Designing dementia-friendly gardens: A workshop for landscape architects: Innovative Practice.

Conception and construction of nursing homes focuses mostly on architectural design. The cost of gardens and amount of work they require is usually underestimated. This often results in inaccessible, unfit and poorly designed outdoor spaces. This article describes a partnership between three French institutions established in response to the needs of people with cognitive disabilities. This partnership led to three different approaches (scientific, pedagogical and practical) with a common objective to provide dementia-friendly outdoor spaces.

[Touchscreen tablets and people with dementia: interest, intentions and modalities of use]. / Tablettes tactiles pour les personnes atteintes de troubles cognitifs liés au vieillissement : intérêts, intentions et modalités d'utilisation.

Touchscreen tablets are increasingly used to support people with dementia. An inventory of the literature is proposed to specify the nature and intentions of use, the modalities of use and technical characteristics. Tablets are used for psychosocial interventions, life support, social living and leisure activities. Autonomously use is possible and group uses promote interpersonal relationships. The equipment must take into account the physical, sensory, cognitive and interests of people with dementia. Use of tablets should promote social inclusion in a non-stigmatizing approach.

Dance interventions for people with dementia: systematic review and practice recommendations.

OBJECTIVES: Dance interventions are pleasant social activities that are often offered to people with dementia in care settings. Effectiveness of dance as a psychosocial intervention for people with dementia has been studied to some extent, but several methodological issues remain unexplored. This review aimed to analyze studies on dance interventions for people with dementia and to identify practice recommendations for the development of these interventions. METHODS: An electronic database search was run in December 2017 to identify records of dance interventions for people with dementia. We included all studies regardless of experimental design. Selected records were analyzed according to five criteria: study design and intentions of interventions; profile of participants and in/exclusion criteria; treatment indications and contraindications; description and performance of the interventions; and involved physical, cognitive, psychological, and social processes in dance. RESULTS: Fourteen records were included in which various study designs were observed. Description and performance of the interventions were well documented. Nine practice recommendations for implementing dance interventions were identified according to primary intentions of the intervention (therapeutic or recreational): indications; contra-indications; participant profile; dosage; session sequencing; setting of intervention; observance/attendance; contributors and facilitators;and assessments. CONCLUSIONS: Dance is a holistic intervention that can be implemented with a therapeutic or a leisure intention. Practice recommendations about dance interventions remain incomplete and insufficiently studied. Such recommendations could be helpful for clinicians to implement dance interventions in facilities where they work to better target people who could benefit from them, and for researchers to develop research in this field.

Effects of active psychosocial stimulation on social interactions of people with dementia living in a nursing home: a comparative study.

Dementia can interfere with the maintenance of social interactions. The ability to participate in social interactions is one of the elements that enables good social health (Hubert et al., 2011), and having dementia does not automatically eliminates the person's opportunity to have good social health (Vernooij-Dassen and Jeon, 2016). We highlighted in a previous study that people with dementia who did not know each other interacted spontaneously when they were in a stimulating social interaction setting (Mabire et al., 2016). However, a lack of activity and social interaction in nursing homes is still a widespread issue (Harper Ice, 2002). Stimulation of social interactions is rarely used as an intervention and social interactions are seldomly used as social health related outcomes.

Social interactions between people with dementia: pilot evaluation of an observational instrument in a nursing home.

BACKGROUND: In dementia, cognitive and psychological disorders might interfere with maintaining social interactions. We have little information about the nature of these interactions of people with dementia in nursing homes. The aim of this study is to investigate social interactions between people with dementia and to validate an observation grid of them. METHODS: Fifty-six institutionalized people with dementia took part in this study. Residents had not met beforehand and were divided into groups of four to six. Social behaviors were videotaped and analyzed by two independent raters with an observation grid measuring frequency of occurrence. The ethogram was the conceptual tool that became the Social Observation Behaviors Residents Index (SOBRI). RESULTS: Two-thousand-six-hundred-seventy instances of behavior were collected. Behaviors directed at others represented 50.90% and self-centered behaviors 47.83%. No negative behaviors were observed. Principal Component Analysis (PCA) was used to validate the SOBRI and showed two components of social behaviors that explained about 30.56% of the total variance: social interactions with other residents (18.36%) and with care staff (12.20%). The grid showed a good internal consistency with a Cronbach's α of 0.90 for the first component and 0.85 for the second one. CONCLUSIONS: The SOBRI presents robust psychometric validity. This pilot study indicates that people with dementia spontaneously interact with other residents. These results contradict the stigma of non-communication and the stereotypes about dementia. More studies and validations are needed to contribute to the knowledge of social interactions in dementia.

Does cognitive function increase over time in the healthy elderly?

BACKGROUND: In dementia screening, most studies have focused on early cognitive impairment by comparing patients suffering from mild dementia or mild cognitive impairment with normal subjects. Few studies have focused on modifications over time of the cognitive function in the healthy elderly. The objective of the present study was to analyze the cognitive function changes of two different samples, born > 15 years apart. METHOD: A first sample of 204 cognitively normal participants was recruited in the memory clinic of Broca hospital between 1991 and 1997. A second sample of 177 cognitively normal participants was recruited in 2008-2009 in the same institution. Both samples were from the same districts of Paris and were assessed with the same neuropsychological test battery. Mean cognitive test scores were compared between 1991 and 2008 samples, between < 80 years old and ≥ 80 years old in 1991 and 2008 samples, and finally between subjects < 80 year old of 1991 sample and subjects ≥ 80 years old of the 2008 sample. Means were compared with T-tests stratified on gender, age-groups and educational level. RESULTS: Cognitive scores were significantly higher in the 2008 sample. Participants < 80 years old outperformed those ≥ 80 in both samples. However, participants < 80 years old in 1991 sample and subjects ≥ 80 in the 2008 sample, born on average in 1923, performed mostly identically. CONCLUSION: This study showed a significant increase of cognitive scores over time. Further, contemporary octogenarians in the later sample performed like septuagenarians in the former sample. These findings might be consistent with the increase in life expectancy and life span in good health. The study highlights the necessity to take into account factors which may contaminate and artificially inflate the age-related differences in favor of younger to the older adults.

[Quality of life in dementia: definitions, difficulties and interest of evaluation]. / Qualité de vie au cours des démences : définitions, difficultés et intérêt de son evaluation.

The concept of quality of life appears to be easy to understand but, actually, is very complex when it comes to define it. Several notions are synonymous and often used indiscriminately such as happiness, life satisfaction and well-being. However, quality of life is dependant on several factors that, according to their presence or their absence, can change its perceptions and evaluation. Besides the difficulties of definition, methodological difficulties are added for its evaluation: how to measure a multi-factor concept whose definition is complex and non-consensual? What about its assessment in the elderly? Are the difficulties of definition and evaluation the same in studies involving elderly dementia patients? Starting from the historical context of quality of life we particularly discuss its definition and assessment in elderly patients with dementia.