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1.
Clin Interv Aging ; 14: 1527-1553, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692559

RESUMO

Purpose: There are few interventions on an individual basis to support community-dwelling people with dementia to continue to fulfill their potential in society and to support their informal caregivers via e-Health. This study explored the effectiveness of the individualized Meeting Centers Support Program (iMCSP) consisting of DemenTalent (people with dementia work as volunteers in a society based on their talents), Dementelcoach (telephone coaching), and STAR e-Learning for caregivers, compared to regular MCSP and No day care support. Method: An explorative randomized controlled trial with pre/post measurements (M0-M6) and two groups (iMCSP and regular MCSP). In addition, a comparison was made between iMCSP and a reference No day care control group. Standardized questionnaires were administered on self-esteem, neuropsychiatric symptoms, experienced autonomy and quality of life of the person with dementia, and on caregiver's sense of competence, quality of life, and happiness. Results: The iMCSP interventions resulted in a broader group of participants utilizing the Meeting Centers. Compared to regular MCSP, DemenTalent had a moderate positive effect on neuropsychiatric symptoms, which also proved less severe. Positive affect of participants improved within the DemenTalent and regular MCSP group after six months. Caregivers of DemenTalent participants experienced less emotional impact of neuropsychiatric symptoms. No differences were found in experienced burden, sense of competence, or quality of life in caregivers using iMCSP or regular MCSP. Compared to those receiving No day care support, caregivers of DemenTalent participants and caregivers using Dementelcoach or STAR e-Learning proved happier. Post-hoc analyses, accounting for potential between-group differences in outcome measures at baseline, generally showed results in the same direction. People with dementia and caregivers highly appreciated iMCSP and regular MCSP. Conclusion: iMCSP can be effectively applied as alternative or additional support via regular Meeting Centers for people with dementia and caregivers who prefer individualized activities/support. DemenTalent decreased the severity of neuropsychiatric symptoms of people with dementia and emotional burden of caregivers. All iMCSP interventions tended to result in caregivers being happier compared to those receiving no support. Larger-scale studies are needed to investigate the effect of iMCSP on other domains of quality of life of participants.


Assuntos
Doença de Alzheimer/reabilitação , Cuidadores/psicologia , Hospital Dia/organização & administração , Processos Grupais , Apoio Social , Idoso , Doença de Alzheimer/psicologia , Cuidadores/educação , Instrução por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Autonomia Pessoal , Qualidade de Vida/psicologia , Inquéritos e Questionários , Revisão da Utilização de Recursos de Saúde
2.
Psychiatriki ; 30(2): 142-155, 2019.
Artigo em Grego Moderno | MEDLINE | ID: mdl-31425142

RESUMO

Τhe rate of patients suffering from mild cognitive impairment or any type of dementia has been constantly on the rise. Considering that no effective treatment of dementia has been discovered to date and that drug use can have numerous side effects, there is an urgent need for the application of alternative, non-pharmacological interventions. To this end, the aim of this study was to investigate the effects of physical activity on the cognitive impairment of the elderly, and its use as a form of non-pharmacological intervention for the treatment of dementia. Taking a review of the relevant literature, as its data collection method, this study examined peer-reviewed papers published between 2010 and 2018 that met the criteria for their inclusion. The articles were drawn from three electronic databases (PubMed, ScienceDirect and Web of Science), and were examined with regard to the populations under consideration, research design, type of intervention programs and assessment tools applied. The vast majority of these research papers tend to support that physical activity offers significant benefits to people suffering from Alzheimer's disease or other dementias. Specifically, it helps stabilize and improve cognitive function as well as reduce and delay the onset of severe neuropsychiatric symptoms such as depression, confusion, apathy, etc. In addition, physical exercise plays an important role in improving the executive functioning of patients with dementia, increasing autonomy in their everyday activities and reducing the risk of falls. In conclusion, recent research shows physical activity to be a promising intervention for the prevention and non-pharmacological treatment of dementia in that it contributes to the improvement of patients' quality of life. However, results vary according to the particularly characteristics of the exercise under review, such as type, intensity, frequency, and duration. It is therefore important to gain both awareness and understanding of the specific factors that give physical activity its therapeutic potential leading to the development of exercise programs designed specially to treat dementia.


Assuntos
Demência/psicologia , Exercício Físico/psicologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/prevenção & controle , Doença de Alzheimer/psicologia , Doença de Alzheimer/reabilitação , Cognição , Demência/prevenção & controle , Demência/reabilitação , Terapia por Exercício , Humanos , Qualidade de Vida
3.
Stud Health Technol Inform ; 264: 1716-1717, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438308

RESUMO

Alzheimer's Disease (AD) is an illness that degenerates an individual's cognitive functions, leaving them unable to take care of themselves. Even without a definitive cure, AD should be treated with remedies and cognitive enhancement. This article presents an application that assists in the cognitive reinforcement of AD patients through games, supports the medical follow-up of patients, and facilitates the daily exchange of information between the caregiver and the doctor.


Assuntos
Doença de Alzheimer , Cognição , Jogos de Vídeo , Doença de Alzheimer/reabilitação , Cuidadores , Humanos , Testes Neuropsicológicos
4.
Ir J Psychol Med ; 36(2): 105-119, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31187720

RESUMO

OBJECTIVES: Research shows that cognitive rehabilitation (CR) has the potential to improve goal performance and enhance well-being for people with early stage Alzheimer's disease (AD). This single subject, multiple baseline design (MBD) research investigated the clinical efficacy of an 8-week individualised CR intervention for individuals with early stage AD. METHODS: Three participants with early stage AD were recruited to take part in the study. The intervention consisted of eight sessions of 60-90 minutes of CR. Outcomes included goal performance and satisfaction, quality of life, cognitive and everyday functioning, mood, and memory self-efficacy for participants with AD; and carer burden, general mental health, quality of life, and mood of carers. RESULTS: Visual analysis of MBD data demonstrated a functional relationship between CR and improvements in participants' goal performance. Subjective ratings of goal performance and satisfaction increased from baseline to post-test for three participants and were maintained at follow-up for two. Baseline to post-test quality of life scores improved for three participants, whereas cognitive function and memory self-efficacy scores improved for two. CONCLUSIONS: Our findings demonstrate that CR can improve goal performance, and is a socially acceptable intervention that can be implemented by practitioners with assistance from carers between sessions. This study represents one of the promising first step towards filling a practice gap in this area. Further research and randomised-controlled trials are required.


Assuntos
Idade de Início , Doença de Alzheimer/reabilitação , Terapia Cognitivo-Comportamental , Qualidade de Vida , Feminino , Humanos , Masculino , Testes Neuropsicológicos/estatística & dados numéricos , Projetos Piloto
5.
Adv Gerontol ; 32(1-2): 211-214, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31228392

RESUMO

The article presents the results of the analysis of the needs of elderly and elderly disabled in various types of rehabilitation, including providing them with technical means of rehabilitation, reflects the problems that this group of people have when it comes to resolving issues of medical and social rehabilitation. The importance of an integrated approach in carrying out rehabilitation measures in the study contingent was stressed. Attention is focused on some imperfection of the current regulatory and legal framework in the part concerning the examination in the service of medical and social expertise of the disabled elderly and senile. It is proposed to make appropriate changes that provide for a simplified, in-absent examination of this contingent of persons in the service of medical and social expertise, if it is necessary to make or introduce changes to the current individual rehabilitation program, to habilitate.


Assuntos
Pessoas com Deficiência , Reabilitação , Idoso , Doença de Alzheimer/reabilitação , Humanos
6.
Adv Gerontol ; 32(1-2): 243-249, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31228397

RESUMO

Due to the introduction of new medical technologies, there is an increase in the number of people, including the elderly and senile age, who have extended their lives, but who need constant care from medical and social services at home. In the study of age differences of biological needs in home care, it was found that for middle-aged people the greatest difficulties and contribution to the reduction of quality of life brought insufficient nutrition, limited independence in the performance of household manipulations due to joint damage, pain and other biological causes, as well as hypothermia syndrome compared with elderly and senile age. For people of older age groups was characterized by the need to bridge the lack of communication; enhancing the role of the family in the implementation of care; increased confidence in caregivers; increased availability of medicines; and increased availability of religious services. Developed on the basis of identified age-based determinants of quality of life, the original model of the bio-psychosocial activating care for the geriatric contingent of patients at home, the difference from traditional approaches is the use of activating kinesitherapy and cognitive exercises, contributes to the achievement of a higher level of functionality and independence of the geriatric patient, which is accompanied by improving the quality of life.


Assuntos
Doença de Alzheimer , Serviços de Assistência Domiciliar , Qualidade de Vida , Idoso , Doença de Alzheimer/reabilitação , Humanos , Pessoa de Meia-Idade , Serviço Social
7.
Psychiatr Pol ; 53(1): 117-127, 2019 Feb 28.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-31008469

RESUMO

The following article discusses the possibility of applying a rehabilitation strategy known as Errorless Learning (EL) in patients suffering from Alzheimer's disease (AD). The authors present the issue in the context of the knowledge on the effectiveness of administering neuropsychological interventions in patients with AD. The history of the EL method development is presented as well as techniques used in its domain. The novelty of the EL methodological approach is shown. It is emphasized that EL, in contrast with the majority of neuropsychological rehabilitation strategies, has a relatively reliable theoretical basis. The remaining part of the work focuses on reviewing empirical findings concerning the effectiveness of employing Errorless Learning in rehabilitation of individuals suffering from AD, which are available in the professional literature. Factors affecting it, such as rehabilitation session organization, frequency of participants' advancements testing and a type of practiced material, are discussed. The effectiveness of EL is compared with the results of other neuropsychological rehabilitation methods. The authors of this article find that the EL strategy may increase cognitive training effectiveness and is a useful option in neuropsychological rehabilitation of patients suffering from moderate to severe Alzheimer's disease.


Assuntos
Doença de Alzheimer/psicologia , Doença de Alzheimer/reabilitação , Biorretroalimentação Psicológica/métodos , Reabilitação Neurológica/métodos , Feminino , Humanos , Masculino , Memória de Curto Prazo , Análise e Desempenho de Tarefas
8.
BMC Geriatr ; 19(1): 66, 2019 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832581

RESUMO

BACKGROUND: Giving up driving is a pivotal life event and universal challenge for people living with dementia and their families, and a complex area of clinical practice for health professionals who monitor driving cessation. The best outcomes are for individuals to plan for and eventually cease driving, however with insufficient support programs in place, many avoid the issue until it is reaches a crisis point. This program of research investigates a comprehensive support- and education-based intervention targeted at people living with dementia and their care partners who are managing driving cessation. The primary aim of this research is to determine the effectiveness of the program through a cluster randomized controlled trial. METHODS/DESIGN: The intervention (CarFreeMe) is an intensive program delivered by a trained health professional that addresses practical and emotional needs relevant to driving cessation. The seven module program is person-centred, covering awareness raising, adjustment, and practical support that is individualized according to geographic location and the particular goals and preferences of participants. A cluster randomized controlled trial will evaluate the effectiveness of the program. Evaluation will take place pre-intervention, immediately following, and three months post-intervention. Clusters are randomized to either intervention or usual treatment. Participants within clusters will be recruited via primary and secondary care clinics, community agencies, service providers, local media, social media, support groups, and word of mouth. The primary outcome measure for persons with dementia and their care partners is lifespace, collected via (i) smartphone GPS technology and (ii) self-reported number of episodes away from home (during the past week). Secondary outcomes include safe alternative transport status, wellbeing, depression, anxiety, and self-efficacy, which will be collected from dyads. Caregiving strain will be collected from care partner/family member only. A process evaluation of the intervention will also be undertaken. DISCUSSION: There is an urgent need for therapeutic approaches to supporting people living with dementia and their families to negotiate the complex decision making involved in deciding to change their approach to driving. The driving cessation intervention may fill an important gap in service delivery to people living with dementia who are adjusting to life without driving. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12618000388213 , 15 March 2018.


Assuntos
Doença de Alzheimer/reabilitação , Condução de Veículo/psicologia , Cuidadores/psicologia , Qualidade de Vida/psicologia , Seguridade Social , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Esgotamento Psicológico/psicologia , Cuidadores/educação , Tomada de Decisões , Feminino , Seguimentos , Humanos , Masculino , Queensland
9.
Int J Geriatr Psychiatry ; 34(5): 709-721, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30724405

RESUMO

OBJECTIVES: To determine whether individual goal-oriented cognitive rehabilitation (CR) improves everyday functioning for people with mild-to-moderate dementia. DESIGN AND METHODS: Parallel group multicentre single-blind randomised controlled trial (RCT) comparing CR added to usual treatment (CR) with usual treatment alone (TAU) for people with an ICD-10 diagnosis of Alzheimer, vascular or mixed dementia, and mild-to-moderate cognitive impairment (Mini-Mental State Examination [MMSE] score ≥ 18), and with a family member willing to contribute. Participants allocated to CR received 10 weekly sessions over 3 months and four maintenance sessions over 6 months. Participants were followed up 3 and 9 months post randomisation by blinded researchers. The primary outcome was self-reported goal attainment at 3 months. Secondary outcomes at 3 and 9 months included informant-reported goal attainment, quality of life, mood, self-efficacy, and cognition and study partner stress and quality of life. RESULTS: We randomised (1:1) 475 people with dementia; 445 (CR = 281) were included in the intention to treat analysis at 3 months and 426 (CR = 208) at 9 months. At 3 months, there were statistically significant large positive effects for participant-rated goal attainment (d = 0.97; 95% CI, 0.75-1.19), corroborated by informant ratings (d = 1.11; 95% CI, 0.89-1.34). These effects were maintained at 9 months for both participant (d = 0.94; 95% CI, 0.71-1.17) and informant (d = 0.96; 95% CI, 0.73-1.2) ratings. The observed gains related to goals directly targeted in the therapy. There were no significant differences in secondary outcomes. CONCLUSIONS: CR enables people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy.


Assuntos
Doença de Alzheimer/reabilitação , Transtornos Cognitivos/reabilitação , Terapia Cognitivo-Comportamental/métodos , Demência/reabilitação , Afeto , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Cognição , Demência/psicologia , Feminino , Objetivos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Autoeficácia
10.
BMC Geriatr ; 19(1): 35, 2019 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-30727947

RESUMO

BACKGROUND: There is a growing interest in developing tailored non-pharmacological strategies to face patients' needs in dementia. Occupational therapy (OT) may contribute to promote self-empowerment of both patients and caregivers. France has implemented nationwide OT over a short-term period of 3/4 months. The main objective of the MathéoAlz study is to measure the impact of maintaining OT over 4 supplementary months on patients' neuropsychiatric symptoms. METHODS/DESIGN: The MatheoAlz trial (Maintenance of Occupational Therapy in Alzheimer's disease) is a multi-center, pragmatic randomized controlled trial testing maintenance of OT over 4 supplementary months compared to routine OT delivered as recommended. This paper describes the study protocol. MatheoAlz plans to enroll 240 dyads, i.e. dementia patients and caregivers, whose main inclusion criteria are: prescription for routine OT, patients with mild or moderate dementia, living at home, receiving support from an informal caregiver. The study will compare a control group of patients benefiting from 12 to 15 initial sessions of OT over 3/4 months and an intervention group of patients benefiting from these initial sessions plus 8 extra home sessions over 4 supplementary months. The main outcome is the patient's neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory at 8 months. Several clinical outcomes and economic consequences are measured at 4, 8 and 12 months. DISCUSSION: This is the first trial designed to assess the specific impact of the maintaining OT on the patients' neuropsychiatric symptoms burden. The results will inform policymakers on strategies to implement in the near future. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on February 16, 2018, identifier: NCT03435705 .


Assuntos
Cuidadores/psicologia , Demência/psicologia , Demência/reabilitação , Terapia Ocupacional/métodos , Idoso , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/psicologia , Doença de Alzheimer/reabilitação , Demência/epidemiologia , Feminino , França/epidemiologia , Humanos , Masculino , Qualidade de Vida/psicologia
11.
Personal Disord ; 10(1): 4-12, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30604979

RESUMO

The objective of this article is to review and integrate interrelated areas of research on personality and Alzheimer's disease (AD). Prospective studies indicate that individuals who score higher on conscientiousness (more responsible and self-disciplined) and lower on neuroticism (less anxious and vulnerable to stress) have a reduced risk of developing dementia, even in the presence of AD neuropathology. Personality is also related to measures of cognitive performance and cognitive decline, with effect sizes similar to those of other clinical, lifestyle, and behavioral risk factors. These associations are unlikely to be due to reverse causality: Long-term prospective data indicate that there are no changes in personality that are an early sign of the disease during the preclinical phase of AD. With the onset and progression of dementia, however, there are large changes in personality that are reported consistently by caregivers in retrospective studies and are consistent with the clinical criteria for the diagnosis of dementia. The review also discusses potential mechanisms of the observed associations and emphasizes the need for prospective studies to elucidate the interplay of personality traits with AD neuropathology (amyloid and tau biomarkers) in modulating the risk and timing of onset of clinical dementia. The article concludes with the implications of personality research for identifying those at greater risk of AD and the potential of personality-tailored interventions aimed at the prevention and treatment of AD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Doença de Alzheimer/fisiopatologia , Transtornos da Personalidade/fisiopatologia , Personalidade/fisiologia , Doença de Alzheimer/reabilitação , Humanos , Transtornos da Personalidade/reabilitação
12.
J Geriatr Psychiatry Neurol ; 32(1): 16-23, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30477375

RESUMO

INTRODUCTION: The benefit of cognitive rehabilitation (CR) for patients with early-stage Alzheimer disease (AD) remains difficult to assess. METHOD: An observational, prospective study was conducted in a sample of 52 patients with AD included in a clinical, individualized CR program. Cognitive rehabilitation consisted of 1 weekly session during 3 months at home, followed by 1 monthly contact for 9 months. Rehabilitation techniques were used by experienced therapists to adapt activities important for the patient. Evaluation of patient's dependence in activities and objective and subjective caregiver's burden was performed with a research quantitative scale immediately after the intervention and at 6-month and 1-year follow-up. RESULTS: Analyses with repeated measure analysis of variance showed decreased patient's dependence for adapted activities at 3 months, 6 months, and 1 year. Objective and subjective percentage of caregiver's burden was also decreased at all evaluations with our research functional scale, while there was no change on Zarit's burden scale. Global cognition slightly decreased over 1 year. CONCLUSIONS: This observational study in a clinical setting is in line with the benefit of CR for patients with mild AD reported in recent randomized controlled trials. The benefit obtained for adapted activities remained after 1 year, even if global cognition declined. Moreover caregiver's burden related to all individually relevant daily activities (from a list of 98) evaluated within the CR program was decreased after 1 year. Those preliminary results emphasize the importance of choice for the measurement instrument to report CR efficacy and claim for further validation of such tools.


Assuntos
Doença de Alzheimer/reabilitação , Terapia Cognitivo-Comportamental/métodos , Adaptação Psicológica , Idoso , Doença de Alzheimer/psicologia , Cuidadores/psicologia , Cognição/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
13.
J Telemed Telecare ; 25(2): 67-79, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29117794

RESUMO

INTRODUCTION: Given the limited effectiveness of pharmacological treatments, non-pharmacological interventions in neurodegenerative diseases have gained increasing attention in recent years and telerehabilitation has been proposed as a cognitive rehabilitation strategy. The purpose of this systematic review is to examine the evidence for the efficacy of cognitive telerehabilitation interventions compared with face-to-face rehabilitation in patients with mild cognitive impairment, Alzheimer's disease and frontotemporal dementia. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of the Medline database was conducted. Out of 14 articles assessed for eligibility, five studies were identified, three in participants with mild cognitive impairment or Alzheimer's disease, two in patients with primary progressive aphasia. RESULTS: The Physiotherapy Evidence Database scale was used to assess the methodological quality of four out of five studies included in this systematic review, with only one report receiving a high-quality rating. Effect-size analysis evidenced positive effects of telerehabilitation interventions, comparable with those reported for face-to-face rehabilitation. DISCUSSION: The available evidence for the effectiveness of cognitive telerehabilitation is limited, and the quality of the evidence needs to be improved. The systematic review provides preliminary evidence suggesting that cognitive telerehabilitation for neurodegenerative disease may have comparable effects as conventional in-person cognitive rehabilitation.


Assuntos
Doença de Alzheimer/reabilitação , Disfunção Cognitiva/reabilitação , Demência Frontotemporal/reabilitação , Telerreabilitação/métodos , Cognição , Humanos
14.
Dementia (London) ; 18(2): 417-431, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27756836

RESUMO

This study examined the effect of a Multicomponent Training (MT) intervention on cognitive function, functional fitness and anthropometric variables in institutionalized patients with Alzheimer's disease (AD). Thirty-seven institutionalized elders (84.05 ± 5.58 years) clinically diagnosed with AD (mild and moderate stages) were divided into two groups: Experimental Group (EG, n = 19) and Control Group (CG, n = 18). The EG participated in a six-month supervised MT program (aerobic, muscular resistance, flexibility and postural exercises) of 45-55 minutes/session, twice/week. Cognitive function (MMSE), physical fitness (Senior Fitness Test) and anthropometric variables (Body Mass Index and Waist Circumference), were assessed before (M1), after three months (M2) and after six months (M3) of the experimental protocol. A two-way ANOVA, with repeated measures, revealed significant group and time interactions on cognitive function, chair stand, arm curl, 2-min step, 8-foot up-and-go (UG), chair sit-and-reach (CSR) and back scratch tests as well as waist circumference. Accordingly, for those variables a different response in each group was evident over the time, supported by a significantly better EG performance in chair stand, arm curl, 2-min step, UG, CSR and back scratch tests from M1 to M3, and a significant increase in MMSE from M1 to M2. The CG's performance decreased over time (M1 to M3) in chair stand, arm curl, 2-min step, UG, CSR, back scratch and MMSE. Results suggest that MT programs may be an important non-pharmacological strategy to improve physical and cognitive functions in institutionalized AD patients.


Assuntos
Doença de Alzheimer/reabilitação , Terapia por Exercício , Casas de Saúde/normas , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Índice de Massa Corporal , Cognição , Feminino , Humanos , Masculino , Aptidão Física , Escalas de Graduação Psiquiátrica , Resultado do Tratamento , Circunferência da Cintura
15.
Dementia (London) ; 18(2): 802-807, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27780860

RESUMO

With the ongoing need to determine effective memory interventions for persons with dementia and other memory impairments, the purpose of this study was to create a unique learning opportunity, where persons with early to moderate Alzheimer's engaged in game play activity. Six female participants, diagnosed with early to moderate dementia, were recruited from an adult day care center and participated in a 10-week study. The participants were placed in groups of three and were taught a tile placement game. Results indicate playing the game yielded inconsistent, but some significant, increases and eventual plateauing of knowing when it was their turn. The results also indicate the participant's maintained improvement in tile placement over the study period. Tile placement accuracy increased over rounds, which points to the importance of practice to maintain learned behavior. The game provided a platform for learning, social engagement, and occupied their time meaningfully.


Assuntos
Doença de Alzheimer/psicologia , Doença de Alzheimer/reabilitação , Jogos Recreativos , Aprendizagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Relações Interpessoais , Pessoa de Meia-Idade , Projetos Piloto
16.
Dementia (London) ; 18(2): 808-813, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28068784

RESUMO

This study examined social engagement during game play among persons with Alzheimer's. In addition to being engaged with the game, engagement with players was noticed. Players would congratulate each other when they won, and they encouraged each other to do well. Natural conversation occurred as a result of playing the game. The researchers observed that as placement accuracy increased, the players developed a friendly competition. They played to win and experienced a sense of accomplishment when they correctly matched tile pieces. Interestingly, the game provided the players an opportunity to help each other. When a player was unable to figure out where to place a tile, oftentimes the other players would remind them of the rules and assist in tile placement. The ability to help and share knowledge is an opportunity often denied to persons with Alzheimer's.


Assuntos
Doença de Alzheimer/psicologia , Doença de Alzheimer/reabilitação , Jogos Recreativos , Relações Interpessoais , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Autoimagem
17.
J Geriatr Phys Ther ; 42(1): 28-47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29210934

RESUMO

BACKGROUND AND PURPOSE: There is growing evidence that exercise interventions can mitigate functional decline and reduce fall risk in older adults with Alzheimer disease and related dementias (ADRD). Although physical performance outcome measures have been successfully used in older adults without cognitive impairment, additional research is needed regarding their use with individuals who have ADRD, and who may have difficulty following instructions regarding performance of these measures. The purpose of this scoping review was to identify commonly used physical performance outcome measures, for exercise interventions, that are responsive and reliable in older adults with ADRD. Ultimately, we aimed to provide recommendations regarding the use of outcome measures for individuals with ADRD across several domains of physical performance. METHODS: A scoping review was conducted to broadly assess physical performance outcome measures used in exercise interventions for older adults with ADRD. Exercise intervention studies that included at least 1 measure of physical performance were included. All physical performance outcome measures were abstracted, coded, and categorized into 5 domains of physical performance: fitness, functional mobility, gait, balance, and strength. Criteria for recommendations were based on (1) the frequency of use, (2) responsiveness, and (3) reliability. Frequency was determined by the number of studies that used the outcome measure per physical performance domain. Responsiveness was assessed via calculated effect size of the outcome measures across studies within physical performance domains. Reliability was evaluated via published studies of psychometric properties. RESULTS AND DISCUSSION: A total of 20 physical performance outcome measures were extracted from 48 articles that met study inclusion criteria. The most frequently used outcome measures were the 6-minute walk test, Timed Up and Go, repeated chair stand tests, short-distance gait speed, the Berg Balance Scale, and isometric strength measures. These outcome measures demonstrated a small, medium, or large effect in at least 50% of the exercise intervention studies. Good to excellent reliability was reported in samples of older adults with mild to moderate dementia. Fitness, functional mobility, gait, balance, and strength represent important domains of physical performance for older adults. The 6-minute walk test, Timed Up and Go, repeated chair stand tests, short-distance gait speed, Berg Balance Scale, and isometric strength are recommended as commonly used and reliable physical performance outcome measures for exercise interventions in older adults with mild to moderate ADRD. Further research is needed on optimal measures for individuals with severe ADRD. CONCLUSIONS: The results of this review will aid clinicians and researchers in selecting reliable measures to evaluate physical performance outcomes in response to exercise interventions in older adults with ADRD.


Assuntos
Doença de Alzheimer/fisiopatologia , Doença de Alzheimer/reabilitação , Teste de Esforço , Desempenho Físico Funcional , Demência/fisiopatologia , Demência/reabilitação , Exercício Físico/fisiologia , Terapia por Exercício , Marcha , Humanos , Força Muscular , Aptidão Física , Equilíbrio Postural , Reprodutibilidade dos Testes , Resultado do Tratamento
19.
Cortex ; 109: 104-123, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30312779

RESUMO

During the last decades, there have been major advances in mapping the brain regions that underlie our ability to perceive, experience, and produce music and how musical training can shape the structure and function of the brain. This progress has fueled and renewed clinical interest towards uncovering the neural basis for the impaired or preserved processing of music in different neurological disorders and how music-based interventions can be used in their rehabilitation and care. This article reviews our contribution to and the state-of-the-art of this field. We will provide a short overview outlining the key brain networks that participate in the processing of music and singing in the healthy brain and then present recent findings on the following key music-related research topics in neurological disorders: (i) the neural architecture underlying deficient processing of music (amusia), (ii) the preservation of singing in aphasia and music-evoked emotions and memories in Alzheimer's disease, (iii) the mnemonic impact of songs as a verbal learning tool, and (iv) the cognitive, emotional, and neural efficacy of music-based interventions and activities in the rehabilitation and care of major ageing-related neurological illnesses (stroke, Alzheimer's disease, and Parkinson's disease).


Assuntos
Envelhecimento/psicologia , Doença de Alzheimer/reabilitação , Aprendizagem/fisiologia , Musicoterapia/métodos , Música/psicologia , Doença de Parkinson/reabilitação , Reabilitação do Acidente Vascular Cerebral/psicologia , Doença de Alzheimer/psicologia , Humanos , Doença de Parkinson/psicologia
20.
Neuropsychology ; 32(6): 664-679, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30080079

RESUMO

OBJECTIVE: The efficacy of cognition-focused interventions (CFIs) for the treatment of Alzheimer's disease (AD) has been questioned recently. To date, the specific effects of cognitive rehabilitation (CR), cognitive training (CT), and cognitive stimulation [CS] have not been analyzed due to inconsistencies in the use of the comparison groups. This work aims to analyze the differential effects of CFIs by removing the influence of the comparison group from the estimates of the effects. METHOD: a literature search performed in Pubmed, Proquest, and Embase databases yielded 65 potential studies, of which 33 studies with a sample size of 1,225 individuals were meta-analyzed. Each intervention group was treated as the unit of analysis to remove the confounding effects of the comparison condition. Measures of general cognitive functioning, memory and functional outcomes were compared using the hierarchical robust variance estimator metaregression. Age, education, sex, risk of bias, sample size, duration of intervention, the proportion of drop-outs, pharmacological treatment, and severity of disease were included as covariates. RESULTS: Only CT differed from no cognition-focused interventions (NCFI) for memory outcomes in univariate analyses, but differences became nonsignificant when covariates were included in the model. CR showed a significantly higher effect in outcomes measuring functioning in targeted domains with no differences in standard cognitive tests relative to NCFI. CONCLUSIONS: This work supports previous findings questioning the efficacy of CT or CS for AD. Moving toward CFIs focused on relevant goals and including measures related to the skills, abilities or activities that are the focus of the intervention is encouraged. (PsycINFO Database Record


Assuntos
Doença de Alzheimer/reabilitação , Remediação Cognitiva/métodos , /estatística & dados numéricos , Humanos
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