Research

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18 pages, 956 KiB

Open AccessArticle

Determinants of Adherence to a “GRADIOR” Computer-Based Cognitive Training Program in People with Mild Cognitive Impairment (MCI) and Mild Dementia

by Angie A. Diaz Baquero, María V. Perea Bartolomé, José Miguel Toribio-Guzmán, Fernando Martínez-Abad, Esther Parra Vidales, Yolanda Bueno Aguado, Henriëtte G. van der Roest and Manuel A. Franco-Martín

J. Clin. Med. 2022, 11(6), 1714; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061714 - 19 Mar 2022

Cited by 4 | Viewed by 2804

Abstract

Background: Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, [...] Read more.

Background: Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, psychological, and physical-health determinants that helped predict adherence or not to a “GRADIOR” computerized cognitive training (CCT) program in people with mild cognitive impairment (MCI) and mild dementia. Method: This study was part of a randomized clinical trial (RCT) (ISRCTN: 15742788). However, this study will only focus on the experimental group (n = 43) included in the RCT. This group was divided into adherent people (compliance: ≥60% of the sessions and persistence in treatment up to 4 months) and non-adherent. The participants were 60–90 age and diagnosed with MCI and mild dementia. We selected from the evaluation protocol for the RCT, tests that evaluated cognitive aspects (memory and executive functioning), psychological and physical health. The CCT with GRADIOR consisted of attending 2–3 weekly sessions for 4 months with a duration of 30 min Data analysis: Phi and Biserial-point correlations, a multiple logical regression analysis was obtained to find the adherence model and U Mann–Whitney was used. Results: The adherence model was made up of the Digit Symbol and Arithmetic of Wechsler Adult Intelligence Scale (WAIS-III) and Lexical Verbal Fluency (LVF) -R tests. This model had 90% sensitivity, 50% specificity and 75% precision. The goodness-of-fit p-value of the model was 0.02. Conclusions: good executive functioning in attention, working memory (WM), phonological verbal fluency and cognitive flexibility predicted a greater probability that a person would be adherent. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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20 pages, 831 KiB

Open AccessArticle

A Qualitative Study of the Cognitive Rehabilitation Program GRADIOR for People with Cognitive Impairment: Outcomes of the Focus Group Methodology

by Eider Irazoki, Mª Cruz Sánchez-Gómez, Leslie María Contreras-Somoza, José Miguel Toribio-Guzmán, Mª Victoria Martín-Cilleros, Sonia Verdugo-Castro, Cristina Jenaro-Río and Manuel A. Franco-Martín

J. Clin. Med. 2021, 10(4), 859; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10040859 - 19 Feb 2021

Cited by 10 | Viewed by 2491

Abstract

In recent years, technology has been implemented in the field of interventions for older adults. GRADIOR 4.5 is a cognitive software within the wide variety of available multimedia programs that support healthcare professionals in cognitive assessment and neuropsychological rehabilitation. The study aimed to [...] Read more.

In recent years, technology has been implemented in the field of interventions for older adults. GRADIOR 4.5 is a cognitive software within the wide variety of available multimedia programs that support healthcare professionals in cognitive assessment and neuropsychological rehabilitation. The study aimed to evaluate the new version of GRADIOR (v4.5) based on the experience of people with mild cognitive impairment (MCI), people with dementia (PWD), and healthcare professionals. A qualitative study using the focus group methodology was carried out involving 13 people with MCI, 13 PWD, and 11 healthcare professionals. An analysis of the content and the level of feedback was performed. The study showed that GRADIOR 4.5 might be sufficiently adapted to PWD and people with MCI. Participants were motivated to use GRADIOR 4.5, showed high acceptability of the software, and a positive attitude towards technology. However, healthcare professionals suggested significant improvements to the software. GRADIOR 4.5 appeared to be a promising intervention that, because of its positive experience and acceptability, could be systematically implemented to complement cognitive rehabilitation interventions for older adults with MCI and dementia. Finally, it is advisable to consider the suggestions gathered in this study for future developments. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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12 pages, 1437 KiB

Open AccessArticle

Hospitalization and Socio-Health Care for Dementia in Spain

by Carlos Llanes-Álvarez, Jesús M. Andrés-de llano, Ana I. Álvarez-Navares, Carlos Roncero, M. Teresa Pastor-Hidalgo, José R. Garmendia-Leiza, Irene Andrés-Alberola and Manuel A. Franco-Martín

J. Clin. Med. 2020, 9(12), 3875; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9123875 - 28 Nov 2020

Cited by 2 | Viewed by 1921

Abstract

Dementias are brain diseases that affect long-term cognitive and behavioral functions and cause a decrease in the ability to think and remember that is severe enough to disturb daily functioning. In Spain, the number of people suffering from dementia is rising due to [...] Read more.

Dementias are brain diseases that affect long-term cognitive and behavioral functions and cause a decrease in the ability to think and remember that is severe enough to disturb daily functioning. In Spain, the number of people suffering from dementia is rising due to population ageing. Reducing admissions, many of them avoidable, would be advantageous for patients and care-providers. Understanding the correlation of admission of people with dementia and its trends in hospitalization would help us to understand the factors leading to admission. We conducted a cross-sectional study of the hospital discharge database of Castilla y León from 2005 to 2015, selecting hospitalizations for dementia. Trends in hospitalizations by year and age quartiles were studied by joinpoint regression analysis. 2807 out of 2,717,192 total hospitalizations (0.10%) were due to dementias; the main groups were degenerative dementia (1907) followed by vascular dementia (607). Dementias are not a major cause of hospitalization, but the average stay and cost are high, and many of them seem avoidable. Decreasing trends were detected in hospitalization rates for all dementias except for the group of mild cognitive impairment, which grew. An increasing–decreasing joinpoint detected in 2007 for vascular dementia and the general downward hospitalization trends for most dementias suggest that socio-health measures established since 2007 in Spain might play a key role in reducing hospitalizations. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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9 pages, 609 KiB

Open AccessArticle

Association of the Qualitative Clock Drawing Test with Progression to Dementia in Non-Demented Older Adults

by Hiroyuki Umegaki, Yusuke Suzuki, Yosuke Yamada, Hitoshi Komiya, Kazuhisa Watanabe, Masaaki Nagae and Masafumi Kuzuya

J. Clin. Med. 2020, 9(9), 2850; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9092850 - 03 Sep 2020

Cited by 12 | Viewed by 2586

Abstract

To evaluate the predictability of progression of cognitive impairment to dementia using qualitative clock drawing test (CDT) scores, we administered both the CDT using Cahn et al.’s qualitative scoring system and the Mini-Mental State Examination (MMSE) to assess cognitive function in non-demented older [...] Read more.

To evaluate the predictability of progression of cognitive impairment to dementia using qualitative clock drawing test (CDT) scores, we administered both the CDT using Cahn et al.’s qualitative scoring system and the Mini-Mental State Examination (MMSE) to assess cognitive function in non-demented older individuals attending a memory clinic at a university hospital. Patients visiting the clinic for assessment of cognitive function between January 2015 and December 2019 were enrolled, and only those who were diagnosed as not having dementia at the time of initial assessment completed a follow-up assessment at 1 y (n = 163). To examine any association of qualitative CDT score with progression to dementia, multiple logistic regression analysis was conducted with the change in diagnosis from non-dementia to dementia at 1 y as the dependent variable. A total of 26 participants (16.0%) were diagnosed as having converted to dementia. Multiple logistic regression analysis revealed that both the qualitative CDT score using Cahn et al.’s scoring system and the existence of conceptual deficits were significantly associated with progression to dementia at 1 y after initial assessment of cognitive function, irrespective of the MMSE score, among non-demented older individuals. The CDT may be a useful predictor of progression to dementia in primary care settings. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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12 pages, 399 KiB

Open AccessArticle

Modifiable Risk Factor Possession Patterns of Dementia in Elderly with MCI: A 4-Year Repeated Measures Study

by Osamu Katayama, Sangyoon Lee, Seongryu Bae, Keitaro Makino, Yohei Shinkai, Ippei Chiba, Kenji Harada and Hiroyuki Shimada

J. Clin. Med. 2020, 9(4), 1076; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9041076 - 10 Apr 2020

Cited by 14 | Viewed by 2869

Abstract

This study clarified the patterns of possessing modifiable risk factors of dementia that can be corrected by the elderly who were primarily determined to have mild cognitive impairment (MCI), and then determined the relationship between retention patterns and outcomes from MCI through a [...] Read more.

This study clarified the patterns of possessing modifiable risk factors of dementia that can be corrected by the elderly who were primarily determined to have mild cognitive impairment (MCI), and then determined the relationship between retention patterns and outcomes from MCI through a 4-year follow-up study. The participants were 789 community-dwelling elders who were ≥65 years old with MCI at baseline. After 4 years, participants were classified into reverters and nonreverters, according to their cognitive function. Repeated measures analysis was performed after imputing missing values due to dropout. Nine modifiable risk factors at baseline were classified by latent class analysis. Subsequently, we performed binomial logistic regression analysis. The reversion rate of 789 participants was 30.9%. The possession patterns of modifiable risk factors among the elderly with MCI were classified into five patterns: low risk, psychosocial, health behavior, educational, and smoking factors. According to logistic regression analysis, the low risk factors class was more likely to recover from MCI to normal cognitive than the other classes (p < 0.05). These results may provide useful information for designing interventions to prevent cognitive decline and dementia in individuals with MCI. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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Review

Jump to: Research

30 pages, 873 KiB

Open AccessReview

The Effects of Technological Interventions on Social Participation of Community-Dwelling Older Adults with and without Dementia: A Systematic Review

by Pascale Heins, Lizzy M. M. Boots, Wei Qi Koh, An Neven, Frans R. J. Verhey and Marjolein E. de Vugt

J. Clin. Med. 2021, 10(11), 2308; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10112308 - 25 May 2021

Cited by 30 | Viewed by 4756

Abstract

Social isolation in community-dwelling older adults with dementia is a growing health issue that can negatively affect health and well-being. To date, little attention has been paid to the role of technology in improving their social participation. This systematic review aims to provide [...] Read more.

Social isolation in community-dwelling older adults with dementia is a growing health issue that can negatively affect health and well-being. To date, little attention has been paid to the role of technology in improving their social participation. This systematic review aims to provide a systematic overview of the effects of technological interventions that target social participation in community-dwelling older adults with and without dementia. The scientific databases Medline (PubMed), PsycINFO, CINAHL, Web of Science, and the Cochrane Library were systematically searched and independently screened by two reviewers. Results were synthesized narratively. The methodological quality of included studies was independently assessed by two reviewers. In total, 36 studies of varying methodological quality were identified. Most studies evaluated social networking technology and ICT training programs. Three studies focused on people with dementia. Quantitative findings showed limited effects on loneliness, social isolation, and social support. Nevertheless, several benefits related to social participation were reported qualitatively. Social interaction, face-to-face contact, and intergenerational engagement were suggested to be successful elements of technological interventions in improving the social participation of community-dwelling older adults. Rigorous studies with larger sample sizes are highly needed to evaluate the long-term effects of technology on the multidimensional concept of social participation. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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22 pages, 717 KiB

Open AccessReview

Methodological Designs Applied in the Development of Computer-Based Training Programs for the Cognitive Rehabilitation in People with Mild Cognitive Impairment (MCI) and Mild Dementia. Systematic Review

by Angie A. Diaz Baquero, Rose-Marie Dröes, María V. Perea Bartolomé, Eider Irazoki, José Miguel Toribio-Guzmán, Manuel A. Franco-Martín and Henriëtte van der Roest

J. Clin. Med. 2021, 10(6), 1222; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10061222 - 16 Mar 2021

Cited by 12 | Viewed by 3064

Abstract

In recent years, different computer-based cognitive training (CT) programs for people with dementia (PwD) have been developed following a psychosocial approach. Aim: This systematic review aims to identify the methodological designs applied in the development of computer-based training (CCT) programs for the rehabilitation [...] Read more.

In recent years, different computer-based cognitive training (CT) programs for people with dementia (PwD) have been developed following a psychosocial approach. Aim: This systematic review aims to identify the methodological designs applied in the development of computer-based training (CCT) programs for the rehabilitation of cognitive functioning in people with mild cognitive impairment (MCI) or mild dementia. Methods: A systematic review was conducted using the databases PubMed and PsycINFO. The search period was between 2000–2019. The study selection and data extraction processes were carried out by two independent reviewers. The protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42020159027. Results: Thirteen studies met the inclusion criteria. The most frequently used methodological design in the development of CCT programs for people with MCI or mild dementia was the user-centered design (UCD). This design involves an interactive system characterized by the inclusion of end users from the initial stages of its development, throughout the establishment of functional requirements, and in the evaluation of the program’s usability and user-experience (UX). Conclusion: UCD was the most used methodological design for the development of CCT programs although there was quite some variation in how this design was applied. Recommendations for future studies about the development of CCT programs for people with MCI and mild dementia are given. Central focus should be the inclusion and active participation of end users from the initial stages of development. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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23 pages, 581 KiB

Open AccessReview

Can Use of Digital Technologies by People with Dementia Improve Self-Management and Social Participation? A Systematic Review of Effect Studies

by David Neal, Floor van den Berg, Caroline Planting, Teake Ettema, Karin Dijkstra, Evelyn Finnema and Rose-Marie Dröes

J. Clin. Med. 2021, 10(4), 604; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10040604 - 05 Feb 2021

Cited by 27 | Viewed by 10723

Abstract

There is increasing interest in the use of technology to support social health in dementia. The primary objective of this systematic review was to synthesize evidence of effectiveness of digital technologies used by people with dementia to improve self-management and social participation. Records [...] Read more.

There is increasing interest in the use of technology to support social health in dementia. The primary objective of this systematic review was to synthesize evidence of effectiveness of digital technologies used by people with dementia to improve self-management and social participation. Records published from 1 January 2007 to 9 April 2020 were identified from Pubmed, PsycInfo, Web of Science, CINAHL, and the Cochrane Central Register of Controlled Trials. Controlled interventional studies evaluating interventions based on any digital technology were included if: primary users of the technology had dementia or mild cognitive impairment (MCI); and the study reported outcomes relevant to self-management or social participation. Studies were clustered by population, intervention, and outcomes, and narrative synthesis was undertaken. Of 1394 records identified, nine met the inclusion criteria: two were deemed to be of poor methodological quality, six of fair quality, and one of good quality. Three clusters of technologies were identified: virtual reality, wearables, and software applications. We identified weak evidence that digital technologies may provide less benefit to people with dementia than people with MCI. Future research should address the methodological limitations and narrow scope of existing work. In the absence of strong evidence, clinicians and caregivers must use their judgement to appraise available technologies on a case-by-case basis. Full article

(This article belongs to the Special Issue Psychosocial Approaches Using Technology in Older People with Mild Cognitive Impairment or Dementia)

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