Cochrane: Activities for people with dementia: what can evidence and experience teach us?

In this blog Sarah Chapman looks at evidence on personally tailored activities for people with dementia and shares insights from her own experience and those of others, acknowledging a wealth of experience to help people with dementia, while we await further research into providing tailored activities for people with dementia.

Blog post available from Evidently Cochrane

Can museums help prevent dementia?

New study suggests visiting museums may be a promising psychosocial activity to support the prevention of dementia | The British Journal of Psychiatry | via The Mental Elf 

A study published in the British Journal of Psychiatry has revealed that people who visited museums often were less likely to develop dementia. In the research, a large cohort of people 50 years-old and older, as part of the English Longitudinal Study of Ageing (ELSA) was used as a sample and tracked across 10 years. The participants in the study did not show any clinical symptoms of dementia at baseline.

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Two main measures were used:

  1. Firstly, the participants had to complete a self-report scale regarding the frequency they were visiting museums and art galleries, varying from “never” to “twice a month or more”.
  2. Secondly, the incidence of dementia was based on a diagnosis of dementia or Alzheimer’s disease or on a score above 3.38 on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).

The sample consisted of 3,911 adults, equally divided to males and females, and the mean age was 64 years-old. 6.3% developed dementia during the follow-up period. A third of participants indicated that they never visited a museum, but around 1 in 5 reported attending once or twice a year and a further 1 in 5 reported attending every few months or more.

The incidence rate of dementia was higher than average for people who never go to museums, lower than average for people who make a few visits per year, while the lowest rate was found for those who frequently visit museums.

Other cognitive activities were taken under consideration by the authors, but were not significantly associated with the occurrence of dementia. Thus, the effect of museum-attendance is thought to be unique and distinct from other activities that have been suggested.

Full research: Fancourt, D., Steptoe, A., & Cadar, D. | Cultural engagement and cognitive reserve: Museum attendance and dementia incidence over a 10-year period |  The British Journal of Psychiatry | Volume 213, Issue 5 | November 2018 | pp. 661-663

Further detail at The Mental Elf

Activities in dementia care

Elizabeth Lokon, et. al. Activities in dementia care: A comparative assessment of activity types. Dementia.  First published online ahead of print December 5, 2016.

dementia-artAbstract:

This exploratory study compares the impact of five activity types on the well-being of institutionalized people with dementia: the intergenerational art program Opening Minds through Art, art and music therapies, creative activities, non-creative activities, and no activities at all.

We validated the Scripps Modified Greater Cincinnati Chapter Well-Being Observational Tool, and used that instrument to systematically observe N = 67 people with dementia as they participated in different activity types.

People with dementia showed the highest well-being scores during Opening Minds through Art compared to all other activities. No significant well-being differences were found between creative activities led by licensed art/music therapist versus regular activity staff. Furthermore, no significant well-being differences were found between creative and non-creative activities that were both led by regular activity staff.

Overall, people with dementia benefit from participating in activities, regardless of the type (creative or non-creative), or who conducts them (licensed therapists or activity staff). However, in order for people with dementia to reach significantly high levels of overall well-being, we recommend that activities are specifically designed for people with dementia and incorporate a 1:1 ratio between people with dementia and well-trained volunteers/staff members.

Mood, activity, and interaction in long-term dementia care

Hanneke C. Beerens et al. The relation between mood, activity, and interaction in long-term dementia care   Aging & Mental Health Published online: 13 Sep 2016
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Objective: The aim of the study is to identify the degree of association between mood, activity engagement, activity location, and social interaction during everyday life of people with dementia (PwD) living in long-term care facilities.

Method: An observational study using momentary assessments was conducted. For all 115 participants, 84 momentary assessments of mood, engagement in activity, location during activity, and social interaction were carried out by a researcher using the tablet-based Maastricht Electronic Daily Life Observation-tool.

Results: A total of 9660 momentary assessments were completed. The mean age of the 115 participants was 84 and most (75%) were women. A negative, neutral, or positive mood was recorded during 2%, 25%, and 73% of the observations, respectively. Positive mood was associated with engagement in activities, doing activities outside, and social interaction. The type of activity was less important for mood than the fact that PwD were engaged in an activity. Low mood was evident when PwD attempted to have social interaction but received no response.

Conclusion: Fulfilling PwD’s need for occupation and social interaction is consistent with a person-centred dementia care focus and should have priority in dementia care

Engagement in elderly persons with dementia attending animal-assisted group activity

Olsen, C. et al. Dementia. Published online: September 2 2016

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Image source: normanack – Flickr // CC BY 2.0

The need for meaningful activities that enhance engagement is very important among persons with dementia (PWDs), both for PWDs still living at home, as well as for PWDs admitted to a nursing home (NH). In this study, we systematically registered behaviours related to engagement in a group animal-assisted activity (AAA) intervention for 21 PWDs in NHs and among 28 home-dwelling PWDs attending a day care centre.

The participants interacted with a dog and its handler for 30 minutes, twice a week for 12 weeks. Video-recordings were carried out early (week 2) and late (week 10) during the intervention period and behaviours were categorized by the use of an ethogram.

AAA seems to create engagement in PWDs, and might be a suitable and health promoting intervention for both NH residents and participants of a day care centre. Degree of dementia should be considered when planning individual or group based AAA.

Read the full article here

The reciprocal relationship between participation in leisure activities and cognitive functioning: the moderating effect of self-rated literacy level

Lifshitz-Vahava, H. et al. Aging & Mental Health: Published online: 08 Jan 2016

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Objective: Participation in leisure activities is beneficial for cognitive functioning of older adults, but it is less known whether it is also beneficial for those with low basic cognitive level. This study examined the reciprocal relationship between participating in leisure activities and cognitive functioning among low and higher literacy level older adults.

Method: Respondents aged 60 years and older who participated in both first waves (2005–2006 and 2009–2010) of the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel) were divided into low (n = 139) and higher literacy level respondents (n = 714). They reported participation in leisure activities and completed measures of cognitive functioning at both waves.

Results: Cross-lagged models showed that participation in leisure activities predicted higher cognitive functioning four years later only among older adults with low literacy level. On the other hand, cognitive functioning predicted more participation in leisure activities four years later only among higher literacy level older adults.

Conclusions: Participating in leisure activities may be especially beneficial to cognitive functioning among older adults with low literacy level, as their initial low cognitive level allows more room for cognitive improvement than among higher literacy level older adults. Public efforts aimed at increasing participation in leisure activities may therefore target particularly older adults with low basic cognitive level.

Read the full abstract here