Can we reduce the stigmatisation experience with psychosocial interventions? An investigation of the meeting centre support programme impact on people with cognitive impairments

Introduction

People living with dementia or mild cognitive impairment (MCI) experience stigmatisation and there are not many specific psychosocial interventions dedicated to help them coping with this issue, reducing its impact on their lives.

Objectives

This study aimed to a) investigate the stigmatisation level among people with dementia and MCI in Poland, Italy and the United Kingdom and b) assess the role of the Meeting Centre Support Programme (MCSP) in decreasing stigmatisation.

Methods

We investigated outcomes for 114 people with dementia and MCI living in Italy, Poland and the UK who participated 6 months in MCSP or usual care (UC) using a pre/post-test control group study design. Level of stigmatisation was assessed with the Stigma Impact Scale: neurological impairment (SIS).

Results

Stigmatisation level (SIS) among participants varied from 2 to 65 (median=33.5; Q1=27; Q3=41) with people from the UK experiencing a statistically significantly higher level of stigmatisation than people in Italy and Poland. In Italy, stigmatisation was lower (p=0.02) in the MCSP group following the intervention. In Poland, the social isolation level did not significantly change in MCSP, but increased (p=0.05) in UC. In the UK, the social rejection level raised (p=0.03) in MCSP. Overall, the combined data of the three countries did not show statistically significant differences in SIS between MCSP and UC.

Conclusions

Stigmatisation among people with dementia and MCI is complex and seems culturally dependent. There is a great opportunity in psychosocial interventions to reduce the burden of stigma among people with dementia which requires further investigation.

Disclosure

No significant relationships.

The psychological burden of long-term care facilities personnel during the SARS-COV-2 pandemic – a national survey in poland

Introduction

The high COVID-19 morbidity and mortality are observed among residents in long-term care facilities (LTCF) worldwide. Employees of LTCF, who are facing a critical epidemiological situation endangering the vulnerable residents, are exposed to pandemic’s psychological consequences daily.

Objectives

The main aim of this study was to assess psychological consequences (somatic symptoms, anxiety and insomnia, social dysfunction, and depression) among LTCF employees exposed to the SARS-CoV-2 pandemic crisis. Moreover, we investigated if factors such as: personal protective equipment (PPE) availability, safety guidelines or access to psychiatric and psychological support at the workplace, correlated with the level of psychological distress experienced by personnel.

Methods

A cross-sectional study was conducted among personnel of LTCF in Poland. The survey consisted of the sociodemographic section, the authors’ questionnaire with questions related to COVID-19 exposure, working conditions, access to PPE and mental health services, GHQ Questionnaire-28.

Results

show that access to PPE (P= .018), to workplace safety guidelines (P= .031), psychological support at workplace (P<0.01), fixed shift schedule (P= .05) and feeling that the right number of staff are employed in the workplace (P= .009), were related to the lower severity of psychopathological symptoms evaluated with the GHQ-28.

Conclusions

The study indicates an evidence that LTCF personnel are susceptible to the development of anxiety, depression, insomnia and social dysfunction during the pandemic crisis. However, these can be modified by: access to PPE, safety guidelines and psychological support. Findings from this study lay a basis for effective interventions aiming to support psychological health within this group.

Comparison of the adaptive implementation and evaluation of the Meeting Centers Support Program for people with dementia and their family carers in Europe; study protocol of the MEETINGDEM project

Background

The MEETINGDEM study aims to implement and evaluate an innovative, inclusive, approach to supporting community dwelling people with mild to moderate dementia and their family carers, called the Meeting Centers Support Program (MCSP), in three countries in the European Union (EU): Italy, Poland and United Kingdom. Demonstrated benefits of this person-centered approach, developed in The Netherlands, include high user satisfaction, reduced behavioral and mood problems, delayed admission to residential care, lower levels of caregiving-related stress, higher carer competence, and improved collaboration between care and welfare organizations.

Methods

The project will be carried out over a 36 month period. Project partners in the three countries will utilize, and adapt, strategies and tools developed in the Netherlands. In Phase One (month 1-18) activities will focus on establishing an initiative group of relevant organizations and user representatives in each country, exploring pathways to care and potential facilitators and barriers to implementing the program, and developing country specific implementation plans and materials. In Phase Two (month 19‑36) training will be provided to organizations and staff, after which the meeting centers will be established and evaluated for impact on behavior, mood and quality of life of people with dementia and carers, cost-effectiveness, changes in service use, user satisfaction and implementation process.

Discussion

An overall evaluation will draw together findings from the three countries to develop recommendations for successful implementation of MCSP across the EU. If the Meeting Centers approach can be widely implemented, this could lead to major improvements in dementia care across Europe and beyond.

Trial registration

The trial was retrospectively registered in May 2016: trial number: NTR5936.

Mild Cognitive Impairments and Whole-body Cryotherapy – Placebo Control Study

Introduction

Cognitive impairment is considered to be a result of oxidative stress and disturbances in inflammatory status. Whole-body cryotherapy (WBC), which is a short exposure to extremely low temperatures, probably regulates the release of cytokines and nitric oxide. The hypothesis is that WBC may be useful in the therapy of mild cognitive impairments (MCI).

Aims

The effect of the whole-body cryotherapy (WBC) on cognitive impairments was investigated.

Objectives

In this study the observation of several biological factors and cognitive functions were conducted to analyse the WBC influence on cognitive deficits.

Methods

People with MCI participated in 10 WBC sessions divided for experimental group (−110 °C till −160 °C) or control group (−10 °C till −20 °C). The MoCa test (scores 26 and lower) was used for inclusion criteria. Cognitive functions were measured with: TYM, DemTect and SLUMS at baseline and in follow-up. Biological factors (cytokines, BDNF, NO) were also assessed.

Results

It was shown that memory domains in experimental group improved after WBC sessions. Also modulatory effect on inflammatory mediators in plasma was shown. The results of this study consist of the comparison of experimental and control groups regarding to cognitive functions as well as biological factors.

Conclusions

Whole-body cryotherapy may be supposed to improve cognitive functions in MCI patients. The modulatory effect of WBC on immunological response may be considered as one of possible mechanisms of its action. However, there is no confirmation how long the effects resist so further investigations are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Not re-inventing the wheel: the adaptive implementation of the meeting centres support programme in four European countries

OBJECTIVES

The implementation of new health services is a complex process. This study investigated the first phase of the adaptive implementation of the Dutch Meeting Centres Support Programme (MCSP) for people with dementia and their carers in three European countries (Italy, Poland, the UK) within the JPND-MEETINGDEM project. Anticipated and experienced factors influencing the implementation, and the efficacy of the implementation process, were investigated. Findings were compared with previous research in the Netherlands.

METHOD

A qualitative multiple case study design was applied. Checklist on anticipated facilitators and barriers to the implementation and semi-structured interview were completed by stakeholders, respectively at the end and at the beginning of the preparation phase.

RESULTS

Overall, few differences between countries were founded. Facilitators for all countries were: added value of MCSP matching needs of the target group, evidence of effectiveness of MCSP, enthusiasm of stakeholders. General barriers were: competition with existing care and welfare organizations and scarce funding. Some countries experienced improved collaborations, others had difficulties finding a socially integrated location for MCSP. The step-by-step implementation method proved efficacious.

CONCLUSION

These insights into factors influencing the implementation of MCSP in three European countries and the efficacy of the step-by-step preparation may aid further implementation of MCSP in Europe.

DemTect®--effective to asses MCI and dementia--validation study of the Polish language version

OBJECTIVES

To validate DemTect®, a highly sensitive psychometric screening tool--designed to identify patients with mild cognitive impairment (MCI) and patients with dementia (AD).

METHOD

A prospective cohort/cross-sectional study was designed. The data were collected from a group of 224 subjects, including 85 patients with MCI, 109 with Alzheimer's disease (AD) and 30 healthy control (HC) subjects. All subjects underwent a detailed neuropsychological assessment including CT, the assessment of biological parameters and a psychometric examination using DemTect®, MMSE, TYM, CDT and FAS.

RESULTS

Subjects ranged in age from 55 to 94 years, with a mean age of 71.42 ± 9.86 years. Classification rates of DemTect® were superior for both the MCI and AD groups compared with the MMSE, with high sensitivities of 90% (cut-off ≤15) and 96.8% (cut-off < 10), respectively. The DemTect® Polish language version proved to be independent of age and education level.

CONCLUSION

The Polish language version of the DemTect® scale is easy to administer. It may be seen as a superior cognitive screening tool in day-to-day practice as it achieves more accurate differentiation between HC/MCI/AD compared with MMSE.

Anserine and carnosine supplementation in the elderly: Effects on cognitive functioning and physical capacity

The aim of this study was to investigate the potential beneficial effects of dietary anserine and carnosine (CRC) supplementation on cognitive functioning and physical activity of the elderly. The fifty-six subjects (65+) were allocated to the CRC group or placebo group at a 1:1 ratio. The double-blind procedure was used. Data were collected at the baseline and after 13-weeks of supplementation. In the follow up procedure fifty one subjects took part. Chicken meat extract (CME) containing 40% of CRC components (2:1 ratio of anserine to carnosine) was administered 2.5 g per day which allowed to rich the level of 1g CRC in dipeptides supplement. The cognitive function, physical capacity, body measurements, blood pressure and heart rate (HR) were assessed. After supplementation Body Mass Index (BMI) decreased significantly (p<0.05) in the CRC group performance comparing the placebo group. In two of six Senior Fitness Test the scores increased significantly (p<0.05) in CRC group comparing to the placebo group. The perceived exertion differed significantly (p<0.05) at the baseline and after follow up at the CRC group. The mean values of the Short Test of Mental Status (STMS) scores showed the significant (p<0.04) increase only in CRC group, in the subscores of construction/copying, abstraction and recall. Conducted anserine and carnosine supplementation in the elderly brings promising effects on cognitive functioning and physical capacity of participants. However, further studies are needed.