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Wang W, Dubois B, Lu Z. Home Triad: A New Exploration of Home for People Living With Dementia Based on Lefebvre's Spatial Triad. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:253-269. [PMID: 37667575 DOI: 10.1177/19375867231195283] [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: 09/06/2023]
Abstract
OBJECTIVES This article examines a novel theoretical framework, which we term Home Triad, for research and practice involving people living with dementia (PLWD). BACKGROUND Most of the existing home-related research on PLWD focuses on interior modifications, home care interventions and models, place attachment, and/or institutional homelike environments. However, limited studies have examined the meaning of home from PLWD's perspective, and even fewer have simultaneously considered the individual experience of PLWD, the external power (e.g., the role of design), and their interaction dynamics in the meaning-making process. METHODS We developed home triad based on Lefebvre's spatial triad. Inspired by Chaudhury's home story structure, we conducted a life story analysis of a person living with dementia, "Kai," under four contexts-childhood home, neighborhood and city, daily routine, and attachment-within home triad. RESULTS Home triad abstracts "home" with a dialectically interconnected relationship of the conceived, perceived, and lived home. Through PLWD's everyday life, the essence of home is primarily shaped by the interaction between their lived and perceived homes. However, a person's experiences of and participation in home living activities are also planned and/or regulated by different groups of people (caregivers, designers, and policymakers), who play important roles in the conceived home. Critically examining how PLWD's lived and perceived home is constrained or enabled through the conceived home deserves greater future research efforts. CONCLUSION A systematic examination of the essence of home for PLWD using home triad can facilitate subsequent research and practice that promote PLWD's health, well-being, and quality of life.
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Affiliation(s)
- Wenjin Wang
- School of Architecture, Texas A&M University, College Station, TX, USA
| | | | - Zhipeng Lu
- School of Architecture, Texas A&M University, College Station, TX, USA
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Lu Z, Wang W, Yan W, Kew CL, Seo JH, Ory M. The Application of Fully Immersive Virtual Reality on Reminiscence Interventions for Older Adults: Scoping Review. JMIR Serious Games 2023; 11:e45539. [PMID: 37801360 PMCID: PMC10589832 DOI: 10.2196/45539] [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: 01/05/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The increasing number of older adults with mental, behavioral, and memory challenges presents significant public health concerns. Reminiscence is one type of nonpharmacological intervention that can effectively evoke memories, stimulate mental activities, and improve psychological well-being in older adults through a series of discussions on previous experiences. Fully immersive virtual reality (FIVR) may be a useful tool for reminiscence interventions because it uses realistic virtual environments connected to a person's significant past stories. OBJECTIVE This review aims to examine empirical evidence regarding the application of FIVR in reminiscence interventions, its usability and acceptability, and its effectiveness in assisting the intervention to achieve optimal outcomes. METHODS We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach for scoping reviews. The PubMed, PsycINFO, Embase, CINAHL, Web of Science, ACM, and IEEE Xplore electronic databases were used for the search. We included peer-reviewed studies that used FIVR as an assistive tool for reminiscence interventions; were published between January 1, 2000, and August 1, 2022; reported empirical research; involved older adults as participants; and addressed health- and behavior-related outcomes or the feasibility and usability of FIVR. We used Endnote X9 to organize the search results and Microsoft Excel for data extraction and synthesis. RESULTS Of the 806 articles collected from the databases and other resources, 11 were identified. Most of the studies involved participants aged between 70 and 90 years. Only 1 study did not involve those with cognitive impairments, whereas 3 specifically targeted people living with dementia. The results indicated that FIVR reminiscence interventions enhanced engagement and reduced fatigue. Although some studies have observed positive effects on anxiety, apathy, depression, cognitive functions, and caregiver burden reduction, these findings were inconsistent across other research. In addition, FIVR showed overall usability and acceptability with manageable side effects among older adults across various health conditions during reminiscence sessions. However, 1 study reported adverse feelings among participants, triggered by unpleasant memories evoked by the virtual reality content. CONCLUSIONS The role of FIVR in reminiscence interventions remains nascent, with limited studies evaluating its impacts on older adults. Many of the reviewed studies had notable limitations: small sample sizes, absence of rigorous research design, limited assessment of long-term effects, lack of measures for health and behavior outcomes, and quality of life. Beyond these limitations, this review identified a list of future research directions in 6 categories. On the basis of the review findings, we provide practical recommendations to enhance FIVR reminiscence interventions, covering topics such as virtual reality content, device choice, intervention types, and the role and responsibility of facilitators.
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Affiliation(s)
- Zhipeng Lu
- Department of Architecture, Texas A&M University, College Station, TX, United States
| | - Wenjin Wang
- Department of Architecture, Texas A&M University, College Station, TX, United States
| | - Wei Yan
- Department of Architecture, Texas A&M University, College Station, TX, United States
| | - Chung Lin Kew
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Jinsil Hwaryoung Seo
- School of Performance, Visualization & Fine Arts, Texas A&M University, College Station, TX, United States
| | - Marcia Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
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Nanousi V, Kalogeraki K, Smyrnaiou A, Tola M, Bokari F, Georgopoulos VC. The Development of a Pilot App Targeting Short-Term and Prospective Memory in People Diagnosed with Dementia. Behav Sci (Basel) 2023; 13:752. [PMID: 37754030 PMCID: PMC10525938 DOI: 10.3390/bs13090752] [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: 07/23/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND According to the World Health Organization, people suffering from dementia exhibit a serious decline in various cognitive domains and especially in memory. AIMS This study aims to create a pilot computer app to enhance short-term memory and prospective memory in individuals with dementia using errorless learning based on their individualized needs. METHODS Fifteen dementia patients and matched controls, matched for age, sex, and education, were selected. Their daily routines were analyzed, and cognitive abilities were assessed using the MoCA test. Considering the participants' illness severity and daily needs, the pilot app was designed to aid in remembering daily tasks (taking medication and meals), object locations, and familiar faces and names. RESULTS An improvement in patients' short-term and prospective memory throughout the training sessions, but not in overall cognitive functioning was observed. A statistically significant difference between patients and healthy controls was indicated in their ability to retain information relevant to them in their short-term memory, or to remember to act in the future following schedules organized at present (p < 0.001). CONCLUSION This app appears beneficial for training dementia patients and healthy individuals in addressing memory challenges. RECOMMENDATION While the pilot app showed promise, further research with larger samples is recommended.
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Affiliation(s)
- Vicky Nanousi
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Konstantina Kalogeraki
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Aikaterini Smyrnaiou
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Manila Tola
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Foteini Bokari
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Voula Chris Georgopoulos
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
- Primary Health Care Laboratory, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
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Serafin P, Zaremba M, Sulejczak D, Kleczkowska P. Air Pollution: A Silent Key Driver of Dementia. Biomedicines 2023; 11:biomedicines11051477. [PMID: 37239148 DOI: 10.3390/biomedicines11051477] [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: 04/27/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
In 2017, the Lancet Commission on Dementia Prevention, Intervention, and Care included air pollution in its list of potential risk factors for dementia; in 2018, the Lancet Commission on Pollution concluded that the evidence for a causal relationship between fine particulate matter (PM) and dementia is encouraging. However, few interventions exist to delay or prevent the onset of dementia. Air quality data are becoming increasingly available, and the science underlying the associated health effects is also evolving rapidly. Recent interest in this area has led to the publication of population-based cohort studies, but these studies have used different approaches to identify cases of dementia. The purpose of this article is to review recent evidence describing the association between exposure to air pollution and dementia with special emphasis on fine particulate matter of 2.5 microns or less. We also summarize here the proposed detailed mechanisms by which air pollutants reach the brain and activate the innate immune response. In addition, the article also provides a short overview of existing limitations in the treatment of dementia.
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Affiliation(s)
- Pawel Serafin
- Military Institute of Hygiene and Epidemiology, 01-163 Warsaw, Poland
| | - Malgorzata Zaremba
- Military Institute of Hygiene and Epidemiology, 01-163 Warsaw, Poland
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research (CBP), Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Dorota Sulejczak
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
| | - Patrycja Kleczkowska
- Military Institute of Hygiene and Epidemiology, 01-163 Warsaw, Poland
- Maria Sklodowska-Curie, Medical Academy in Warsaw, Solidarnosci 12 Str., 03-411 Warsaw, Poland
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Guzzon A, Rebba V, Paccagnella O, Rigon M, Boniolo G. The value of supportive care: A systematic review of cost-effectiveness of non-pharmacological interventions for dementia. PLoS One 2023; 18:e0285305. [PMID: 37172047 PMCID: PMC10180718 DOI: 10.1371/journal.pone.0285305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/20/2023] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND Almost 44 million people are currently living with dementia worldwide. This number is set to increase threefold by 2050, posing a serious threat to the sustainability of healthcare systems. Overuse of antipsychotic drugs for the management of the symptoms of dementia carries negative consequences for patients while also increasing the health expenditures for society. Supportive care (SC) interventions could be considered a safer and potentially cost-saving option. In this paper we provide a systematic review of the existing evidence regarding the cost-effectiveness and cost-utility of SC interventions targeted towards persons living with dementia and their caregivers. METHODS A systematic literature review was performed between February 2019 and December 2021 through searches of the databases PubMed (MEDLINE), Cochrane Library, CENTRAL, Embase and PsycINFO. The search strategy was based on PRISMA 2020 recommendations. We considered studies published through December 2021 with no lower date limit. We distinguished between five categories of SC strategies: cognitive therapies, physical activity, indirect strategies (organisational and environmental changes), interventions primarily targeted towards family caregivers, and multicomponent interventions. RESULTS Of the 5,479 articles retrieved, 39 met the inclusion criteria. These studies analysed 35 SC programmes located at different stages of the dementia care pathway. Eleven studies provided evidence of high cost-effectiveness for seven interventions: two multicomponent interventions; two indirect interventions; two interventions aimed at caregivers of community-dwelling persons with dementia; one community-based cognitive stimulation and occupational programme. CONCLUSION We find that the most promising SC strategies in terms of cost-effectiveness are multicomponent interventions (targeted towards both nursing home residents and day-care service users), indirect strategies (group living and dementia care management at home), some forms of tailored occupational therapy, together with some psychosocial interventions for caregivers of community-dwelling persons with dementia. Our results suggest that the adoption of effective SC interventions may increase the economic sustainability of dementia care.
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Affiliation(s)
- Angelica Guzzon
- CRIEP (Interuniversity Research Centre on Public Economics), Veneto, Italy
- Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Vincenzo Rebba
- CRIEP (Interuniversity Research Centre on Public Economics), Veneto, Italy
- Department of Economics and Management "Marco Fanno", University of Padova, Padova, Italy
| | - Omar Paccagnella
- Department of Statistical Sciences, University of Padova, Padova, Italy
| | | | - Giovanni Boniolo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Bakrim S, Aboulaghras S, El Menyiy N, El Omari N, Assaggaf H, Lee LH, Montesano D, Gallo M, Zengin G, AlDhaheri Y, Bouyahya A. Phytochemical Compounds and Nanoparticles as Phytochemical Delivery Systems for Alzheimer's Disease Management. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27249043. [PMID: 36558176 PMCID: PMC9781052 DOI: 10.3390/molecules27249043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Alzheimer's disease remains one of the most widespread neurodegenerative reasons for dementia worldwide and is associated with considerable mortality and morbidity. Therefore, it has been considered a priority for research. Indeed, several risk factors are involved in the complexity of the therapeutic ways of this pathology, including age, traumatic brain injury, genetics, exposure to aluminum, infections, diabetes, vascular diseases, hypertension, dyslipidemia, and obesity. The pathophysiology of Alzheimer's disease is mostly associated with hyperphosphorylated protein in the neuronal cytoplasm and extracellular plaques of the insoluble β-amyloid peptide. Therefore, the management of this pathology needs the screening of drugs targeting different pathological levels, such as acetylcholinesterase (AchE), amyloid β formation, and lipoxygenase inhibitors. Among the pharmacological strategies used for the management of Alzheimer's disease, natural drugs are considered a promising therapeutic strategy. Indeed, bioactive compounds isolated from different natural sources exhibit important anti-Alzheimer effects by their effectiveness in promoting neuroplasticity and protecting against neurodegeneration as well as neuroinflammation and oxidative stress in the brain. These effects involve different sub-cellular, cellular, and/or molecular mechanisms, such as the inhibition of acetylcholinesterase (AchE), the modulation of signaling pathways, and the inhibition of oxidative stress. Moreover, some nanoparticles were recently used as phytochemical delivery systems to improve the effects of phytochemical compounds against Alzheimer's disease. Therefore, the present work aims to provide a comprehensive overview of the key advances concerning nano-drug delivery applications of phytochemicals for Alzheimer's disease management.
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Affiliation(s)
- Saad Bakrim
- Geo-Bio-Environment Engineering and Innovation Laboratory, Molecular Engineering, Biotechnology and Innovation Team, Polydisciplinary Faculty of Taroudant, Ibn Zohr University, Agadir 80000, Morocco
| | - Sara Aboulaghras
- Physiology and Physiopathology Team, Faculty of Sciences, Genomic of Human Pathologies Research, Mohammed V University in Rabat, Rabat 10100, Morocco
| | - Naoual El Menyiy
- Laboratory of Pharmacology, National Agency of Medicinal and Aromatic Plants, Taounate 34025, Morocco
| | - Nasreddine El Omari
- Laboratory of Histology, Embryology and Cytogenetic, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat 10100, Morocco
| | - Hamza Assaggaf
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia
| | - Domenico Montesano
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, 80131 Naples, Italy
| | - Monica Gallo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Gokhan Zengin
- Department of Biology, Science Faculty, Selcuk University, 42130 Konya, Turkey
- Correspondence: (G.Z.); (Y.A.); (A.B.)
| | - Yusra AlDhaheri
- Department of Biology, College of Science, United Arab Emirates University, Al Ain 15551, United Arab Emirates
- Correspondence: (G.Z.); (Y.A.); (A.B.)
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat 10106, Morocco
- Correspondence: (G.Z.); (Y.A.); (A.B.)
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Sohn M, Yang J, Sohn J, Lee JH. Digital healthcare for dementia and cognitive impairment: A scoping review. Int J Nurs Stud 2022; 140:104413. [PMID: 36821951 DOI: 10.1016/j.ijnurstu.2022.104413] [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: 04/29/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cognitive disorders, such as Alzheimer's disease, are a global health problem. Digital healthcare technology is an innovative management tool for delaying the progression of dementia and mild cognitive impairment. Thanks to digital technology, the possibility of safe and effective care for patients at home and in the community is increasing, even in situations that threaten the continuity of care, such as the COVID-19 pandemic. However, it is difficult to select appropriate technology and alternatives due to the lack of comprehensive reviews on the types and characteristics of digital technology for cognitive impairment, including their effects and limitations. OBJECTIVE This study aims to identify the types of digital healthcare technology for dementia and mild cognitive impairment and comprehensively examine how its outcome measures were constructed in line with each technology's purpose. METHODS According to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines, a literature search was conducted in August 2021 using Medline (Ovid), EMBASE, and Cochrane library. The search terms were constructed based on Population-Concept-Context mnemonic: 'dementia', 'cognitive impairment', and 'cognitive decline'; digital healthcare technology, such as big data, artificial intelligence, virtual reality, robots, applications, and so on; and the outcomes of digital technology, such as accuracy of diagnosis and physical, mental, and social health. After grasping overall research trends, the literature was classified and analysed in terms of the type of service users and technology. RESULTS In total, 135 articles were selected. Since 2015, an increase in literature has been observed, and various digital healthcare technologies were identified. For people with mild cognitive impairment, technology for predicting and diagnosing the onset of dementia was studied, and for people with dementia, intervention technology to prevent the deterioration of health and induce significant improvement was considered. Regarding caregivers, many studies were conducted on monitoring and daily living assistive technologies that reduce the burden of care. However, problems such as data collection, storage, safety, and the digital divide persisted at different intensities for each technology type. CONCLUSIONS This study revealed that appropriate technology options and considerations may differ depending on the characteristics of users. It also emphasises the role of humans in designing and managing technology to apply digital healthcare technology more effectively.
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Affiliation(s)
- Minsung Sohn
- Division of Health and Medical Sciences, The Cyber University of Korea, Seoul, Republic of Korea
| | - JungYeon Yang
- Transdisciplinary Major in Learning Health Systems, Department of Public Health Science, Graduate School, Korea University, Republic of Korea
| | - Junyoung Sohn
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Jun-Hyup Lee
- Department of Health Policy and Management, College of Health Sciences, Korea University, Republic of Korea.
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Sun W, Bartfay E, Smye V, Biswas S, Newton D, Pepin M, Ashtarieh B. Living well with dementia: The role volunteer-based social recreational programs in promoting social connectedness of people with dementia and their caregivers. Aging Ment Health 2022; 26:1949-1962. [PMID: 34353187 DOI: 10.1080/13607863.2021.1950614] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objectives: This evaluation study was designed to examine the factors that contribute the promotion of social connectedness among people with dementia and their caregivers through social recreational programs; develop an understanding of volunteer's impact on program success; and identify the barriers and facilitators to improve the volunteer-based programs to promote social connectedness.Method: A qualitative descriptive research design was used to explore the study participants' lived experiences of social recreational programs from Alzheimer's Society of Durham Region (ASDR) in Ontario, Canada. A final sample of 31 participants was recruited including people with dementia, informal caregivers, and community volunteers. Qualitative data was collected through face-to-face semi-structured interviews. Emerging themes were derived from the qualitative descriptive data using thematic analysis.Results: The qualitative interviews highlighted the impact of social recreational programs on people with dementia, caregivers and volunteers in the promotion of social connectedness, as well as the examination of barriers and facilitators to identify opportunities for the future improvement of ASDR programs that would benefit the dementia populations. The study findings revealed that the project 'Living Well with Dementia' has been able to successfully foster social connectedness through its volunteer-led social recreational programs by promoting the physical and mental well-being of people with dementia and their caregivers.Conclusion: Our study findings underscored the critical roles of volunteers who contributed to the success of community-based programs. Future research is needed to identify the opportunities to address current gaps in services and to strengthen the social recreational programs using evidence-based practices and client-centered approaches.Supplemental data for this article can be accessed online at http://doi.org/10.1080/13607863.2021.1950614.
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Affiliation(s)
- Winnie Sun
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Emma Bartfay
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Victoria Smye
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Canada
| | - Srija Biswas
- Master of Science in Community, Public and Population Health, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | | | | | - Bahar Ashtarieh
- Bachelor of Science in Nursing, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
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Cammisuli DM, Cipriani G, Giusti EM, Castelnuovo G. Effects of Reminiscence Therapy on Cognition, Depression and Quality of Life in Elderly People with Alzheimer’s Disease: A Systematic Review of Randomized Controlled Trials. J Clin Med 2022; 11:jcm11195752. [PMID: 36233620 PMCID: PMC9570531 DOI: 10.3390/jcm11195752] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Patients with Alzheimer’s disease (AD) present with cognitive function deterioration, neuropsychiatric symptoms (NPS)—especially depression—and low quality of life (QoL). Management of AD remains difficult, especially in the elderly. Reminiscence therapy (RT) is a well-known cognitive rehabilitation intervention that can be adopted in nursing and residential care homes to restore autobiographical memory, ameliorate NPS, and improve the QoL of people with dementia. However, the evidence-based efficacy of RT for elderly patients with AD remains to be determined. Methods: Here, we synthesized findings of randomized controlled trials (RCTs) exploring the effects of RT on cognition, depression, and QoL in elderly people with AD, according to the most recent PRISMA statement. We searched for RCTs in PubMed, Web of Science, and Cochrane Central Register of Controlled Trials, and in trial registries (i.e., clinicaltrials.gov and International Clinical Trials Registry Platform of the World Health Organization). Two review authors extracted data of interest, with cognition, depression, and QoL measures as outcomes. Results: A total of five articles were included in the final analysis. Findings globally showed that RT, both administered in individual or group sessions at least once a week for 30–35 min over a period of 12 weeks, is effective in supporting global cognition, ameliorating depression, and improving specific aspects of the QoL in elderly people with AD. Conclusions: RT has the potential to be a routine non-pharmacological therapy for elderly people with AD, thanks to its wider effects on the individual in terms of cognitive vitality and emotional status promotion, with positive implications for patient’s daily life. Despite such evidences, caution should be used in findings’ generalizability in relation to the paucity of existing RCTs with long-term follow-up.
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Affiliation(s)
| | - Gabriele Cipriani
- Division of Neurology, Versilia Hospital, 55049 Lido di Camaiore, Italy
| | - Emanuele Maria Giusti
- Istituto Auxologico Italiano IRCCS, Clinical Psychology Research Laboratory, 28824 Verbania, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, 20123 Milan, Italy
- Istituto Auxologico Italiano IRCCS, Clinical Psychology Research Laboratory, 28824 Verbania, Italy
- Correspondence:
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Caramelli P, Marinho V, Laks J, Coletta MVD, Stella F, Camargos EF, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Chaves MLF, Brucki SMD, Nitrini R, Durgante HB, Bertolucci PHF. Treatment of dementia: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Dement Neuropsychol 2022. [DOI: 10.1590/1980-5764-dn-2022-s106en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
ABSTRACT There is currently no cure for neurodegenerative or vascular dementias, but some pharmacological and non-pharmacological interventions may contribute to alleviate symptoms, slow disease progression and improve quality of life. Current treatment approaches are based on etiology, symptom profile and stage of dementia. This manuscript presents recommendations on pharmacological and non-pharmacological treatments of dementia due to Alzheimer’s disease, vascular cognitive impairment, frontotemporal dementia, Parkinson’s disease dementia, and dementia with Lewy bodies.
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Affiliation(s)
| | | | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Brasil; Universidade do Estado do Rio de Janeiro, Brasil
| | | | - Florindo Stella
- Universidade Estadual Paulista, Brasil; Universidade de São Paulo, Brasil
| | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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11
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Caramelli P, Marinho V, Laks J, Coletta MVD, Stella F, Camargos EF, Smid J, Barbosa BJAP, Schilling LP, Balthazar MLF, Frota NAF, Souza LCD, Vale FAC, Chaves MLF, Brucki SMD, Nitrini R, Durgante HB, Bertolucci PHF. Tratamento da demência: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Dement Neuropsychol 2022; 16:88-100. [DOI: 10.1590/1980-5764-dn-2022-s106pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022] Open
Abstract
RESUMO Atualmente não há tratamento curativo para as demências neurodegenerativas ou para a demência vascular, mas algumas intervenções farmacológicas e não farmacológicas podem contribuir para aliviar os sintomas, retardar a progressão da doença e melhorar a qualidade de vida. As abordagens terapêuticas atuais são baseadas na etiologia, no perfil dos sintomas e no estágio da demência. Neste artigo apresentamos recomendações sobre os tratamentos farmacológicos e não farmacológicos da demência devida à doença de Alzheimer, comprometimento cognitivo vascular, demência frontotemporal, demência da doença de Parkinson e demência com corpos de Lewy.
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Affiliation(s)
| | | | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Brasil; Universidade do Estado do Rio de Janeiro, Brasil
| | | | - Florindo Stella
- Universidade Estadual Paulista, Brasil; Universidade de São Paulo, Brasil
| | | | | | - Breno José Alencar Pires Barbosa
- Universidade de São Paulo, Brasil; Universidade Federal de Pernambuco, Brasil; Instituto de Medicina Integral Prof. Fernando Figueira, Brasil
| | - Lucas Porcello Schilling
- Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil; Pontifícia Universidade do Rio Grande do Sul, Brasil
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Lanzi AM, Saylor AK, Cohen ML. Survey Results of Speech-Language Pathologists Working With Cognitive-Communication Disorders: Improving Practices for Mild Cognitive Impairment and Early-Stage Dementia From Alzheimer's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1653-1671. [PMID: 35605597 PMCID: PMC9531927 DOI: 10.1044/2022_ajslp-21-00266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/06/2021] [Accepted: 02/22/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE As the incidence of Alzheimer's disease (AD) continues to rise, there is a need for interventions that focus on risk reduction and early disease management. Speech-language pathologists (SLPs) can contribute to risk reduction efforts and deliver cognitive interventions; however, the nature and frequency of current clinical practice in those areas is unclear. Therefore, the purpose of this study was to conduct an exploratory survey of the cognitive-communication practices and needs of SLPs for adults with mild cognitive impairment (MCI) and early-stage dementia from AD, to inform future research and clinical training efforts. METHOD SLPs completed an online survey that assessed five areas of practice specific to cognitive-communication and MCI and early-stage dementia: (a) education and training, (b) MCI subtype knowledge and consideration, (c) goals and treatment practices, (d) assessment of everyday living skills, and (e) general clinical practices and needs. RESULTS One hundred fifty-seven SLPs completed the survey and represented a range of practice experience. Results revealed a discrepancy between the number of SLPs who provide services to adults with MCI or early-stage dementia and those who have received formal training to do so, suggesting a reliance on clinical practice experience. Participants primarily reported using interview and informal methods to assess daily activities and often described using compensatory-based treatments. CONCLUSIONS These findings contribute to the limited knowledge about SLPs' cognitive-communication practices to help improve early-disease management for AD, a rapidly growing population in need of SLPs' services. More research is needed to support SLPs in being maximally effective when working with clients early in the AD continuum. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19787728.
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Affiliation(s)
- Alyssa M. Lanzi
- Department of Communication Sciences & Disorders, University of Delaware, Newark
| | - Anna K. Saylor
- Department of Communication Sciences & Disorders, University of Delaware, Newark
| | - Matthew L. Cohen
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
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Assess of Combinations of Non-Pharmacological Interventions for the Reduction of Irritability in Patients with Dementia and their Caregivers: A Cross-Over RCT. Brain Sci 2022; 12:brainsci12060691. [PMID: 35741577 PMCID: PMC9221291 DOI: 10.3390/brainsci12060691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction: Dementia is a very common disorder that affects people over 65 years old all over the world. Apart from the cognitive decline, Behavioral and Psychological Symptoms of Dementia (BPSD) are a crucial matter in dementia, because they affect up to 90% of the patients during the course of their illness. Irritability has been found to be a common BPSD and one of the most distressing behaviors for the caregivers. The aim of the current study was to explore the efficacy of a combination of non-pharmacological interventions to treat irritability. Methods: Sixty patients with different types and stages of dementia with irritability were participated in a cross-over RCT. Three non-pharmacological interventions were used; (a) Validation Therapy (VT)/Psycho-educational program, (b) Aromatherapy/massage and (c) Music Therapy (MT). The study assessed the three non-pharmacological interventions in order to find the most effective combination of the interventions. This study did not compare pharmacological and non-pharmacological treatments. The interventions lasted for five days. There was no drop-out rate. All patients were assessed at baseline using Mini Mental State of Examination (MMSE), Addenbrooke’s Cognitive Examination Revised (ACE-R), Geriatric Depression Scale (GDS), Functional Rating Scale for symptoms in dementia (FRSSD), and Neuropsychiatric Inventory (NPI) (sub questions for irritability). Only NPI used for the assessment after each intervention. The analyses used categorical variables, Wilcoxon signed-rank test, Chi-square test and z value score. Results: The most effective combination of non-pharmacological interventions was Aromatherapy/massage (p = 0.003)-VT plus Psycho-educational program (p = 0.014) plus MT (p = 0.018). The same combination was the most effective for the caregivers’ burden, too (p = 0.026). Conclusions: The above combination of non-pharmacological interventions can reduce irritability in patients with dementia and caregivers’ burden.
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Cammisuli DM, Cignoni F, Ceravolo R, Bonuccelli U, Castelnuovo G. Transcranial Direct Current Stimulation (tDCS) as a Useful Rehabilitation Strategy to Improve Cognition in Patients With Alzheimer's Disease and Parkinson's Disease: An Updated Systematic Review of Randomized Controlled Trials. Front Neurol 2022; 12:798191. [PMID: 35185754 PMCID: PMC8847129 DOI: 10.3389/fneur.2021.798191] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022] Open
Abstract
Alzheimer's disease (AD) and Parkinson's disease (PD) are neurodegenerative disorders characterized by cognitive impairment and functional decline increasing with disease progression. Within non-pharmacological interventions, transcranial direct current stimulation (tDCS) might represent a cost-effective rehabilitation strategy to implement cognitive abilities with positive implications for functional autonomy and quality-of-life of patients. Our systematic review aimed at evaluating the effects of tDCS upon cognition in people suffering from AD and PD. We searched for randomized controlled trials (RCTs) into PubMed, Web of Science, and Cochrane Library. Three review authors extracted data of interest, with neuropsychological tests or experimental cognitive tasks scores as outcome measures. A total of 17 RCTs (10 trials for AD and 7 trials for PD) were included. Compared with sham stimulation, tDCS may improve global cognition and recognition memory in patients with AD and also some executive functions (i.e., divided attention, verbal fluency, and reduction of sensitivity to interference) in patients with PD. Criticism remains about benefits for the other investigated cognitive domains. Despite preliminary emerging evidences, larger RCTs with common neuropsychological measures and long-term follow-ups establishing longevity of the observed effects are necessary for future research in applied psychology field, alongside improved clinical guidelines on the neurodegenerative disorders pertaining electrodes montage, sessions number, duration and intensity of the stimulation, and cognitive battery to be used.
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Affiliation(s)
| | - Fabio Cignoni
- Neurological Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
- *Correspondence: Gianluca Castelnuovo ;
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Manera V, Agüera-Ortiz L, Askenazy F, Dubois B, Corveleyn X, Cross L, Febvre-Richards E, Fabre R, Fernandez N, Foulon P, Gros A, Gueyraud C, Lebourhis M, Malléa P, Martinez L, Pancrazi MP, Payne M, Robert V, Tamagno L, Thümmler S, Robert P. In-Person and Remote Workshops for People With Neurocognitive Disorders: Recommendations From a Delphi Panel. Front Aging Neurosci 2022; 13:747804. [PMID: 35126087 PMCID: PMC8814601 DOI: 10.3389/fnagi.2021.747804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/07/2021] [Indexed: 12/01/2022] Open
Abstract
Workshops using arts and board games are forms of non-pharmacological intervention widely employed in seniors with neurocognitive disorders. However, clear guidelines on how to conduct these workshops are missing. The objective of the Art and Game project (AGAP) was to draft recommendations on the structure and content of workshops for elderly people with neurocognitive disorders and healthy seniors, with a particular focus on remote/hybrid workshops, in which at least a part of the participants is connected remotely. Recommendations were gathered using a Delphi methodology. The expert panel (N = 18) included experts in the health, art and/or board games domains. They answered questions via two rounds of web-surveys, and then discussed the results in a plenary meeting. Some of the questions were also shared with the general public (N = 101). Both the experts and the general public suggested that organizing workshops in a hybrid format (some face-to-face sessions, some virtual session) is feasible and interesting for people with neurocognitive disorders. We reported guidelines on the overall structure of workshops, practical tips on how to organize remote workshops, and a SWOT analysis of the use of remote/hybrid workshops. The guidelines may be employed by clinicians to decide, based on their needs and constraints, what interventions and what kind of workshop format to employ, as well as by researcher to standardize procedures to assess the effectiveness of non-pharmacological treatments for people with neurocognitive disorders.
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Affiliation(s)
- Valeria Manera
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- *Correspondence: Valeria Manera,
| | - Luis Agüera-Ortiz
- Servicio de Psiquiatría, Instituto de Investigación (i + 12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Florence Askenazy
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- University Department of Child and Adolescent Psychiatry, Children’s Hospitals of Nice CHU-Lenval, Nice, France
| | - Bruno Dubois
- Institut de la mémoire et de la Maladie d’Alzheimer (IM2A), INSERM, U1127, AP-HP, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France
- Institut du Cerveau et de la Moelle Épinière (ICM), INSERM, U1127, AP-HP, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Xavier Corveleyn
- Laboratoire d’Anthropologie et de Psychologie Cliniques, Cognitives et Sociales (LAPCOS), Université Côte d’Azur, Nice, France
- Maison des Sciences de l’Homme et de la Société Sud-Est (MSHS Sud-Est), Nice, France
| | - Liam Cross
- Department of Psychology, Edge Hill University, Liverpool, United Kingdom
| | - Emma Febvre-Richards
- Whiti o Rehua School of Art, College of Creative Arts, Massey University, Wellington, New Zealand
| | - Roxane Fabre
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- Public Health Department, Nice University Hospital, Côte d’Azur University, Nice, France
| | | | - Pierre Foulon
- GENIOUS Healthcare–Mindmaze Group Co., Lausanne, Switzerland
| | - Auriane Gros
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
| | - Cedric Gueyraud
- Centre National de Formation aux Métiers du Jeu et du Jouet (FM2J), Caluire-et-Cuire, France
| | | | | | - Léa Martinez
- Asmodee Research, Asmodee, Guyancourt, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Université de Poitiers, Poitiers, France
| | | | - Magali Payne
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d’Azur, Nice, France
- Centre Mémoire de Ressources et de Recherche, Université Côte d’Azur, Nice, France
| | | | | | - Susanne Thümmler
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- University Department of Child and Adolescent Psychiatry, Children’s Hospitals of Nice CHU-Lenval, Nice, France
| | - Philippe Robert
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d’Azur, Nice, France
- Centre Mémoire de Ressources et de Recherche, Université Côte d’Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
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Thoft DS, Ottesen AC, Jensen AM, Ward A. Assessing people with dementia participating in cognitive stimulation activities-A qualitative pilot video analysis exploring the importance of facilitating the participation. Health Expect 2021; 24:1524-1534. [PMID: 34114709 PMCID: PMC8369123 DOI: 10.1111/hex.13300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This pilot video analysis was part of a feasibility control study, which aimed to gain information about the size and variability of the changes in outcome measures to plan a substantive effect study. It compared a cognitive stimulation programme named Lifelong Learning with other existing dementia services. OBJECTIVE The pilot video analysis explored how facilitation is performed, when assessing people with dementia with standardized measures, to ensure their participation in research. DESIGN A test battery of five measures (Mini-Mental State Examination (MMSE), Quality of Life in Alzheimer's Disease Scale (QoL-AD), General Self-Efficacy Scale, Rosenberg Self-Esteem Scale and Hawthorn Friendship Scale) was used. Each assessment was video-recorded. The findings from a microanalysis of 10 videos are presented in this article. SETTING The study involved 55 active participants with mild-to-moderate dementia in six municipalities in Northern Denmark. RESULTS The identified themes related to supportive facilitation: Positive facilitator strategies; Creating a safe and comfortable environment; and to dilemmas in facilitation: Balancing multiple dilemmas and Balancing the MMSE test. DISCUSSION Results are discussed in relation to using standardized measures. CONCLUSION The quality of facilitation when using standardized measures is of great importance as it may influence the participant, the assessment and the answers given. The facilitation role needs to be thoroughly planned and executed with ethical consideration to improve the participation of vulnerable groups in research and ensure a person-centred approach. PATIENT OR PUBLIC CONTRIBUTION The identified measures were chosen based upon previous qualitative results and user-involvement workshops with people with dementia.
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Sittler MC, Worschech F, Wilz G, Fellgiebel A, Wuttke-Linnemann A. Psychobiological mechanisms underlying the health-beneficial effects of music in people living with dementia: A systematic review of the literature. Physiol Behav 2021; 233:113338. [DOI: 10.1016/j.physbeh.2021.113338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/23/2020] [Accepted: 01/21/2021] [Indexed: 01/06/2023]
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Pérez-Ros P, Cubero-Plazas L, Mejías-Serrano T, Cunha C, Martínez-Arnau FM. Preferred Music Listening Intervention in Nursing Home Residents with Cognitive Impairment: A Randomized Intervention Study. J Alzheimers Dis 2020; 70:433-442. [PMID: 31177232 DOI: 10.3233/jad-190361] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The current trend in addressing symptoms of dementia comprises non-pharmacological strategies such as music interventions for the management and improvement of cognitive function, memory, agitation, depression, or anxiety. OBJECTIVE To determine the impact of a preferred music listening group intervention upon the functional, cognitive, and emotional dimensions in nursing home residents. METHODS A randomized intervention study was carried out. The study was conducted from June to August 2015, and involved a preferred music listening group intervention lasting 60 minutes, 5 days/week during 8 weeks. A total of 119 adults aged ≥65 years, with annual permanent residence in the nursing home (Málaga, Spain) were included in the study. 47 (39.5%) subjects were randomized to the music group intervention. The nurses and physiotherapists were blinded to the assessments. RESULTS The sample had a mean age of 80.52 (SD7.44) years, with female predominance. The subjects presented dependency in Barthel, and cognitive impairment as determined by the MMSE. The Tinetti scores yielded fall risk and depression as evidenced by the Yesavage scale. The Cornell scores evidenced no depression in elderly people with dementia. Following the intervention, function improved significantly with a medium effect size, as did emotional state, with a large effect size. Cognitive function was seen to worsen in the control group, but remained stable in the intervention group, with a large effect size. CONCLUSIONS A preferred music listening group intervention among elderly people in nursing homes is effective, resulting in improvements in functional and emotional condition.
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Affiliation(s)
- Pilar Pérez-Ros
- Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, Valencia, Spain
| | - Laura Cubero-Plazas
- Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, Valencia, Spain
| | - Trinidad Mejías-Serrano
- Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, Valencia, Spain
| | - Cristina Cunha
- Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, Valencia, Spain
| | - Francisco M Martínez-Arnau
- Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Espartero 7, Valencia, Spain.,Department of Physiotherapy, Universidad de Valencia, Gascó Oliag 5, Valencia, Spain
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Quail Z, Carter MM, Wei A, Li X. Management of cognitive decline in Alzheimer's disease using a non-pharmacological intervention program: A case report. Medicine (Baltimore) 2020; 99:e20128. [PMID: 32481282 PMCID: PMC7249940 DOI: 10.1097/md.0000000000020128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In China, the over 60 population is estimated to grow from 12% in 2010 to 33% of the overall population by 2050. The escalation in the aging population is projected to result in an Alzheimer's disease prevalence of 27.7 million people in China by 2050 causing substantial health and economic burden. While there are some published studies on multicomponent, non-pharmacological interventions for people with dementia, we have found no published community-based approach to care that encompasses personalized selection of non-pharmacological interventions, active social participation, and dementia education. PATIENT CONCERNS An elderly female living at home alone in urban Beijing presented with significant short-term memory impairment, episodes of confusion, difficulty with language skills, and episodes of wandering. She had become reclusive and disengaged from her previous social networks, and no longer attended any community activities or events. The patient had no significant past medical or psychiatric history. DIAGNOSIS The patient was diagnosed with Alzheimer's disease by a local physician based on clinical features of impaired communication, disorientation, confusion, poor judgement, behavioral changes, and difficulty speaking. Depression was considered a differential diagnosis but is also both a risk factor and symptom of dementia. INTERVENTIONS A novel, community-based, multicomponent social care program for dementia was used to facilitate implementation of non-pharmacological interventions, gradual socialization and provide supportive carer and community education. Non-pharmacological interventions included a combination of validation therapy, music therapy, art therapy, reminiscence therapy, talking therapy, reality orientation, cognitive training, smell therapy, food therapy, sensory stimulation, garden therapy, and physiotherapy. OUTCOMES Improvements in the patient's Geriatric Depression Scale and Mini Mental State Examination scores were noted in association with increased social participation in the community. CONCLUSION The community-based, multicomponent dementia social care program described in this case report has enabled a socially isolated patient with Alzheimer's disease to reduce her social isolation with an associated improvement in her mood and prevention of cognitive decline. Educating the community was an essential part of re-integrating the patient into the social setting. Reducing social isolation and increasing community engagement were essential to maintaining the patient's independence in her own home.
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Affiliation(s)
- Zara Quail
- Care Visions Limited, Stirling, Scotland, UK
| | - Mark Mclean Carter
- Care Visions Limited, Stirling, Scotland, UK
- Care Visions China, Beijing, China
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Abstract
In China, the ageing population and the prevalence of dementia are projected to escalate significantly by 2050 resulting in a substantial increase in health and economic burden on caregivers, healthcare facilities, healthcare providers and communities. There is no published national dementia policy or strategy in China. This case report describes significant barriers contributing to diagnostic problems and inadequate care of dementia through the case of an older female in rural China, whose condition deteriorated due to neuropsychiatric and functional symptoms of undiagnosed dementia. Intersectoral collaboration between care organisations facilitated delivery of a non-pharmacological intervention programme which was associated with improvements in the patient’s functional and neuropsychiatric symptoms. The case demonstrates that recruitment and training of a wider range of health and care professionals and caregivers in a systematic approach to non-pharmacological interventions could help overcome barriers to the specialised care needs of people with dementia where resources are lacking.
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Affiliation(s)
- Zara Quail
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, Scotland, UK
| | - Angelina Wei
- Care Visions Dementia Services, Care Visions China, Beijing, China
| | - Vicky Fan Zhang
- Care Visions Dementia Services, Care Visions China, Beijing, China
| | - Mark McLean Carter
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, Scotland, UK .,Care Visions Dementia Services, Care Visions China, Beijing, China
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21
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Chao ICI, Nicpon K, Roduta Roberts M. Effect of Cognitive Stimulation Therapy on Quality of Life: A Critical Review. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1716915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Iris C. I. Chao
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Katarzyna Nicpon
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Carter M, Quail Z, Bourke A, Young C. A Structured Cognitive Intervention Pathway as a decision-support tool for non-pharmacological interventions within a dementia care service (Innovative practice). DEMENTIA 2019; 20:398-409. [PMID: 31707842 PMCID: PMC7940799 DOI: 10.1177/1471301219886243] [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] [Indexed: 11/15/2022]
Abstract
Individual cognitive interventions for Alzheimer's disease have been shown to be beneficial and cost effective when evaluated as sole interventions. However, there is a need for a systematic, person-centric, structured approach to guide non-pharmacological intervention selection based on disease stage, symptoms, outcome assessment, and individual requirements. Our Structured Cognitive Intervention Pathway aims to facilitate the selection of first-line, or subsequent, non-pharmacological management for people with Alzheimer's disease living at home and in elderly care facilities. We discuss the Pathway's conceptual basis and evaluation of implementation as a decision-support tool within a dementia care service in China.
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Affiliation(s)
- Mark Carter
- Care Visions China, Beijing, China; Care Visions, Stirling, Scotland
| | | | | | - Charles Young
- Care Visions, Stirling, Scotland; Guys and St Thomas NHS Foundation Trust, London, UK; Wiley, London, UK; Capita plc, London, UK
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Packer R, Ben Shlomo Y, Whiting P. Can non-pharmacological interventions reduce hospital admissions in people with dementia? A systematic review. PLoS One 2019; 14:e0223717. [PMID: 31634375 PMCID: PMC6802851 DOI: 10.1371/journal.pone.0223717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/26/2019] [Indexed: 12/21/2022] Open
Abstract
Background People with dementia who are admitted to hospital have worse outcomes than those without dementia. Identifying interventions that could reduce the risk of hospitalisation in people with dementia has the potential to positively impact on lives of people with dementia. This review aimed to investigate whether there are non-pharmacological interventions that successfully reduce hospitalisation risk, length of stay and mortality in people with dementia. Methods 7 electronic databases and trial registries were searched from inception to October 2018. We included randomised controlled trials that evaluated non-pharmacological interventions in out of hospital settings and targeted people with any type of dementia. All stages of the review process were performed by two reviewers. Risk of bias was assessed using the Cochrane Risk of Bias tool. We grouped studies based on intervention: care management, counselling/self-help, enhanced GP services or memory clinics, and physiotherapy or occupational therapy. Data were pooled within intervention categories using random effects meta-analysis. Results There was no evidence that any of the intervention categories were associated with reduced hospital admission or mortality. There was very weak evidence to suggest that care management interventions (mean difference, MD, -0.16, 95% CI -0.32, 0.01), physiotherapy/occupational therapy (MD -0.16, 95% CI -0.36, 0.03) and enhanced GP/memory clinics (MD -0.14, 95% CI -0.31, 0.03) were associated with small reductions in hospital stay. There was no evidence for an effect of counselling/self-help interventions on length of hospital stay. Conclusions Current evidence from randomised trials suggests no clear benefit or harm associated with any of interventions on risks of hospitalisation, duration of hospitalisation or death. Further research with the primary aim to reduce hospitalisation in people with dementia is required.
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Affiliation(s)
- Richard Packer
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Yoav Ben Shlomo
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Penny Whiting
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- * E-mail:
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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: 34] [Impact Index Per Article: 6.8] [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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Carter MM, Wei A, Li X. An individualised, non-pharmacological treatment strategy associated with an improvement in neuropsychiatric symptoms in a man with dementia living at home. BMJ Case Rep 2019; 12:12/5/e229048. [PMID: 31076493 PMCID: PMC6536240 DOI: 10.1136/bcr-2018-229048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
More than 90% of people with dementia experience neuropsychiatric symptoms which are often distressing and can result in early institutionalisation, diminished quality of life, increased frequency of emergency department visits along with stress and ill-health in caregivers. Non-pharmacological interventions are recommended as first-line treatment for neuropsychiatric symptoms, instead of medications such as atypical antipsychotics which have significant side effects. Most systematic reviews of non-pharmacological interventions for neuropsychiatric symptoms of dementia focus on patients in long-term care facilities and there are a limited number of research studies assessing the use of non-pharmacological interventions for patient’s living at home. In this case report, we discuss an elderly man with dementia whose cognitive symptoms were accompanied by significant neuropsychiatric symptoms of suspicion, delusions, agitation and aggression. We describe how a programme of individualised, non-pharmacological interventions was associated with an improvement in neuropsychiatric symptoms within 3 months.
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Affiliation(s)
- Mark McLean Carter
- Dementia Services, Care Visions China, Beijing, China.,Care Visions Dementia Care, Care Visions, Stirling, UK
| | - Angelina Wei
- Dementia Services, Care Visions China, Beijing, China
| | - Xinlei Li
- Dementia Services, Care Visions China, Beijing, China
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Boronat AC, Ferreira-Maia AP, Wang YP. Sundown Syndrome in Older Persons: A Scoping Review. J Am Med Dir Assoc 2019; 20:664-671.e5. [PMID: 31043358 DOI: 10.1016/j.jamda.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To map comprehensive investigations of the sundown syndrome (SS), highlighting its key definition and associated characteristics. DESIGN Scoping review of published articles on SS in PubMed, OVID, EMBASE, Scopus, CINAHL, and Science Direct. SETTING Post-acute and long-term health care settings. PARTICIPANTS Older adults aged ≥60 years. MEASURES Articles must present primary data on specific SS behavior, with explicit psychopathological and quantitative outcomes; and/or evening disruptive behavior. RESULTS From a total number of 460 articles focusing on psychopathology and standardized outcomes of SS, 23 were retained for the final analysis (n = 1210 subjects). The mean age of participants was 63.2 years, and slightly more participants were women. The samples were recruited by convenience from long-term care facilities and tertiary outpatient clinics. The frequency of SS varied from 2% to 82%, without evident difference between genders and race/ethnicity. Generally, the sundown episode occurred during later daytime, when psychomotor alterations and cognitive disturbance manifested repeatedly. The symptomatic manifestations of SS were heterogeneous across the studies. Demographic risk factors were inconsistent. Although some authors have viewed cognitive impairment as a substantive predisposing factor to SS, others supported SS as a predictor of looming cognitive decline. The disrupted circadian rhythm was the most accepted pathophysiology. To date, clinical trials to guide the management of SS with specific pharmacologic and nonpharmacologic approaches are scant. CONCLUSIONS AND IMPLICATIONS SS can be viewed as a cyclic delirium-like condition affecting the older population around the sunset hour that may last for a few hours. The scarcity of comprehensive studies makes it difficult to determine whether and to what extent it can represent a distinct disease, a prodromal stage of dementia, or an epiphenomenon of incipient or worsening dementia. Extensive gathering of clinical data from multiple health care settings, using uniform measurement tools, is much needed.
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Affiliation(s)
- Alexandre C Boronat
- Instituto de Psiquiatria (LIM-23), Hospital das Clinicas HC FMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ana Paula Ferreira-Maia
- Instituto de Psiquiatria (LIM-23), Hospital das Clinicas HC FMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Yuan-Pang Wang
- Instituto de Psiquiatria (LIM-23), Hospital das Clinicas HC FMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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Mendelevich EG. Alzheimer's disease: some pharmacological and non-pharmacological approaches to correcting neuropsychiatric disorders. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2018. [DOI: 10.14412/2074-2711-2018-3-129-134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Today, there is no reliable pharmacological correction of dementia, despite its high prevalence worldwide. The clinical presentation of Alzheimer's disease at one or another stage is accompanied by neuropsychiatric disorders (NPDs) in addition to cognitive defect. The intensity and range of NPDs are different. The possibilities of drug therapy for NPDs are demonstrated. The role of akatinol memantine in correcting a number of psychological and behavioral disorders is highlighted. Biological, psychological, social, and environmental factors are identified among those that contribute to or provoke the development of NPDs. Knowledge of the triggers of mental disorders makes it possible to prevent and thereby reduce or eliminate NPDs. Special emphasis is laid on the patient-caregiver relationship. In recent years, non-pharmacological interventions have been increasingly used as priority-line therapy for NPDs. There are data on main methods for non-pharmacological correction and on the efficiency of their application.
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Affiliation(s)
- E. G. Mendelevich
- Kazan State Medical University, Kazan, Republic of Tatarstan, Russia 49, Butlerov St., Kazan, Republic of Tatarstan
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Cipriani G, Danti S, Carlesi C, Di Fiorino M. Aging With Down Syndrome: The Dual Diagnosis: Alzheimer's Disease and Down Syndrome. Am J Alzheimers Dis Other Demen 2018; 33:253-262. [PMID: 29504408 PMCID: PMC10852513 DOI: 10.1177/1533317518761093] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND People with Down syndrome (DS) enjoy a longer life expectancy now than they ever have before and are therefore at greater risk of developing conditions associated with aging, including dementia. OBJECTIVES To explore the phenomenon of dementia in DS. METHODS Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published until 2017. Search terms included Alzheimer's disease, cognitive impairment, dementia, DS, and trisomy 21. Publications found through this indexed search were reviewed for further references. RESULTS AND CONCLUSIONS Virtually, all subject aged 35 to 40 show key neuropathologic changes characteristic of Alzheimer's disease, but only a part of them show clinical signs of dementia, usually around the age of 50 years. Early signs of dementia in people with DS may be different from those experienced by the general population. Failure to recognize this can delay diagnosis and subsequent interventions.
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Affiliation(s)
- Gabriele Cipriani
- Neurology Unit, Hospital of Versilia, Lido di Camaiore, Lucca (LU), Italy
- Psychiatry Unit, Hospital of Versilia, Lido di Camaiore, Lucca (Lu), Italy
| | - Sabrina Danti
- Clinical and Health Psychology Unit, Hospital of Pontedera, Pontedera (PI), Italy
| | - Cecilia Carlesi
- Neurology Unit, Hospital of Versilia, Lido di Camaiore, Lucca (LU), Italy
| | - Mario Di Fiorino
- Psychiatry Unit, Hospital of Versilia, Lido di Camaiore, Lucca (Lu), Italy
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Scales K, Zimmerman S, Miller SJ. Evidence-Based Nonpharmacological Practices to Address Behavioral and Psychological Symptoms of Dementia. THE GERONTOLOGIST 2018; 58:S88-S102. [PMID: 29361069 PMCID: PMC5881760 DOI: 10.1093/geront/gnx167] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives To draw from systematic and other literature reviews to identify, describe, and critique nonpharmacological practices to address behavioral and psychological symptoms of dementia (BPSDs) and provide evidence-based recommendations for dementia care especially useful for potential adopters. Research Design and Methods A search of systematic and other literature reviews published from January 2010 through January 2017. Nonpharmacological practices were summarized to describe the overall conceptual basis related to effectiveness, the practice itself, and the size and main conclusions of the evidence base. Each practice was also critically reviewed to determine acceptability, harmful effects, elements of effectiveness, and level of investment required, based on time needed for training/implementation, specialized care provider requirements, and equipment/capital requirements. Results Nonpharmacological practices to address BPSDs include sensory practices (aromatherapy, massage, multi-sensory stimulation, bright light therapy), psychosocial practices (validation therapy, reminiscence therapy, music therapy, pet therapy, meaningful activities), and structured care protocols (bathing, mouth care). Most practices are acceptable, have no harmful effects, and require minimal to moderate investment. Discussion and Implications Nonpharmacological practices are person-centered, and their selection can be informed by considering the cause and meaning of the individual's behavioral and psychological symptoms. Family caregivers and paid care providers can implement evidence-based practices in home or residential care settings, although some practices require the development of more specific protocols if they are to become widely used in an efficacious manner.
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Affiliation(s)
| | - Sheryl Zimmerman
- School of Social Work, The University of North Carolina at Chapel Hill
- Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill
| | - Stephanie J Miller
- Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill
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It is not only memory: effects of sensecam on improving well-being in patients with mild alzheimer disease. Int Psychogeriatr 2017; 29:741-754. [PMID: 28124633 DOI: 10.1017/s104161021600243x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive interventions (either restorative or compensatory) developed for mild Alzheimer's Disease (AD) have been tested widely with cognitive measures, but less is known about how the effects of such interventions are generalizable to daily functioning. In the present study, we looked at affective state and perceived functionality and quality of life indicators, for three different cognitive rehabilitation programs. METHODS Fifty-one AD patients in the mild stage of the disease were selected for the study and were randomly assigned to one of three cognitive training groups: (1) Memo+ (a paper and pencil memory training program); (2) SenseCam (wearable camera used as a passive external memory aid); (3) Written diary (a personal journal, used as control condition). All patients attended 11 sessions, twice a week, of 1-hour length. The three outcome indicators were examined with standardized instruments applied before the intervention, one week after and at six months follow-up. RESULTS After treatment, the SenseCam and Memo+ groups had significantly reduced depressive symptoms compared to the Diary control condition. The same was found for measures of perceived functional capacity. No intervention effects were found for quality of life measures. The immediate effects of the interventions were not maintained at follow-up. CONCLUSIONS Our results suggest that two types of memory rehabilitation can improve depressive symptomology and instrumental activities of daily living, suggesting that these interventions can stimulate not only cognition but also well-being, at least in the short term.
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Stewart DB, Berg-Weger M, Tebb S, Sakamoto M, Roselle K, Downing L, Lundy J, Hayden D. Making a Difference: A Study of Cognitive Stimulation Therapy for Persons with Dementia. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2017; 60:300-312. [PMID: 28409672 DOI: 10.1080/01634372.2017.1318196] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Affecting nearly 5.4 million older adults in the United States and 35.6 million individuals worldwide, dementia is one of the greatest public health crises of our time. As a result, helping professionals, clients, and care partners seek effective and affordable treatment. Developed in the United Kingdom by Spector and colleagues, Cognitive Stimulation Therapy (CST) is a non-pharmacologic psychosocial group intervention for persons with dementia. To expand upon and fill the gaps within existing research, the authors developed a descriptive study to assess the impact of CST on cognition, quality of life, and depression, among six CST groups (n = 40). A paired sample t-test was run among pre- and post-test measures. There was a statistically significant difference in Saint Louis University Mental Status Exam (SLUMS) scores after CST (t = 2.80, p = 0.008). There was also a statistically significant difference in Cornell Scale for Depression in Dementia scores (t = -3.36, p = 0.002). There was no statistically significant difference in Quality of Life scores.
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Affiliation(s)
- Daniel B Stewart
- a Saint Louis University School of Social Work , St. Louis , Missouri , USA
| | - Marla Berg-Weger
- a Saint Louis University School of Social Work , St. Louis , Missouri , USA
| | - Susan Tebb
- a Saint Louis University School of Social Work , St. Louis , Missouri , USA
| | - Michele Sakamoto
- a Saint Louis University School of Social Work , St. Louis , Missouri , USA
| | - Kristina Roselle
- a Saint Louis University School of Social Work , St. Louis , Missouri , USA
| | - Laura Downing
- a Saint Louis University School of Social Work , St. Louis , Missouri , USA
| | - Janice Lundy
- b Department of Social Work and Geriatric Care Management , Perry County Memorial Hospital , Perryville , Missouri , USA
| | - Deborah Hayden
- b Department of Social Work and Geriatric Care Management , Perry County Memorial Hospital , Perryville , Missouri , USA
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