Reliability and Validity of a Chinese Version of the Cohen-Mansfield Agitation Inventory-Short Form in Assessing Agitated Behavior.

BACKGROUND: Patients with dementia often present agitated behaviors. The Cohen-Mansfield Agitation Inventory-short form (CMAI-SF) is one of the most widely used instruments to evaluate agitated behaviors that affect patients' quality of life and impose burden on caregivers. However, there is no simplified Chinese version of the CMAI-SF (C-CMAI-SF) in clinical settings. PURPOSE: This study aimed to develop a Chinese version of the C-CMAI-SF and examine its validity and reliability. METHODS: This cross-sectional study included three phases. In Phase I, the original CMAI-SF was translated to Chinese. In Phase II, experts were invited to examine the content validity index (CVI). Phase III was conducted to test the validity and reliability of the C-CMAI-SF. RESULTS: The scale showed good validity and reliability with a scale-level CVI of 0.89, Cronbach's alpha (measure of internal consistency) of 0.874, and test-retest correlation coefficient of 0.902 (for 257 individuals). Using factor analysis, three factors were identified. Regarding concurrent validity, the C-CMAI-SF score was correlated with the Neuropsychiatric Inventory (agitation aggression subscale) and the Cornell Scale for Depression in Dementia (agitation subscale). CONCLUSIONS: The study demonstrated that the C-CMAI-SF is a valid and reliable instrument for evaluating agitated behaviors in people with dementia. RELEVANCE TO CLINICAL PRACTICE: The C-CMAI-SF is an easy and quick tool used to identify and evaluate agitated behaviors in busy clinical settings.

The Effect of Group Music Therapy with Physical Activities to Prevent Frailty in Older People Living in the Community.

BACKGROUND: The frail elderly are prone to falls and fractures, which can result in dependency, disability, admission to institutions, and even death. They are at increased risk of frailty due to decreased physical activity, cognitive decline, and depression. Some evidence suggests that music therapy with physical activities may be particularly beneficial. OBJECTIVE: This study aimed to investigate the intervention effect of music therapy with physical activities (MTPA) on frail elderly in the community. METHODS: A quasi-experimental design was adopted. We selected 10 community care centers in southern Taiwan, in which elderly people over the age of 65 were assigned to a MTPA group and a comparison group after obtaining their informed consent. The MTPA group performed group music activities once a week for 120 min for 12 weeks, while the comparison group only continued with their daily activities. Instruments in this study included the Kihon Checklist, Senior Fitness Test (with Body Mass Index (BMI) and seven physical fitness items), Mini-Mental Status Examination (MMSE), and Geriatric Depression Scale Short Form (GDS-SF). RESULTS: A total of 132 community elders agreed to participate in this study, and 122 completed both the pretest and posttest, with 62 in the music therapy group and 60 in the comparison group. The results of ANCOVA showed that after intervention, except for BMI, the Kihon frailty assessment, seven fitness scores individually and in total, MMSE, and depression showed significant improvements in the music therapy group relative to the comparison group (all p < 0.05). CONCLUSION: MTPA can improve the frailty index, cognitive function, depression, and physical fitness index in the community elderly. The results of this study can be used as a reference for the design of activities for the community elderly, to provide them with appropriate activities, improve their physical functions, and improve or delay their disability.

Modelling factors of urinary incontinence in institutional older adults with dementia.

AIMS AND OBJECTIVES: This study applied structural equation modelling to explore the relationships among agitated behaviours, depression, cognitive function and activities of daily living, as well as associations between these factors and urinary incontinence). BACKGROUND: A high prevalence of urinary incontinence is found among institutional older adults with dementia. People with urinary incontinence suffer from increased financial burden and social isolation and experience reduced quality of life. DESIGN: Cross-sectional correlational research. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. METHODS: In total, 226 older adults with dementia were recruited through convenience sampling at 15 long-term care facilities in southern Taiwan. The urinary incontinence frequency, agitated behaviours, depression, cognitive function and activities of daily living were evaluated using bladder records, the Cohen-Mansfield Agitation Inventory, the Cornell Scale for Depression in Dementia, the Mini-Mental State Examination and the Barthel Index, respectively. RESULTS: Activities of daily living performance was found to be significantly associated with urinary incontinence; however, age, cognitive function, depression and agitated behaviours were not significantly related to urinary incontinence. Age did not have effects on any of the variables tested in this model, whereas activities of daily living performance was significantly associated with cognitive function and depression. Results further showed that cognitive function and depression were mediators between activities of daily living and agitated behaviours. CONCLUSION: Enhanced activities of daily living independency directly reduced urinary incontinence, improved cognitive function, decreased degrees of depression and indirectly reduced agitated behaviours. RELEVANCE TO CLINICAL PRACTICE: The findings could serve as a valuable reference for long-term care facilities in providing effective urinary incontinence care and prevention to older adults with dementia.

The effect of music therapy on reducing depression in people with dementia: A systematic review and meta-analysis.

The aim of this study was to determine the effectiveness of music therapy on reducing depression for people with dementia during different intervention intervals. A systematic review with a meta-analysis of randomized controlled trials. The databases surveyed include AgeLine, CINAHL, MEDLINE, PsycINFO, PubMed, and Cochrane. Seven studies were included in this review. The result revealed that music therapy significantly reduced depression at six, eight, and 16 weeks. This study also supported that music therapy significantly improved depression when the results of six studies with medium-term interventions were pooled. However, no evidence of effect of music therapy on depression was observed at three, four, 12 weeks, and five months during intervention, and one and two months after the cease of music therapy. Music therapy without a music therapist involved did not significantly reduce depression at any time. Medium-term of music therapy might be appropriate in reducing depression for people with dementia.

Lower urinary tract symptoms of prostate cancer patients undergoing treatments over eight-month follow-up.

AIMS AND OBJECTIVES: To examine the changes in lower urinary tract symptoms after open radical prostatectomy, laparoscopic radical prostatectomy and brachytherapy and to determine which treatment resulted in improved lower urinary tract symptoms at 8 months follow-up. BACKGROUND: Lower urinary tract symptoms are a primary side effect after prostate cancer treatment. DESIGN: A time-series survey design with descriptive and comparative elements. METHODS: A sample of 51 prostate cancer patients was recruited: open radical prostatectomy = 20, laparoscopic radical prostatectomy = 23 and brachytherapy = 8. Data were collected at six time points: before treatment/baseline, 1 week post-treatment, 1 month post-treatment, 2 month post-treatment, 3 month post-treatment and 8 months post-treatment. The lower urinary tract symptoms were assessed using the International Prostate Symptom Score, with a higher score indicating a worse condition. One-way anova was used to predict the progress of urinary symptoms after treatments. Bootstrap re-sampling was conducted to assess the stability of the outcomes. RESULTS: Although there were no significant differences in the lower urinary tract symptoms among the three groups after treatments, the laparoscopic radical prostatectomy group had the lowest International Prostate Symptom Score score at baseline. Compared with the baseline symptoms for patients undergoing each treatment, there were significant improvements after 2 months in the open radical prostatectomy and brachytherapy groups, and after 3 months in the laparoscopic radical prostatectomy group. CONCLUSIONS: The prostate cancer patients undergoing the three treatments have similar lower urinary tract symptoms over 8-month follow-up although different lower urinary tract symptoms were presented before treatments. RELEVANCE TO CLINICAL PRACTICE: Results could be applied to educating and counselling prostate cancer patients regarding symptoms during recovery after surgery. It could also help patients better understand the outcomes related to the differing treatment methods.

The Effects of a Diet and Exercise Program for Older Adults With Metabolic Syndrome.

BACKGROUND: The prevalence of metabolic syndrome is high among older adults in Taiwan. However, few studies have studied the effect of a combined diet and exercise program on managing metabolic syndrome (MetS) in individuals 65 years and older and living in Taiwan's rural areas. PURPOSE: This study tests the effectiveness of a diet and exercise program on the MetS biomarkers in older community residents with MetS. METHODS: This study used a quasiexperimental study design. All participants were 65 years and older and were diagnosed with MetS. The outcome variables included biomarkers (blood pressure, waist circumference, hip circumference, body mass index, blood sugar, cholesterol, and triglycerides) and demographic characteristics. The participants were distributed into a diet-and-exercise group (n = 163) and a nondiet-and-nonexercise group (n = 138). The outcome variables were examined 3 months after the start of the intervention program. RESULTS: The participants in the diet-and-exercise group had lower values than the nondiet-and-nonexercise group for blood pressure, waist circumference, hip circumference, body mass index, blood sugar, cholesterol, and triglyceride (all ps < .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The diet and exercise program is an effective intervention for treating older individuals with MetS. Clear and concise information concerning the effects of diet and exercise in promoting the health of older residents with MetS is helpful to improve the health of the older adults inTaiwan.

The effect of music therapy on cognitive functioning among older adults: a systematic review and meta-analysis.

OBJECTIVES: To conduct a systematic review and a meta-analysis of current studies to determine whether music therapy affects the cognitive function of older people. DESIGN: The databases surveyed include PsycINFO, PsycARTICLES, PubMed, MEDLINE, CINAHL, AgeLine, Cochrane Library, and the Chinese Electronic Periodical Services (CEPS) as well as the reference lists of the included studies. The Consolidated Standards of Reporting Trials (CONSORT) extension checklist for nonpharmacologic treatment was used to evaluate the literature. SETTING: Music therapy intervention offered in nursing homes, hospitals, or communities. PARTICIPANTS: A total of 234 participants from 5 studies were assessed in the meta-analysis, with a mean age per study of 71.4 to 82.0 years. MEASUREMENTS: Cognitive outcome domains were analyzed in a systematic review. The short-term effects of music therapy in Mini-Mental State Examination data for meta-analysis were compiled. A forest plot was constructed using a fixed effect model to obtain a pooled mean difference. RESULTS: Active music therapy comprising singing and other musical activities was generally determined to effect a significant improvement in the Mini-Mental State Examination according to individual retrieval studies. However, this study showed no significant improvement in the short-term effects of music therapy when all related studies in meta-analysis were combined. The pooled mean difference was 0.73 (95% confidence interval -0.07 to 1.54; Z = 1.79; P = .07) for using music therapy overall and 0.74 (95% confidence interval -0.08 to 1.56; Z = 1.76; P = .08) for using active music therapy. CONCLUSIONS: The findings of the meta-analysis indicate that the short-term effects of music therapy do not improve the cognitive function of older people. Future studies that utilize a good quality methodology with a long-term design and diversified active music therapy are recommended.