Effectiveness of online mindfulness-based interventions for improving mental health in patients with physical health conditions: Systematic review and meta-analysis.

We aimed to determine the effectiveness of online mindfulness-based interventions (MBIs) for improving mental health in patients with physical health conditions. Randomized controlled trials (RCTs) in PubMed, Cochrane Library, Web of Science, Elsevier, and CINAHL published through September 2019 were searched. Two reviewers selected trials, conducted a critical appraisal, and extracted the data. Meta-analyses were performed. A total of nine RCTs were included. Analyses revealed that online MBIs was effective in improving depression [standardized mean difference (SMD) = -0.22, 95% confidence interval (CI) (-0.37, -0.07), p = 0.004], anxiety [SMD = -0.19, 95% CI (-0.33, -0.04), p = 0.01], and stress [SMD = -0.32, 95% CI (-0.52, -0.13), p = 0.001], and mindfulness [SMD = 1.67, 95% CI (0.14, 3.20), p = 0.03] in patients with physical conditions. We did not find any obvious effects on well-being [SMD = 1.12, 95% CI (-0.11, 2.36), p = 0.08]. Nevertheless, additional well-designed randomized clinical trials are further needed.

The effect of combined cognitive intervention and physical exercise on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials.

BACKGROUND: The state of mild cognitive impairment (MCI) provides an optimal window for preventing progression to dementia. Combined cognitive intervention and physical exercise may yield additive and synergistic effects on cognition in older adults with MCI. OBJECTIVES: The purpose of this study was to assess the efficacy of a combined intervention to improve cognition in older adults with MCI by comparing a control group that underwent only cognitive intervention, a control group that underwent only physical exercise, and a control group that did not undergo cognitive intervention or physical exercise. DESIGN: Meta-analysis of randomized controlled trials (RCTs). DATA SOURCES: The online databases of PubMed, Web of Science, Embase, the Cochrane Library, PsycINFO, and CINAHL were systematically searched. REVIEW METHODS: The outcomes were global cognition, memory, and executive function/attention. A sensitivity analysis was conducted when the I2 statistic was > 50%. RESULTS: A total of 16 studies were included. The results showed that the combined intervention had positive effects on global cognition compared to the effects of the other control group [SMD = 0.27, 95% CI (0.09, 0.44), p = 0.003]. Regarding memory, the combined intervention had positive effects compared to the effects observed in the single physical exercise group [SMD = 0.25, 95% CI (0.07, 0.44), p = 0.006] and the other control group [SMD = 0.29, 95% CI (0.12, 0.47), p = 0.001]. For executive function/attention, the combined intervention had also positive effects compared to the effects of the single cognitive intervention group [SMD = 0.28, 95% CI (0.09, 0.47), p = 0.004], the single physical exercise group [SMD = 0.32, 95% CI (0.16, 0.49), p = 0.0002], and the other control group [SMD = 0.23, 95% CI (0.05, 0.41), p = 0.01]. CONCLUSIONS: The combined intervention resulted in cognitive benefits in older adults with MCI and exhibited limited superiority over the single cognitive intervention and the single physical exercise on cognitive subdomains.

How Exercise Protects Against Mild Cognitive Impairment in Nursing Home-Dwelling Older Adults: A Path Analysis.

ABSTRACT: To explore how exercise protects against mild cognitive impairment (MCI) from physical, psychological, and social perspectives, we conducted a cross-sectional study in four nursing homes in Changchun, China, selected by convenience sampling. A total of 338 older adults aged 60 years or more with normal cognition or MCI were included. Data including demographic characteristics, exercise habits, frailty status, depression, sleep quality, social support, and cognitive status were collected. Weighted least squares estimation with mean and variance adjusted chi-square and bootstrapping with 2000 resamples were used to conduct the analyses through Mplus 8.3. The results showed that both direct and indirect effects of exercise on MCI were significant. Frailty and depression were two independent mediating factors, and depression could also play a mediating role when combined with sleep quality or frailty. Social support played a partial mediating role between exercise and depression. Formulations of exercise programs for MCI prevention and improvement in nursing home-dwelling older adults should consider the mediating factors.

Effect of humour intervention programme on depression, anxiety, subjective well-being, cognitive function and sleep quality in Chinese nursing home residents.

AIM: To evaluate the effect of an 8-week humour intervention programme on reducing depression and anxiety and improving subjective well-being, cognitive function and sleep quality in nursing home residents. DESIGN: A single-blinded and quasi-experimental design with repeated measures. METHODS: Seventy-four older adults were recruited from May 2018-September 2018, with 37 older adults in the humour group received humour intervention and 37 in the control group received no intervention. The intervention was an 8-week humour intervention programme for older adults to learn to use humour and release their emotions. Primary outcomes include depression, anxiety and subjective well-being and secondary outcomes were cognitive function and sleep quality. Two-way repeated measures ANOVA was used to compare the differences of outcome measures between the two groups. Outcomes were measured at baseline, 8 and 16 weeks. RESULTS: There was no significant difference between the two groups at baseline. The adherence to the sessions of humour intervention over the 8-weeks was 97.6%. Two-way repeated measures ANOVA revealed significant improvement in depression, anxiety, subjective well-being and sleep quality during the postintervention (8 weeks) and follow-up (16 weeks) periods in the humour group versus the control group. However, a significant time × group interaction for cognitive function was only found during postintervention. CONCLUSION: The humour intervention programme was effective in reducing depression and anxiety symptoms and increasing subjective well-being, cognitive function and sleep quality in older adults. IMPACT: Physical and mental health problems are common among older adults in nursing homes. The study demonstrated that humour intervention has feasibility and potential to be used as an effective non-pharmacological intervention in improving well-beings of Chinese nursing home residents. TRIAL REGISTRATION: ChiCTR1800016148.

Effects of dance intervention on frailty among older adults.

OBJECTIVE: The aims of this study were to examine the effects of dance intervention on frailty in pre-frail and frail older persons. DESIGN: This is a quasi-experimental, two-group trial. SETTING: Older adults living nursing home. PARTICIPANTS: Participants aged ≥ 60 years with low physical activity (mean age was 81.8 years; 71 % were female) (N = 66). METHODS: Participants allocated to the dance group attended 40 min dance sessions in a nursing home, three times a week for 12-weeks. Participants allocated to the control group maintained their normal daily activities. Assessments were conducted at baseline, 6 weeks, and 12 weeks by researchers blinded to the allocation. Frailty was measured based on Fried criteria. Estimates of frailty between groups over time were calculated using the generalized estimating equations (GEE) and mixed effects models. RESULTS: The prevalence of frailty decreased over time in the dance group compared to the control group (P = 0.002). The mean frailty scores decreased 0.69 at 6 weeks and 1.06 at 12 weeks. Compared to the control group, the prevalence of slowness (p = 0.002), weakness (p = 0.005), and low physical activity (p < 0.001) significantly decreased in the dance group. CONCLUSIONS: Dance intervention may reduce the presence and severity of frailty in older adults. Slowness and low physical activity improve following 12 weeks of dance intervention.

Effects of dance intervention on global cognition, executive function and memory of older adults: a meta-analysis and systematic review.

OBJECTIVE: To summarize and assess the effects of dance intervention on global cognition, executive function and memory in older adults. METHODS: We searched the databases PubMed, Web of Science, Cochrane Library, EMBASE, Clinical Trials.Gov and four Chinese databases (CNKI, CBM, Wan Fang Data and VIP) to identify articles written in English or Chinese and published until April 2018. Randomized controlled trials and quasi-experiment were included if they evaluated the impact of dance on cognition, and individuals aged 60 and over. RESULTS: Thirteen studies with a total of 1605 participants met the inclusions criteria. Our primary outcomes of interest are cognitive functions and are categorized into three cognitive domains: (1)Global cognition: meta-analyses for outcome related to global cognition indicated a large effect size. In the subgroup of using MMSE, results indicated a significant effect for dance on cognition [MD = 1.57, 95% CI (0.53, 2.61), p = 0.003; I2 = 62%], in the subgroup of using SCEF, effect sizes was statically significant and no heterogeneity between studies [MD = 33.25, 95% CI (30.94, 35.56), p < 0.00001; I2 = 0%]. (2)Executive functioning domain: meta-analyses revealed that there were no significant differences between the two groups in measures of executive function after the one study with a low-quality score was excluded [SMD = 0.13, 95% CI (- 0.02, 0.27), p = 0.09; I2 = 0%]. (3)Memory domain: quantitative analysis showed that dance may benefit memory function in older adults. However, in our review, dance was more effective for elderly cognitions than exercise may be not support. CONCLUSIONS: Our meta-analysis and systematic review suggest that dance may be a safe and effective approach to improve cognitive function in older adults.

Effects of Chinese square dancing on older adults with mild cognitive impairment.

The present study aimed to explore the effects of square dancing on global cognition, depressive symptoms, balance, and quality of life of older adults with mild cognitive impairment. We studied 66 older adults with mild cognitive impairment in a large nursing home. Participants were assigned to the intervention group (n = 33) or the control group (n = 33), according to their residential floor, which was determined by coin tossing. The intervention group underwent a 12-week Chinese square dancing routine, while the control group maintained usual lifestyle (without square dancing). Outcomes were assessed at baseline and at weeks 6 and 12. The results showed positive effects of square dancing on all outcomes assessed, especially on depressive symptoms and quality of life-related mental well-being of the participants. This study showed that square dancing is a promising strategy for older adults with mild cognitive impairment and that long-term adherence can be beneficial.

The effect of smart homes on older adults with chronic conditions: A systematic review and meta-analysis.

As populations continue to age, the prevalence of multiple chronic conditions in older adults grows. The purpose of this study was to evaluate the effect of smart homes on older patients with chronic conditions. A review and meta-analysis were conducted after searching both English and Chinese databases. Fifteen RCTs were included in the review, with six studies qualifying for the meta-analysis. The meta-analysis revealed no significant effects on measures of hospital admissions (RR =0.90, 95% CI (0.57, 6.34), P = 0.65) or emergency department admissions (RR =0.99, 95% CI (0.34, 2.91), P = 0.98). Likewise, no effects were observed for tele-monitoring on days spent in the hospital (MD =-0.90, 95% CI (-3.34, 1.55), P = 0.47) or quality of life. However, almost all participants were satisfied with the smart homes. The effect of tele-exercise on cognitive functioning was unclear. However, the smart homes did have an effect on physical functioning and depression in older adults with chronic conditions. Future studies should focus on the economic effectiveness, security, accessibility and practicality of smart homes on older adults with chronic conditions.

A meta-analysis of randomized controlled trials of laughter and humour interventions on depression, anxiety and sleep quality in adults.

AIM: To quantify the effect of laughter and humour interventions on depression, anxiety, and sleep quality in adults. DESIGN: A meta-analysis of randomized controlled trials. DATA SOURCES: PubMed, Embase, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Weipu, and Wanfang Data were searched from their inception up to December 2018. REVIEW METHODS: The reporting of this meta-analytical review was conducted according to the guidelines of the Cochrane Collaboration. Two reviewers selected the studies, extracted the data, and evaluated the risk of bias (Cochrane Collaboration bias assessment tool) of the included papers independently. RESULTS: Ten studies comprising 814 participants were included. Meta-analysis showed that these interventions significantly decreased adults' depression, anxiety, and improved their sleep quality. The results of subgroup analysis showed that depression benefits more from long-term laughter intervention. CONCLUSIONS: This meta-analysis revealed that laughter and humour interventions are effective in relieving depression, anxiety, and improve sleep quality in adults. More studies with high quality and follow-up assessment should be conducted for future research. IMPACT: This review synthesized current evidence using laughter and humour interventions to reduce negative emotion and promote better results in adults, especially with respect to target the applicability between different populations or intervention methods. In addition, humour and laughter interventions are safe, convenient, interesting and can promote interpersonal relationship in both patients and medical workers, which have great feasibility and potential to be used as an aspect of psychotherapy for clinical and nursing to improve well-beings in adults.

Nonpharmacological interventions to improve sleep in nursing home residents: A systematic review.

Sleep disturbance is one of the most prevalent symptoms among elderly adults, especially those living in nursing homes. Sleep disturbance adversely affects the healthcare system as well as elderly adults' quality of life. Nonpharmacological interventions have shown promising results regarding improvements in sleep. This systematic review intended to identify the effects of nonpharmacological interventions on sleep quality and nighttime sleep among nursing home residents. We searched both English and Chinese databases through December 2018 and found 28 eligible studies describing five types of interventions: physical activity (n = 6), light therapy (n = 5), mind-body practices (n = 2), complementary and alternative therapy (n = 8), and multicomponent interventions (n = 7). Although the wide variety of interventions in each category limited the generalizability of the results, physical activity, mind-body practices, acupressure and chamomile extract intake demonstrated positive and promising impacts on sleep quality and nighttime sleep. Due to the small number of included trials, the results should be interpreted cautiously. Further higher-quality studies concerning nonpharmacological treatments are needed.

Interventions to promote mental health in nursing students: A systematic review and meta-analysis of randomized controlled trials.

AIMS: The aim of this study was to systematically examine the efficacy of interventions aimed at improving nursing students' mental health and to identify which form of interventions was effective. BACKGROUND: Recent research has demonstrated mental disorders in common among nursing students and may lead to adverse consequences like low self-efficacy and poor academic performance. DESIGN: According to the recommendations of the Cochrane Collaboration, a systematic review and meta-analysis was conducted. DATA SOURCES: PubMed, EMBase, the Cochrane central register of randomized controlled trials, PsycINFO and Web of Science were used to identify potential studies (January 1990-April 2017). REVIEW METHODS: A systematic review of the literature and meta-analysis of randomized controlled trials on the efficacy of interventions on reducing mental disorders in nursing students. Review Manager version 5.3 was used to obtain pooled results. RESULTS: Twelve studies with a total sample size of 651 participants met the inclusion criteria. Interventions included psychotherapy, exercise, training programme and other forms of intervention. The results of subgroup analysis showed that depression benefit more from psychotherapy, anxiety benefit from psychotherapy and non-psychotherapy. Interventions were effective in managing stress and systolic blood pressure. Improvements on self-efficacy and diastolic blood pressure was not observed. CONCLUSION: Psychotherapy should be chosen to reduce depression and anxiety of nursing students. There is a need for further studies should explore more potential value of psychotherapy on stress and biological change.