Efficacy of group-based multi-component psycho-education for caregivers of people with dementia: A randomized controlled study.

AIM: The aim of this study was to examine the ability of a group-based multi-component psycho-educational intervention (GMC-PEI) to reduce depression, and improve caregiving appraisals, coping skills of informal caregivers and the condition of people with dementia. METHODS: In this randomized controlled and blinded trial, we enrolled 54 informal caregivers of people with dementia visiting the Japan National Center of Geriatrics and Gerontology, and divided them into GMC-PEI and control groups. The intervention group received a 12-week GMC-PEI program that included six 2-h structured sessions to enhance their knowledge of dementia, caregiving skills and coping skills. The control group received leaflets containing information about dementia. We evaluated caregivers' depression, caregiving time, subjective burden, caregiving appraisal and care coping skills. We also evaluated people with dementia at baseline and 12 weeks, and reassessed 20 participants from the intervention group at 24 and 48 weeks. RESULTS: The GMC-PEI significantly improved depression, positive appraisals of fulfillment in caregiving, affection for care recipients, self-growth and coping skills, such as seeking formal support. Depression, fulfillment and affection for people with dementia showed a peak improvement at 24 weeks; formal support-seeking showed a linear improvement throughout the 48-week follow-up period. CONCLUSIONS: The group-based multi-component psycho-educational intervention reduced depression, improved self-appraisal and enhanced coping skills in caregivers. However, emotional enhancements dissipated sooner than support-seeking skills, suggesting that caregivers should be reviewed every 12-24 weeks. Geriatr Gerontol Int 2021; 21: 561-567.

Developing an interdisciplinary program of educational support for early-stage dementia patients and their family members: an investigation based on learning needs and attitude changes.

AIM: The National Center for Geriatrics and Gerontology has begun to provide educational support for family caregivers through interdisciplinary programs focusing on patients in the early stage of dementia. These interdisciplinary programs have established two domains for the purpose of "educational support": cure domains (medical care, medication) and care domains (nursing care, welfare). In the present study, we examined the learning needs and post-learning attitude changes of patients and their families who participated in these programs in order to assess the effectiveness of an interdisciplinary program of educational support in each of these domains. METHODS: A total of 170 participants (51 dementia patients, 119 family members) were included in the study. Data were obtained from electronic health records, and through a written survey administered before and immediately after each program. RESULTS: A high percentage of patients and family members desired knowledge about the progression and symptoms of dementia, as well as measures to prevent progression, both of which fall under the medical care content. For patients, education in the medical care content increased their motivation to live. For families, education in the medical and nursing care contents promoted their understanding of dementia, while education in medication and welfare contents improved their skills for handling dementia patients and their symptoms. CONCLUSION: Both patients and family members expressed a need to learn medical care content, including the progression and disease symptoms of dementia, and methods to prevent the progression of dementia symptoms. Their responses showed that learning medical care was effective for understanding dementia. We suggested that medical care content was the core of interdisciplinary educational support for early-stage dementia patients and their family members.

Effect of cerumen impaction on hearing and cognitive functions in Japanese older adults with cognitive impairment.

AIM: To assess the effect of cerumen impaction and its removal on hearing ability and cognitive function in elderly patients with memory disorders in Japan. METHODS: Pure tone audiometry (PTA) and the Mini-Mental State Examination (MMSE) were administered to participants before and after cerumen removal. Participants who had cerumen impaction in the better-hearing ear comprised the case group; the control group consisted of participants who either did not have cerumen impaction or had it in the worse hearing ear. Hearing and cognition changes were compared between the groups after cerumen removal. RESULTS: A total of 55 patients who completed all examinations were assigned to the case group (29 patients) or the control group (26 patients). The average hearing change was 4.6 ± 7.4 in the case group and 0.9 ± 0.9 in the control group (P = 0.029). The average change in MMSE score was 0.7 ± 2.5 in the case group and -1.0 ± 4.1 in the control group (P = 0.068). The case group showed a significant improvement in MMSE scores after age adjustment compared with the control group (P = 0.049). CONCLUSION: Hearing improved significantly in the case group relative to controls after cerumen removal. A significant cognitive improvement in the case group relative to controls was additionally observed after cerumen removal with age adjustment. Thus, the present results suggest routine ear canal examinations might benefit elderly individuals with memory disorders.

[Dementia Care Mapping-Japanese version(DCM-J) as a research evaluation method for measuring quality of life among elderly patients with dementia: reliability and validity of Well-being and Ill-being value].

AIM: Dementia Care Mapping is a behavior evaluation tool that can be used to measure and improve the quality of life of elderly patients with dementia. However, the reliability and validity of the Dementia Care Mapping-Japanese version (DCM-J) has not yet been established. Therefore, the purpose of this research was to clarify the reliability and validity of the Well-being and Ill-being (WIB) value of the DCM-J as a method for evaluating quality of life. METHODS: The study was conducted from April 1, 2005 to June 30, 2006. The participants included 130 elderly patients (men 31, women 99, average age 82.65+/-7.69 years) who were given a diagnosis of dementia. We established inter-rater reliability during a parallel observation method and also used test-retest for reliability. The correlation between the WIB value of the DCM-J and the Japanese Quality of Life Inventory for Elderly with Dementia (QOL-D) was used to establish criterion-related validity. RESULTS: Forty-nine (37.7%) subjects were given a diagnosis of dementia of Alzheimer's type, 80 (61.5%) had vascular dementia and 1 (0.8%) had dementia with Lewy bodies. The results showed correlation between the WIB value and social withdrawal measured by the behavioral category code (BCC) on the DCM-J and the three subscales of QOL-D: "interacting with surroundings", "expressing self", and "experiencing minimum negative behaviors". There was good internal consistency among these items. The interclass correlation coefficient was 82.32 (+/-5.85) for the WIB value of the DCM-J. The correlation coefficient of the retest, administered one week later, was 0.836 (p=0.001). The WIB value was significantly correlated with three sub-scales of QOL-D, and the correlation coefficient was greater than 0.53. CONCLUSION: We demonstrated that the WIB value of the DCM-J has good inter-rater reliability and test re-test reliability and criterion-related validity. In this study, the WIB value was shown to have similar reliability to the WIB value of the original DCM. Furthermore, our results suggest that the DCM-J could be useful for evaluating quality of life among elderly Japanese patients with dementia.