Co-designing community-level integral interventions for active ageing: a systematic review from the lens of community-based participatory research.

BACKGROUND: While community-level interventions for promoting active ageing have received increasing attention and there is a trend to leverage technology to support traditional physical or social interventions, little hands-on guidance exists for designing these integral interventions. This study aimed to examine the interventions reported in the literature guided by Community-Based Participatory Research (CBPR) principles. The goal is to extract insights that inform future practices in co-designing integral interventions for active ageing. METHODS: The systematic review focused on community-level interventions promoting active ageing that integrated physical, social, and digital elements, i.e., integral interventions. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The included interventions were analysed abductively based on the CBPR principles. RESULTS: A total of 13 studies were included, and 24 design considerations were generated under eight categories. Further reflection identified the interrelated nature of these design considerations and pinpointed the gaps in current research. This study highlights the urgency and importance of sharing recruitment methods and resource allocation details, recording and reporting collaboration specifics, and disseminating findings to stakeholders beyond academia. CONCLUSIONS: This study offers valuable insights and practical guidance to researchers and practitioners developing community-level integral interventions for active ageing. The findings also serve as a starting point for accumulating knowledge and practice in co-designing integral interventions for active ageing at the community level. The next crucial phase involves evaluating these design considerations within real-world cases to assess their applicability and identify potential areas for improvement.

A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia: from a perspective of ergonomics.

BACKGROUND: Non-pharmacological interventions for Behavioral and Psychological Symptoms of Dementia (BPSD) have been developed; however, a systematic review on the effectiveness of this type of intervention from a perspective of ergonomics is lacking. According to ergonomics, the capabilities of Persons with Dementia (PwD) should be considered in the interventions for the outcomes to be reliable. We aimed to systematically review the non-pharmacological interventions for BPSD in nursing home residents with an additional assessment criterion based on ergonomics, specifically, capability consideration. METHODS: The electronic databases MEDLINE, EMBASE, and PsycINFO were searched for non-pharmacological interventions treating BPSD in nursing homes. The interventions were categorized according to the capabilities of PwD required to participate. Study quality was assessed by National Health and Medical Research Council (NHMRC) evidence hierarchy and the capability consideration. RESULTS: Sixty-four clinical trials met the inclusion criteria; 41 trials reported a significant reduction in at least one BPSD symptom; 20 trials reported no significant reduction in BPSD symptoms; three trials reported adverse effects after the intervention. Interventions were categorized into sensory-, cognition-, and movement-oriented. Capabilities of PwD were not considered in 28 trials, especially for sensory capabilities. CONCLUSIONS: The majority of the clinical trials reported a significant reduction in BPSD. The quality of evidence for nonpharmacological interventions in these trials is low due to the lack of capability consideration, data inhomogeneity, and inadequate study design and reporting. Future studies should focus on improving the quality of evidence by including capability consideration and examining if a relationship between capability consideration and effectiveness of non-pharmacological interventions exists.

Ultrasound signal wavelet analysis to quantify the microstructures of normal and frozen tissues in vitro.

Cryosurgery has a number of advantages that make it particularly appealing in the treatment of liver cancer. However, a major problem for the wide clinical adoption of hepatic cryosurgery is the lack of a cost effective high resolution imaging way which is capable of both performing precise monitoring of the freezing process in situ and evaluating the postoperative effects after surgery. The mean scatterer spacing has been found to be an important parameter for describing the ultrasonic scattering and characterization of biological tissues. However, its potential values in the evaluation of cryosurgical effects of tissues reserved unclear so far. Here, we investigated the wavelet analysis to estimate the mean scatterer spacing parameter in normal and freeze-thawed tissues on porcine livers in vitro. The experimental results carried out at 10 MHz using weakly focused pulse-echo signal element transducer indicated that the mean scatterer spacing in normal liver tissues is 1.12 ± 0.13 mm whereas it is 1.67 ± 0.25 mm in several pre-frozen and then thawed tissues. These results disclosed the good correlation between the wavelet data and microstructures of the normal or thawed tissues, and hence demonstrated that the wavelet analysis holds promise to be used as an effective method for the characterization of thawed tissues scatterer spacing. The present method offers a potential pragmatic strategy for monitoring the transition zone between frozen and unfrozen tissues during the surgical therapy, and evaluating postoperative effects.

A Toolkit for Co-Designing towards Community-Based Active Ageing: Lessons Learned during Development.

It is increasingly recognized that community-based interventions for active ageing are more lasting and effective, yet the tools and methods for developing these interventions are lacking. This study investigates how to co-design community-based active ageing with older adults via the development of a toolkit to support this goal. Rapid reviews were conducted to understand (i) the effective behavioural change techniques for older adults, (ii) how to co-design with older adults for community-based interventions, and (iii) how to design tools for behaviour change that are easy to use. These reviews served as the foundation for developing a toolkit to support the co-design of community-based active ageing, which was evaluated during an interdisciplinary hackathon with older adults. Quantitative data from the surveys suggested that the confidence levels of students in developing interventions for health behaviour change and in co-designing with older adults increased after the hackathon, and the enjoyment of participating in the hackathon and of using the toolkit were statistically significant factors influencing this increase. Qualitative data from interviews and observations revealed how the toolkit was (un)used by the participants and what aspects of the toolkit can be improved. We encourage future researchers and practitioners to apply and adapt our research findings to the communities of older adults that they are working with.

A Digital Platform for Facilitating Personalized Dementia Care in Nursing Homes: Formative Evaluation Study.

BACKGROUND: Care personalization is key to the well-being of people with dementia according to person-centered care. With the development of the internet of things, a large quantity of personal data can be collected securely and reliably, which has the potential to facilitate care personalization for people with dementia. Yet, there are limited assistive technologies developed for this purpose, and the user acceptance of assistive technologies is low in nursing homes. Therefore, through a data-enabled design approach, a digital platform was developed for helping the care team in a nursing home to personalize dementia care, specifically in the management of behavioral and psychological dementia symptoms. OBJECTIVE: This study aimed to evaluate the digital platform in a real-life context with potential users from the following two aspects: (1) to explore if the digital platform could help with generating insights on the current state of each person with dementia and (2) to gather feedback on the digital platform from the care team. METHODS: The digital platform was deployed in the nursing home for 7 weeks and the data collected were visualized and presented to the care team via the digital platform. The visualizations were analyzed by the researchers for pattern detection. Meanwhile, the care team was asked to examine the visualizations and were interviewed for the following: (1) if any insights and actions were generated from the examination, (2) the usefulness of the digital platform, and (3) the improvements they would like to see. RESULTS: The data collected on the digital platform demonstrated its potential for pattern detection. Insights were generated by the care team and categorized into "client level," "ward level," and "team level." The corresponding actions taken by the care team were classified into "investigation" and "implementation." User acceptance varied across the care team, and three aspects of improvement for the digital platform were identified. CONCLUSIONS: By evaluating the digital platform, this study gained insights on applying data-enabled design for personalizing dementia care; besides, it offers future researchers some recommendations on how to integrate assistive technologies in the nursing home context.

Know-Me: A Toolkit for Designing Personalised Dementia Care.

Personalisation is a crucial element in providing person-centred care for people with dementia. This paper presents the development and evaluation of a design toolkit to facilitate the work of designers and healthcare professionals in personalising dementia care. This toolkit, named "Know-me", was grounded in the findings of Ergonomics in Aging, Co-design, and Data-enabled Design, derived from literature review and from the field during a four-year doctorate project. "Know-me" was designed to be easily accessible, flexible, and engaging, providing concrete and hands-on guidance for designers and healthcare professionals to use in designing for personalised dementia care. A proof-of-concept evaluation of the "Know-me" toolkit was conducted via student projects on design for dementia care. During this process, we found that "Know-me" could be adapted flexibly so that the care team could use some of the tools by themselves. A feature-by-feature comparison of the "Know-me" toolkit with similar state-of-the-art toolkits was conducted, and based upon this, the strengths and weaknesses of the "Know-me" toolkit are discussed. This preliminary study indicates that the "Know-me" toolkit is a helpful addition to the current pool of toolkits on designing for dementia care.

Personalising Management of Behavioural and Psychological Symptoms of Dementia in Nursing Homes: Exploring the Synergy of Quantitative and Qualitative Data.

Researchers have been exploring how to manage Behavioural and Psychological Symptoms of Dementia (BPSD) in a personalised way, meanwhile, assistive technologies have been developed to collect a variety of personal data. This urges more research in investigating the combination of: data collected by the care team, which are mainly qualitative; and data collected by assistive technologies, the majority of which are quantitative. Previous studies, however, have yet to explore if and how a combination of quantitative and qualitative data could facilitate the care team to better understand each resident with dementia in the nursing home context for personalised BPSD management. Guided by a Research through Design approach, a prototype for collecting and visualising the quantitative and qualitative data towards personalised BPSD management was developed together with the care team. Via developing this prototype, knowledge was gained in what types of data could be combined for personalised BPSD management in nursing homes, what are their values, how to collect and present them, and how to introduce them in the working routine of the care team for analysis. The main findings suggest that the types of data to be collected could be unique for each resident with dementia; the quantitative and qualitative data are of value to each other during data collection and analysis; data collection should be quick and standardised yet flexible for the care team; the overview page is vital for data presentation; and user scenarios could be created to nudge the care team to analyse the data at certain points of their working routine. In general, a combination of qualitative data and quantitative data could help the care team to discover more insights about each resident with dementia and thus improve the current practice of personalised BPSD management.

Co-designing with people with dementia: A scoping review of involving people with dementia in design research.

Co-designing with people with dementia (PwD) can uncover their needs and preferences, which have been often overlooked. It is difficult for PwD to understand designers and express themselves in a conventional co-design session. This study aims to evaluate the effects of involving PwD in design research on both PwD and the design process; to identify the trends of involving PwD in design research; to extract tools, recommendations, and limitations of involving PwD from reviewed studies to update the recommendations on how to co-design with PwD. A scoping review was carried out within the electronic databases PubMed and Scopus, and eight research questions were proposed, in order to gain specific knowledge on the involvement of PwD in design research. Twenty-six studies met the inclusion criteria, and 32 sessions were evaluated. Beneficial effects on both PwD and the design process were reported. The number of studies involving PwD in the moderate and severe stages of dementia has increased. Based on the review, an update of the existing tools and recommendations for co-designing with PwD is provided and a list of limitations of involving PwD is presented. The review shows that involving PwD in design research is beneficial for both the PwD and the design process, and there is a shift towards involving people who are in the moderate and severe stages of dementia. The authors propose that multidisciplinary meetings and case studies should be carried out to evaluate and refine the list of tools and recommendations as well as the list of limitations generated in this review.

Risk Factors and Neuropsychological Assessments of Subjective Cognitive Decline (plus) in Chinese Memory Clinic.

BACKGROUND: Since subjective cognitive decline (SCD) was standardized in 2014, many studies have investigated its features. However, the risk of SCD (plus) progressing to AD is much higher, and yet there have been few studies reporting the risk factors and neuropsychological assessment characteristics of SCD (plus). OBJECTIVE: To characterize SCD (plus) by comparing it with normal control (NC), amnesic mild cognitive impairment (aMCI), and Alzheimer Disease (AD) regarding their demographics, lifestyle, family history of dementia, multimorbidity and the neuropsychological assessments. METHODS: A total of 135 participants were recruited, including 23 NC, 30 SCD (plus), 45 aMCI and 37 AD. Descriptive statistics were provided. A logistic regression model was used to analyze the affecting factors of SCD (plus), and finally the Receiver Operating Characteristic (ROC) analysis was applied to distinguish between SCD (plus) and NC. RESULTS: (1) SCD (plus) group was younger than both the aMCI group and AD group. It consisted of more participants with mental work and higher body mass index (BMI) than the AD group. (2) Scores of Auditory Verbal Learning Test - Immediate recall (AVLT-IR) and AVLT-Long delayed recall (AVLT-LR) decreased in the following order: NC→SCD (plus)→aMCI→AD. (3) The Area Under Curve (AUC) for discriminating SCD (plus) and NC group was from 0.673 to 0.838. CONCLUSION: Aging is an important risk factor of both NC progressing to SCD (plus), and SCD (plus) progressing to aMCI or AD. In addition to aging, lower education level and lower BMI were significantly associated with greater odds of SCD (plus) progressing to aMCI or AD patients, whereas mental work was a protective factor of SCD (plus) progressing to AD. Finally, AVLT is a sensitive indicator of the cognitive decline and impairment in SCD (plus) in relative to normal controls.