The effects of mindfulness and health education programs on the emotional state and cognitive function of elderly individuals with mild cognitive impairment: A randomized controlled trial.

This study aimed to determine the efficacy of mindfulness practice on emotional state and cognitive function of community-living elderly with mild cognitive impairment. A randomized controlled trial was conducted with the experimental group undergoing a Mindfulness Awareness Program (MAP) and an active control group undergoing a Health Education Program (HEP) over a nine month period. Sessions were conducted weekly for the first three months and monthly for the remaining six months. Self-reported questionnaires in English and Chinese were administered through face-to-face interviews to collect data at baseline, three months and nine months. Descriptive statistics and analysis of covariance (ANCOVA) were used to analyse data. Fifty-five elderly participants aged sixty and above, were randomized to MAP (N = 28) and HEP (N = 27) programs. Participants in both intervention arms experienced decreases in depressive and anxiety symptoms over the nine-month period. A significant improvement occurred in the HEP group in depression scores at three months and anxiety scores at both three and nine months. There were no statistically significant changes on cognitive function in both groups over the nine-month period. Both the MAP and HEP can benefit the emotional states of community-living elderly with mild cognitive impairment. Our study supports the usefulness of group-based HEP as a low cost intervention for promoting active aging and psychological health in a community setting.

An integrated, collaborative healthcare model for the early diagnosis and management of dementia: Preliminary audit results from the first transdisciplinary service integrating family medicine and geriatric psychiatry services to the heart of patients' homes.

BACKGROUND: The number of dementia cases is expected to rise exponentially over the years in many parts of the world. Collaborative healthcare partnerships are envisaged as a solution to this problem. Primary care physicians form the vanguard of early detection of dementia and influence clinical care that these patients receive. However, evidence suggests that they will benefit from closer support from specialist services in dementia care. An interdisciplinary, collaborative memory clinic was established in 2012 as a collaborative effort between a large family medicine based service and a specialist geriatric psychiatry service in Singapore. It is the first service in the world that integrates a family medicine based service with geriatric psychiatry expertise in conjunction with community-based partnerships in an effort to provide holistic, integrated care right into the heart of patients' homes as well as training in dementia care for family medicine physicians. We describe our model of care and the preliminary findings of our audit on the results of this new model of care. METHODS: This was a retrospective audit done on the electronic medical records of all patients seen at the Memory Clinic in Choa Chu Kang Polyclinic from August 2013 to March 2016. The information collected included gender, referral source, patient trajectories, presence of behavioural and psychological symptoms of dementia and percentage of caregivers found to be in need of support. A detailed outline of the service workflow and processes were described. RESULTS: A majority (93.5%) of the patients had their memory problems managed at the memory clinic without escalation to other specialist services. 22.7% of patients presented with behavioural and psychological symptoms of dementia. When initially assessed, a majority (82.2%) of patients' caregivers were found to be in need of support with 99.5% of such caregivers' needs addressed with memory clinic services. CONCLUSION: Our model of care has the potential to shape future dementia care in Singapore and other countries with a similar healthcare setting. Redesigning and evolving healthcare services to promote close collaboration between primary care practitioners and specialist services for dementia care can facilitate seamless delivery of care for the benefit of patients.