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Effects of dance on cognitive function in older adults: a systematic review and meta-analysis
- Authors:
- HEWSTON Patricia, et al
- Journal article citation:
- Age and Ageing, 50(4), 2021, pp.1084-1092.
- Publisher:
- Oxford University Press
Background: dance is a mind–body activity that stimulates neuroplasticity. We explored the effect of dance on cognitive function in older adults. Methods: we searched MEDLINE, EMBASE, CENTRAL and PsycInfo databases from inception to August 2020 (PROSPERO:CRD42017057138). Inclusion criteria were (i) randomised controlled trials (ii) older adults (aged ≥ 55 years), (iii) intervention—dance and (iv) outcome—cognitive function. Cognitive domains were classified with the Diagnostic and Statistical Manual of Mental Disorders-5 Neurocognitive Framework. Meta-analyses were performed in RevMan5.3 and certainty of evidence with GradePro. Results: we reviewed 3,997 records and included 11 studies (N = 1,412 participants). Seven studies included only healthy older adults and four included those with mild cognitive impairment (MCI). Dance interventions varied in frequency (1–3×/week), time (35–60 minutes), duration (3–12 months) and type. We found a mean difference (MD) = 1.58 (95% confidence interval [CI) = 0.21–2.95) on the Mini Mental State Examination for global cognitive function (moderate-certainty evidence), and the Wechsler Memory Test for learning and memory had an MD = 3.02 (95% CI = 1.38–4.65; low-certainty evidence). On the Trail Making Test-A for complex attention, MD = 3.07 (95% CI = −0.81 to 6.95; high-certainty evidence) and on the Trail Making Test-B for executive function, MD = −4.12 (95% CI = −21.28 to 13.03; moderate-certainty evidence). Subgroup analyses did not suggest consistently greater effects in older adults with MCI. Evidence is uncertain for language, and no studies evaluated social cognition or perceptual–motor function. Conclusions: dance probably improves global cognitive function and executive function. However, there is little difference in complex attention, and evidence also suggests little effect on learning and memory. Future research is needed to determine the optimal dose and if dance results in greater cognitive benefits than other types of physical activity and exercise. (Edited publisher abstract)
Can mindfulness-based interventions influence cognitive functioning in older adults? A review and considerations for future research
- Authors:
- BERK Lotte, BOXTEL Martin van, OS Jim van
- Journal article citation:
- Aging and Mental Health, 21(11), 2017, pp.1113-1120.
- Publisher:
- Taylor and Francis
Objectives: An increased need exists to examine factors that protect against age-related cognitive decline. There is preliminary evidence that meditation can improve cognitive function. However, most studies are cross-sectional and examine a wide variety of meditation techniques. This review focuses on the standard eight-week mindfulness-based interventions (MBIs) such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). Method: The authors searched the PsychINFO, CINAHL, Web of Science, COCHRANE, and PubMed databases to identify original studies investigating the effects of MBI on cognition in older adults. Results: Six reports were included in the review of which three were randomised controlled trials. Studies reported preliminary positive effects on memory, executive function and processing speed. However, most reports had a high risk of bias and sample sizes were small. The only study with low risk of bias, large sample size and active control group reported no significant findings. Conclusion: The authors conclude that eight-week MBI for older adults are feasible, but results on cognitive improvement are inconclusive due a limited number of studies, small sample sizes, and a high risk of bias. Rather than a narrow focus on cognitive training per se, future research may productively shift to investigate MBI as a tool to alleviate suffering in older adults, and to prevent cognitive problems in later life already in younger target populations. (Edited publisher abstract)
Cognitive impairment in elderly patients with schizophrenia: age related changes
- Author:
- HARVEY Philip D.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(S1), December 2001, pp.78-85.
- Publisher:
- Wiley
Cognitive impairment in schizophrenia is a major feature of the illness, however it has not been studied extensively in older patients. This article provides an overview of the research in this area looking specifically at: comparisons of good and poor outcome; age effects of on cognition in poor outcome patients; the course of cognitive and functional deficits in late life; and evidence regarding progressive decline in individual patients with schizophrenia.
Self-awareness of memory impairment in Parkinson’s disease: a review of the literature
- Authors:
- BLOOMFIELD Jacqueline, WOODS Damith Thushara, LUDINGTON Jason
- Journal article citation:
- Working with Older People, 20(1), 2016, pp.57-64.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to review and provide information on the small but growing body of literature that demonstrates that some people with Parkinson’s disease (PD) are unaware of the memory impairment, and this has clinical implications for how family members care for their loved one, and how clinical staff and others may interact with them on a day-to-day perspective. Design/methodology/approach: The approach takes the form of a general review. Findings: People with PD experience a variety of cognitive impairment including deficits in memory and higher level executive processes. Impairment in these areas can occur early in the disease course and result in adverse consequences including distractibility, trouble recalling information, and problems remembering to execute planned actions like adhering to medication regimes. The literature also suggests heterogeneity in both the memory performance of people with PD and in the definition of awareness used to investigate this phenomenon. Practical implications: Strategies for remembering may be of practical importance for people with PD, and/or caregivers should be introduced and educated to the nature of memory impairment in PD, as well as its likely course and natural progression in a non-threatening way before they are later instructed on “tips” for maximising daily functioning as more severe cognitive deficits begin to appear. Originality/value: This paper adds to the small body of literature that investigates patients’ awareness of memory impairment in PD and advocates for ongoing research within the area. (Publisher abstract)
Drug cessation in complex older adults: time for action
- Authors:
- van der CAMMEN Tischa J.M., et al
- Journal article citation:
- Age and Ageing, 43(1), 2014, pp.20-25.
- Publisher:
- Oxford University Press
Background: general opinion is growing that drug cessation in complex older patients is warranted in certain situations. From a clinical viewpoint, drug cessation seems most warranted in four situations, i.e., falls, delirium, cognitive impairment and end-of-life situations. To date, little information about the effects of drug cessation in these four situations is available. Objectives: To identify the effects and effectiveness of drug cessation on falls, delirium and cognitive impairment. For end-of-life situations, we reviewed cessation of inappropriate drug use. Methods: Electronic databases were searched using MeSH terms and relevant keywords. Studies published in English were included if they evaluated the effects of drug cessation in older persons, aged ≥65 years, with falls, delirium or cognitive impairment; or cessation of inappropriate drug use in end-of-life situations. Results: The authors selected seven articles for falls, none for delirium, two for cognition and two for end-of-life situations. Withdrawal of psychotropics reduced fall rate; a prescribing modification programme for primary care physicians reduced fall risk. Withdrawal of psychotropics and a systematic reduction of polypharmacy resulted in an improvement of cognition. Very little rigorous research has been conducted on reducing inappropriate medications in patients approaching end of life. Conclusion: Little research has focussed on drug cessation. Available studies showed a beneficial impact of cessation of psychotropic drugs on falls and cognitive status. More research in this field is needed. The issue of systematic drug withdrawal in end-of-life cases is controversial, but is increasingly relevant in the face of rising numbers of older people of this clinical status. (Publisher abstract)
Anxiety and related symptoms in older persons with dementia: directions for practice
- Authors:
- MCCLIVE-REED Kimberly P., GELLIS Zvi D.
- Journal article citation:
- Journal of Gerontological Social Work, 54(1), January 2011, pp.6-28.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, thus significantly decreasing their functional abilities and reducing their quality of life. This evidence-based review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions for anxiety in persons with dementia. A wide variety of non-pharmacological interventions are examined, including emotion-oriented therapies, behavioural modification and cognitive-behavioural therapy programmes, structured activity programmes, and sensory stimulation therapies, including multisensory approaches. The approaches that appear to show clinical promise for successful treatment of anxiety and related symptoms in dementia include behavioural and cognitive-behavioural therapies, music therapies, animal-assisted therapy (AAT), exercise therapy, and touch therapies. The need for more rigorous research to establish the validity and safety of non-pharmacological interventions in persons with cognitive impairment is discussed.
Alcohol, ageing and dementia: a Scottish perspective
- Author:
- McCabe Louise F.
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 10(2), May 2011, pp.149-163.
- Publisher:
- Sage
There is a complex relationships between alcohol misuse, ageing and cognitive impairment. This article uses Scotland as a case study to examine these relationships and their implications for people who drink as they age. In recent years several policy documents have been published in Scotland that acknowledge the increasing prevalence of alcohol problems among people as they age. The article is based on a review of the literature, analysis of recent Scottish policy documents and two previous research projects carried out by the author. The links between alcohol use and dementia are discussed, focusing on biological and social implications for individuals as they age. Current responses in Scotland to these different issues are examined from individual, cultural and policy perspectives. The article concludes that the needs of older individuals who experience alcohol-related morbidity are not adequately addressed in Scotland.
A review of observational pain scales in nonverbal elderly with cognitive impairments
- Authors:
- PARK Juyoung, CASTELLANOS-BROWN Karen, BELCHER John
- Journal article citation:
- Research on Social Work Practice, 20(6), November 2010, pp.651-664.
- Publisher:
- Sage
Pain assessment for nonverbal older adults with cognitive impairments or dementia presents many challenges, and it is important to determine which scales are most useful in assessing pain among this population. In this review, eleven observational scales for assessment of pain in older adults with dementia or cognitive impairments were evaluated in four main areas: pain indicators; reliability; validity; and clinical utility. Findings suggest that various scales were available for assessing pain in cognitively impaired or demented older people who were unable to report their pain. The authors concluded, however, that future research should focus on further psychometric evaluations. In ending, the paper suggests that social workers should be trained as raters of pain assessment methods.
Older persons' and their caregivers' perspectives and experiences of research participation with impaired decision-making capacity: a scoping review
- Authors:
- HOSIE Annmarie, et al
- Journal article citation:
- Gerontologist, 62(2), 2022, pp.e112-e122.
- Publisher:
- Oxford University Press
Background and Objectives: Human research ethics statements support the equitable inclusion of diverse groups. Yet older people are underrepresented in clinical research, especially those with impaired decision-making capacity. The aim of this study was to identify the perspectives and experiences of older persons and their caregivers of research participation with impaired decision-making capacity. Research Design and Methods: Scoping review of the literature and online sources in January-February 2019 (updated June 2020) according to Joanna Briggs Institute methodology and PRISMA Extension for Scoping Reviews. English-language peer-reviewed research articles and Australian online narratives were included. Data were tabulated and narratively synthesized. Results: From 4,171 database records and 93 online resources, 22 articles (2000-2019, 82% United States, 16 first authors) and one YouTube webinar (2018) were initially included; updated searches yielded an additional article (2020) and YouTube webinar (2020). Studies were heterogeneous in terminology, methods, and foci, with hypothetical scenarios, quantitative analyses, and examination of proxy consent predominating. Participants (N = 7,331) were older persons (71%), caregivers of older persons with dementia/cognitive impairment (23%), and older persons with dementia/cognitive impairment (6%). Synthesis identified 2 themes: willingness to participate and decision-making approaches. Discussion and Implications: Research participation by older persons with dementia may be optimized through reducing risks and burdens and increasing benefits for participants, greater consumer input into study development, and shared and supported decision-making. Older persons' and caregivers' perspectives and experiences of research participation with impaired decision-making capacity require investigation in a greater range of countries and conditions other than dementia, and dissemination through more varied media. (Edited publisher abstract)
Enabling older people with mental health needs to engage with community social care: a scoping review to inform a theory of change
- Authors:
- NEWBOULD Louise, TUCKER Susan, WILBERFORCE Mark
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.1286-1306.
- Publisher:
- Wiley
Despite apparent need, many older people with cognitive impairment and/or mental health needs do not fully engage with social care. This can manifest in different ways, including passive or aggressive attempts to avoid or repel care workers. However, little is known about how to support such individuals in their own homes and deliver effective care. Against this background, the researchers undertook a scoping review with a view to developing a preliminary theory of change suggesting how care might be modified to engage this client group. The most recent search was conducted on 21/04/21. Papers were included if they (i) focused on older people (65+) living at home with social care needs and (ii) described difficulties/problems with the provision/receipt of social care associated with individuals’ mental health needs. Twenty-six citations were identified through electronic database searches and reference screening, and the results were charted according to key theory of change concepts (long-term outcomes, preconditions, interventions, rationale and assumptions). All the included papers were related to people with dementia. Four subgroups of papers were identified. The first highlights those external conditions that make it more likely an intervention will be successful; the second describes specific interventions to engage older people who by virtue of their mental health needs have not engaged with social care; the third explores what services can be done to increase service uptake by older people with mental health needs and their caregivers more generally; and the fourth details theoretical approaches to explaining the behaviour of people with dementia. Each provides information that could be used to inform care delivery and the development of interventions to improve engagement with health and social care for these individuals. The study concludes that different framing of engagement difficulties, such as that offered through positioning theory, may assist in future service design. (Edited publisher abstract)