, depression, wellbeing, autonomy in daily living, cortical thickness, and subcortical volumes.

Results

Results showed a full mediation of depression on the link between cortical thickness and frailty, while the cognitive level showed no significant mediating role. In particular, left supramarginal thickness had a predicting role on depression, that in turn impacted frailty occurrence. Finally, handgrip weakness was an early key indicator of frailty in this study's cohort.

Conclusion

These data substantiate the role of depression in mediating the link between neural integrity of the supramarginal gyrus and frailty. In the complexity of frailty, handgrip weakness seems to be an early key indicator. These results are relevant for the design of rehabilitation interventions aimed at reversing the frail condition.

Evaluation of art making activity as a pain management strategy for older adults and their experience using an art making intervention

Chronic pain is a common and bothersome experience for older adults. Consequently, pain management is critical to maintaining their function and well-being. Art making, a non-pharmacological approach, has gained empirical support and is used for functional and cognitive improvement in older adults. However, it has rarely been used to manage chronic pain. The purpose of this descriptive qualitative study was to understand older adults' experience using a newly designed art making intervention and its influence on their pain. Overall, 11 older adults used the intervention and reported its quality to be appropriate. Moreover, older adults reported that art making was an engaging, diversional activity which reduced their pain severity and improved their mood. The findings of this study will be used to inform a future pilot study to assess the impact of art making on pain management in older adults with chronic pain.

Can we really 'read' art to see the changing brain? A review and empirical assessment of clinical case reports and published artworks for systematic evidence of quality and style changes linked to damage or neurodegenerative disease

The past three decades have seen multiple reports of people with neurodegenerative disorders, or other forms of changes in their brains, who also show putative changes in how they approach and produce visual art. Authors argue that these cases may provide a unique body of evidence, so-called 'artistic signatures' of neurodegenerative diseases, that might be used to understand disorders, provide diagnoses, be employed in treatment, create patterns of testable hypotheses for causative study, and also provide unique insight into the neurobiological linkages between the mind, brain, body, and the human penchant for art-making itself. However-before we can begin to meaningfully build from such emerging findings, much less formulate applications-not only is such evidence currently quite disparate and in need of systematic review, almost all case reports and artwork ratings are entirely subjective, based on authors' personal observations or a sparse collection of methods that may not best fit underlying research aims. This leads to the very real question of whether we might actually find patterns of systematic change if fit to a rigorous review-Can we really 'read' art to illuminate possible changes in the brain? How might we best approach this topic in future neuroscientific, clinical, and art-related research? This paper presents a review of this field and answer to these questions. We consider the current case reports for seven main disorders-Alzheimer's and Parkinson's disease, frontotemporal and Lewy body dementia, corticobasal degeneration, aphasia, as well as stroke-consolidating arguments for factors and changes related to art-making and critiquing past methods. Taking the published artworks from these papers, we then conduct our own assessment, employing computerized and human-rater-based approaches, which we argue represent best practice to identify stylistic or creativity/quality changes. We suggest, indeed, some evidence for systematic patterns in art-making for specific disorders and also find that case authors showed rather high agreement with our own assessments. More important, through opening this topic and past evidence to a systematic review, we hope to open a discussion and provide a theoretical and empirical foundation for future application and research on the intersection of art-making and the neurotypical, the changed, and the artistic brain.

Art Making as a Health Intervention: Concept Analysis and Implications for Nursing Interventions

Art making has been adopted across multiple disciplines as a health intervention. However, our understanding of art making as a health intervention and how it differs from art therapy is still limited. Therefore, we conducted a concept analysis to better understand art making as a health intervention guided by Walker and Avant's approach. We examined 85 studies in which we found 4 defining attributes, 4 antecedents, and physical, cognitive, emotional, and psychological consequences. We suggest several nursing research and practical implications for nurse researchers and clinicians to aid in designing and implementing art making health interventions.

The impacts of visual Art Therapy for elderly with Neurocognitive disorder: a systematic review

Aging is characterized by a reduction in physical, cognitive, and emotional functions, allowing multiple losses in the quality of life of the elderly. As a clinical situation that has a common association with pathological aging, neurocognitive disorder, previously named dementia, has become epidemiologically more relevant over the years. Thus, art therapy has recently emerged as an alternative technique for approaching these individuals, with the aim of improving cognitive, emotional, and quality of life aspects.

Neuroimaging Biomarkers Predicting the Efficacy of Multimodal Rehabilitative Intervention in the Alzheimer's Dementia Continuum Pathology

In this work we aimed to identify neural predictors of the efficacy of multimodal rehabilitative interventions in AD-continuum patients in the attempt to identify ideal candidates to improve the treatment outcome. Subjects in the AD continuum who participated in a multimodal rehabilitative treatment were included in the analysis [n = 82, 38 Males, mean age = 76 ± 5.30, mean education years = 9.09 ± 3.81, Mini Mental State Examination (MMSE) mean score = 23.31 ± 3.81]. All subjects underwent an MRI acquisition (1.5T) at baseline (T0) and a neuropsychological evaluation before (T0) and after intervention (T1). All subjects underwent an intensive multimodal cognitive rehabilitation (8–10 weeks). The MMSE and Neuropsychiatric Inventory (NPI) scores were considered as the main cognitive and behavioral outcome measures, and Delta change scores (T1–T0) were categorized in Improved (ΔMMSE > 0; ΔNPI < 0) and Not Improved (ΔMMSE ≤ 0; ΔNPI ≥ 0). Logistic Regression (LR) and Random Forest classification models were performed including neural markers (Medial Temporal Brain; Posterior Brain (PB); Frontal Brain (FB), Subcortical Brain indexes), neuropsychological (MMSE, NPI, verbal fluencies), and demographical variables (sex, age, education) at baseline. More than 50% of patients showed a positive effect of the treatment (ΔMMSE > 0: 51%, ΔNPI < 0: 52%). LR model on ΔMMSE (Improved vs. Not Improved) indicate a predictive role for MMSE score (p = 0.003) and PB index (p = 0.005), especially the right PB (p = 0.002) at baseline. The Random Forest analysis correctly classified 77% of cognitively improved and not improved AD patients. Concerning the NPI, LR model on ΔNPI (Improved vs. Not Improved) showed a predictive role of sex (p = 0.002), NPI (p = 0.005), PB index (p = 0.006), and FB index (p = 0.039) at baseline. The Random Forest reported a classification accuracy of 86%. Our data indicate that cognitive and behavioral status alone are not sufficient to identify best responders to a multidomain rehabilitation treatment. Increased neural reserve, especially in the parietal areas, is also relevant for the compensatory mechanisms activated by rehabilitative treatment. These data are relevant to support clinical decision by identifying target patients with high probability of success after rehabilitative programs on cognitive and behavioral functioning.

Benefits of Cultural Activities on People With Cognitive Impairment: A Systematic Review

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.

Impact of Alzheimer's Dementia on Caregivers and Quality Improvement through Art and Music Therapy

Dementia is a general term for a series of medical conditions that affect the brain and evolve progressively. According to the literature, there are over 200 subtypes and causes of dementia, with Alzheimer's disease (AD) being the most common in elderly people. AD is an irreversible progressive neurodegenerative condition that leads to a decline in mental function, enough to disrupt daily life. Thinking skills slowly deteriorate, which, in advanced stages, makes it impossible to perform simple tasks. Besides the change in the quality of life of AD patients and their families, there is a considerable alteration in the quality of life of their caregivers, whose health can be negatively affected by the development of mental and somatic disorders. This article reviews the literature in order to reveal the benefits of applying non-pharmacological interventions such as music and art therapy to improve quality of life. This article also aims to shed light on the impact of this disease on the caregiver's life. Music and art therapy have produced reliable results in the treatment of patients with AD, and the best effects are related to increased socialization and the maintenance of social status.