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Mediating effects of psychosocial factors on concerns about falling and daily activity in a multicomponent cognitive behavioral group intervention
- Authors:
- ZIJLSTRA G.A. Rixt, et al
- Journal article citation:
- Aging and Mental Health, 15(1), January 2011, pp.68-77.
- Publisher:
- Taylor and Francis
This study explored the mediating effects of psychosocial factors on concerns about falling and daily activity in a cognitive behavioural group intervention. Five hundred and forty older people, with concerns about falling and activity avoidance, participated in a randomised controlled trial evaluating this intervention. Control beliefs, self-efficacy beliefs, outcome expectations, social interactions, and concerns about falling and daily activity were assessed at baseline, and at 2, 8, and 14 months. Moderate statistically significant effects of the intervention on the potential mediators were found at nearly all follow-up assessments. Separate psychosocial factors showed modest mediating effects on the outcomes. Overall, the multicomponent cognitive behavioural intervention improved control beliefs, self-efficacy, outcome expectations, and social interactions. These variables mediated the association between the intervention and concerns about falling or daily activity in older people. The authors suggest that this study may enable further improvement and development of interventions to reduce concerns about falling for old people.
Therapeutic interventions in dementia 1: cognitive symptoms and function
- Authors:
- TAYLOR Clare, et al
- Journal article citation:
- Nursing Times, 13.1.09, 2009, pp.16-17.
- Publisher:
- Nursing Times
This is the first of a two part article on therapeutic interventions in dementia which outlines how to maintain function and independence for patients with dementia. It also examines specific interventions - both psychological and pharmacological - for cognitive symptoms. The article draws on recently developed national guidance from NICE and the Social Care Institute for Excellence (SCIE).
Cognitive support for elders through technology
- Authors:
- ROGERS Wendy A., FISK Arthur D.
- Journal article citation:
- Generations, 30(2), Summer 2006, pp.38-43.
- Publisher:
- American Society on Aging
Describe an innovative research programme at Georgia Institute of Technology in the United States, which focused on the development of 'aware home technology', that is cognitive interventions for older adults that support the maintenance of their health and well-being.
Effectiveness of multicomponent exercise interventions in older adults with dementia: a meta-analysis
- Authors:
- BORGES-MACHADO Flavia, et al
- Journal article citation:
- Gerontologist, 61(8), 2021, pp.e449-e462.
- Publisher:
- Oxford University Press
Background and Objectives: Multicomponent training (MT) combines aerobic, strength, postural, and balance exercises and may be a promising intervention strategy for dementia. This meta-analysis study aims to systematize evidence concerning the effectiveness of MT in physical fitness, cognition, and functionality on activities of daily living (ADL) in older adults with dementia and to identify moderation patterns regarding training variables. Research Design and Methods: 4 databases were systematically searched to locate potential trials through March 2019. A total of 2,312 records were identified and a final set of 17 manuscripts reviewed; of these, 6 satisfied all eligibility criteria. Results: Samples sizes ranged from 27 to 170 participants; MT programs lasted between 4 weeks and 12 months, took place from a daily basis to twice a week, and sessions ranged from 30 to 60 min. The TESTEX scale was used to analyze the methodological quality, and the funnel plots to assess the risk of bias. This meta-analysis revealed that MT interventions benefit older adults with dementia regarding ADL performance (effect size = 0.313 [0.16–0.46]; p < .01), but the evidence was not sufficiently robust to determine the effectiveness of MT on cognitive function and physical fitness, particularly, on agility. Discussion and Implications: MT may be an important nonpharmacological strategy to enhance ADL functionality on older adults with dementia. Findings suggest that long-term interventions are more prevalent than high-frequency and longer duration exercise sessions. Further evidence is needed for acknowledging its benefits in specific cognitive abilities and physical fitness. This meta-analysis is registered in PROSPERO (no. CRD42020141545). (Edited publisher abstract)
Effective peer leader attributes for the promotion of walking in older adults
- Authors:
- KRITZ Marlene, et al
- Journal article citation:
- Gerontologist, 60(6), 2020, pp.1137-1148.
- Publisher:
- Oxford University Press
Peer-led interventions are promising for the promotion of physical activity behavior in older adults. However, little is known about the attributes of effective older peer leaders in such intervention programs. The objective was to determine what older adults perceive to be effective peer leader attributes. Research Design and Methods: A mixed-methods concurrent triangulation design was used. articipants, aged 60 years and older, were recruited from retirement villages and existing walking groups in Western Australia. They were predominantly white, Australian-born, female, healthy retirees. The sample consisted of four groups of older adults: those who had taken part in past peer-led walking programs (experienced walkers; n = 18), those interested in joining as walkers in a peer-led walking intervention (inexperienced walkers; n = 43), those interested to take on a peer leader role (inexperienced peer leaders; n = 25), and those who had already served as peer leaders (experienced peer leaders; n = 15). Questionnaires measured perceived effective leadership attributes, and physical activity was measured using ActivPAL devices (N = 101; Mage [SD] = 75.36 [7.59]). Semistructured interviews were conducted with the majority of participants (N = 68; Mage [SD] = 74.68 [7.78]).Results: Overall, participants described an effective peer leader as optimistic, compassionate, and friendly, but differences in perceptions were apparent between the groups. Discussion and Implications: The authors findings advance knowledge about important characteristics of an effective older peer leader, which can inform peer leader training, recruitment of peer leaders, and future scale development. (Edited publisher abstract)
Interventions to reduce dependency in bathing in community dwelling older adults: a systematic review
- Authors:
- GOLDING-DAY Miriam, et al
- Journal article citation:
- Systematic reviews, 6(1), 2017, Online only
- Publisher:
- BioMed Central
Background: The onset of bathing disability for older adults has been found to be an indicator and potential precursor of further disability. Thus interventions targeting bathing may prevent or delay further disability and the use of health and social care services. The aim of this systematic review was to identify interventions targeted at reducing dependency in bathing for community dwelling older adults, and determine their content and effectiveness in maintaining or improving function and quality of life. Methods: The authors conducted a systematic search of electronic databases including: The Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; AMED; CINAHL; PsycINFO and OTSeeker. The search took place on 18 October 2016. The review included randomised controlled trials, nonrandomised controlled trials, and controlled before and after studies that evaluated an intervention designed to reduce dependency in bathing. Articles were screened for inclusion by two independent reviewers; risk of bias was assessed using quality assessment tools; and data extracted using pre-prepared forms. Disagreements were resolved by discussion and inclusion of a third reviewer. Results: The search process identified one study for inclusion in the review. This study evaluated a bathing intervention delivered by an occupational therapist following discharge from hospital. Overall, the findings suggest modest improvements in functional ability in favour of the intervention group although the results should be interpreted with caution. Conclusion: Despite evidence suggesting the importance of addressing bathing difficulties as a means of possible prevention of disability in the ageing process, there is a dearth of evaluative or interventional research studies. Further robust research is warranted, including studies of randomised and controlled design. (Edited publisher abstract)
The determinants of informal caregivers' burden in the care of frail older persons: a dynamic and role-related perspective
- Authors:
- MELLO J. de Almedia, et al
- Journal article citation:
- Aging and Mental Health, 21(8), 2017, pp.838-843.
- Publisher:
- Taylor and Francis
Abstract: Research into informal caregivers' burden does not distinguish between different stages of impairment. This study explored the determinants of burden from an in-depth perspective in order to identify which determinants apply to which phases of impairment. Methods: This was a cross-sectional study including frail older persons aged 65 and above. Instruments used were the interRAI Home Care, the Zarit-12 interview and an ad hoc economic questionnaire. A combination of variables from the Stress Process Model and Role Theory and a sub-group analysis enabled refined multivariate logistic analyses. Results: The study population consisted of 4175 older persons (average age: 81.4 ± 6.8, 67.8% female) and their informal caregivers. About 57% of them perceived burden. Depressive symptoms, behavioural problems, IADL impairment, previous admissions to nursing homes and risk of falls yielded significant odds ratios in relation to informal caregivers’ burden for the whole sample. These determinants were taken from the Stress Process Model. When the population was stratified according to impairment, some factors were only significant for the population with severe impairment (behavioural problems OR:2.50; previous admissions to nursing homes OR:2.02) and not for the population with mild or moderate impairment. The informal caregiver being an adult child, which is a determinant from Role Theory, and cohabitation showed significant associations with burden in all strata. Conclusion: Determinants of informal caregivers’ burden varied according to stages of impairment. The results of this study can help professional caregivers gain a greater insight into which informal caregivers are most susceptible to perceive burden. (Edited publisher abstract)
Effects of self-management support programmes on activities of daily living of older adults: a systematic review
- Authors:
- BOLSCHER-NIEHUIS Marian J.T. ven het, et al
- Journal article citation:
- International Journal of Nursing Studies, 61, 2016, pp.230-247.
- Publisher:
- Elsevier
Background: The ability of older adults to carry out activities of daily living and to adapt and to manage their own life decreases due to deterioration of their physical and cognitive condition. Nurses and other health care professionals should support the self-management ability of older adults to prevent activities of daily living dependence and increase the ability to adapt and to self-manage the consequences of living with a chronic condition. Objective: This systematic literature review aimed to gain insight into the evidence of the effects of self-management support programmes on the activities of daily living of older adults living at home. Data sources: Searches were performed in PubMed, CINAHL, PsychInfo, EMBASE and the Cochrane Central Register of Controlled Trials (in February 2016). No limitations were applied regarding date of publication, language or country. Review methods: Publications were eligible for this review on condition that they described a self-management support programme directed at adults of on average 65 years or older, and living in the community; used a randomized control group design; and presented information about the effects on activities of daily living. The methodological quality of the included studies was independently assessed by the authors using the quality criteria for reviews of the Cochrane Effective Practice and Organisation of Care Review Group. A best evidence synthesis was performed using guidelines provided by the Cochrane Collaboration Back Review Group. Results: A total of 6246 potentially relevant references were found. After screening the references, 12 studies with a randomised controlled trial design were included. The methodological assessment of the 12 studies indicated variations in the risk of bias from low (n = 1) to unclear (n = 3) and high (n = 8). Although there was considerable variation in study population, intervention characteristics and measurement instruments used, most studies (n = 11) showed effects of self-management support programmes on the activities of daily living of older adults. Conclusions: There is a moderate level of evidence that self-management support programmes with a multi-component structure, containing disease-specific information, education of knowledge and skills and, in particular, individually tailored coaching, improve the activities of daily living of older adults. Further research is required to gain insight into the most appropriate context and approach of self-management support interventions targeting activities of daily living of older adults living in the community. (Edited publisher abstract)
A randomized controlled trial of a Functioning Improvement Tool home-visit program and its effect on cognitive function in older persons
- Authors:
- UKAWA Shigekazu, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(6), June 2012, pp.557-564.
- Publisher:
- Wiley
This study, conducted in two rural towns in northern Japan, looked at whether mini mental state examination (MMSE) scores improved in older participants of a Functioning Improvement Tool (FIT) home-visit program. A total of 252 participants living at home and receiving community preventive services were enrolled and randomly assigned to an intervention group (n=128) or a control group (n=124). Intervention group subjects received a 60-min FIT home-visit program once a month for 3 months. This included guidance, assistance, and help in writing and teaching calculation in order to complete the FIT. Control subjects did not receive any home visits. Fifty-three subjects were excluded because of withdrawal, hospitalisation, death, relocation, or missing data. 199 subjects (60 men, 139 women; age 78.6 years) were analysed. The baseline MMSE scores did not differ between the intervention and control groups (24.2 vs. 24.1). After the study period, the change in the MMSE score was significantly better in the intervention group than in the control group (0.8 vs. −0.1 ). Stratified analyses showed that the intervention strategy was most effective in subjects with mild cognitive decline, with baseline MMSE scores from 18 to 23 points. The authors conclude that this FIT home-visit program improved MMSE scores in older participants with mild cognitive decline.
Enriching opportunities for people living with dementia: the development of a blueprint for a sustainable activity-based model
- Authors:
- BROOKER Dawn J., WOOLEY Rosemary J.
- Journal article citation:
- Aging and Mental Health, 11(4), July 2007, pp.371-383.
- Publisher:
- Taylor and Francis
The aim of this paper is to describe the process of building a multi-level intervention called the Enriched Opportunities Programme, the objective of which is to provide a sustainable activity-based model for people with dementia living in long-term care. It is hypothesised that five key elements need to work together to bring about a sustainable activity-based model of care. These elements are specialist expertise-the staff role of Locksmith was developed as part of this programme; individualised assessment and case work; an activity and occupation programme; staff training; and management and leadership. These elements working together are known as the Enriched Opportunities Programme. This paper reports on the processes undertaken to develop Enriched Opportunities from its inception to the present, and focuses on lessons learnt from the literature, an expert working group and action research in four UK study sites. A blueprint for evaluation in other long-term care facilities is described.