scholarly journals Tailored Music Listening to Improve Sleep in Older Adults With Dementia: A Randomized Clinical Trial

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 235-235
Author(s):  
Nalaka Gooneratne ◽  
Joke Bradt ◽  
Miranda Varrasse McPhillips ◽  
Ime Etokebe ◽  
Laura Gitlin ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Mobile Application ◽  
Sleep Disturbances ◽  
Intervention Group ◽  
Well Being ◽  
Community Dwelling ◽  
Music Listening ◽  
Post Intervention ◽  
Feasibility Rct

Abstract Sleep disturbances in persons living with dementia (PLWD) contribute to reduced well-being. Music has shown promise to improve sleep among older adults, but there is limited evidence of music interventions improving sleep specifically in PLWD. The purpose of this wait-list RCT was to examine the i) feasibility; ii) acceptability and iii) preliminary efficacy of tailored music listening intervention in community-dwelling PLWD and their caregivers (dyads). Thirty consented dyads out of 33 (91%) completed the RCT. Tailored music for sleep was feasible based on screening (26%), enrollment (89%), and recruitment (3 dyads/month) rates. The intervention was found acceptable, as evidenced by post-intervention interviews. Compared to controls, PLWD in the intervention group reported greater global sleep quality improvement post-intervention (PSQI mean change -0.08 vs -1.65; p=0.06). The results from this feasibility RCT have informed the development of a music mobile application that will be tested in a future clinical trial.

scholarly journals AN MHEALTH BEHAVIORAL INTERVENTION FOR PROMOTING PHYSICAL ACTIVITY AND SLEEP IN COMMUNITY-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S169-S169
Author(s):  
Junxin Li ◽  
Sarah Szanton ◽  
Minhui Liu ◽  
Nada Lukkahatai ◽  
Junxin Li ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sleep Quality ◽  
Behavioral Intervention ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Post Intervention ◽  
Tnf Α ◽  
Community Dwelling Older Adults

Abstract Evidence suggests physical activity (PA) improves sleep in older adults. This study examined the preliminary effect of a personalized mHealth behavioral intervention on PA and sleep in older adults. We conducted a randomized controlled pilot trial in 21 community-dwelling older adults with sleep complaints. The 24-week mHealth behavioral intervention included a 2-hour in person training session, personalized exercise prescription, real time PA self-monitoring, interactive prompts, phone consultation, and weekly financial incentives. PA and sleep were measured objectively using Actiwatch 2.0 and subjectively using questionnaires. Peripheral blood was drawn for measuring Plasma inflammatory biomarkers [interleukin 1β, 6, 8, Tumor Necrosis Factor- alpha (TNF-α), and c-reactive protein (CRP)]. Data were collected at baseline, 8-week, 16-week, and post intervention. Repeated measures ANOVA (time*group) was used to examine differences of PA and sleep across times between the two groups. Majority of participants are women (71.4%) with mean age of 73.7 (SD = 6.9). Repeated measure ANOVA showed significant (p <0.05) improvement of objective and subjective PA, objective nocturnal sleep duration, self-report sleep quality (measured by Pittsburg Sleep Quality Index and Insomnia Severity Index) and decreasing of sedentary time over times in the intervention group (n=11), compared to the control group. The intervention group showed significant reduction of plasma TNF-α and CRP levels at 16-week and post intervention. Interventions combining personalized PA and mHealth strategies may positively affect physical activity and sleep in older adults. A larger study is needed to test the efficacy of this intervention and the mechanisms associated with it.

scholarly journals Effects of a Brief Behavioral Training Program on Sleep Quality in Older Adults With Moderate Sleep Disturbances

2020 ◽  
Vol 9 (1) ◽  
pp. 7-13
Author(s):  
Maryam Eshghizadeh ◽  
Mahboubeh Esmaeili ◽  
Shahnaz Ahrari
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Training Program ◽  
Sleep Disturbances ◽  
Adult Population ◽  
Intervention Group ◽  
Control Group ◽  
Behavioral Training ◽  
Post Intervention ◽  
Subjective Sleep Quality

Background: Sleep disturbances are very common among elderly population and mostly remain incurable. Practical, brief, and effective interventions are needed to promote sleep quality in older adults with moderate sleep disturbances. This study aimed to investigate the effectiveness of a brief behavioral training program in ameliorating sleep quality in older adults suffering from moderate sleep disturbances. Materials and Methods: This study was conducted on 64 older adults with moderate sleep disturbances, as defined by Pittsburgh Sleep Quality Index (PSQI) score ≥5. Participants were randomly allocated to either intervention (n=32) or control (n=32) group. Older adults in the intervention group received a brief behavioral-based sleep training program which was delivered in a single in-person session followed by four telephone sessions during 4 weeks. While their peers in the control group did not receive any intervention. The main outcome of the study was scores on the PSQI which was compared at pre- and post-intervention between both groups. Data were analyzed using the SPSS software version 19.0. Results: At 4 weeks, PSQI scores decreased in older adults receiving intervention, as compared with the scores of participants to the control group (P<0.001). Subjects in the intervention group also showed significant improvements in sleep latency, subjective sleep quality, sleep duration, and sleep efficiency (P<0.05). Conclusion: Brief behavioral interventions may be promising and useful for older adult population with moderate problems, and can be considered an efficacious and non-invasive intervention approach to improve elderly’s sleep quality.

Abstract 13768: Adoption and Effectiveness of an Mhealth Intervention for Hypertension in Older Adults: A Pilot Clinical Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Matthew F Muldoon ◽  
Julian Einhorn ◽  
Jonathan Yabes ◽  
Danielle Burton ◽  
Bruce Rollman ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Clinical Trial ◽  
Self Efficacy ◽  
Intervention Group ◽  
Primary Care Providers ◽  
Text Messages ◽  
Community Dwelling ◽  
Effect Estimate ◽  
Care Providers

Introduction: Hypertension is uncontrolled in 50% of diagnosed adults in the US, and especially in older adults. Home blood pressure monitoring (HBPM) can improve hypertension management by providing clinicians with up-to-date information on BP control and by improving patients’ adherence to prescribed medications and other healthy behaviors. MyBP is a patient-facing HBPM aide that provides video-based education and supports BP self-monitoring with recurring feedback using proactive, bidirectional, automated text messages. Summary reports are routed to primary care providers. Hypothesis: In this proof-of-concept, pragmatic clinical trial, we tested the hypothesis that MyBP will improve hypertension self-efficacy and lower BP in older adults. Methods: Community-dwelling adults ≥55 y/o with uncontrolled hypertension were recruited from primary care offices. Enrollees were provided a standard automatic BP cuff and randomized 2:1 to MyBP vs treatment-as-usual (control). Engagement with MyBP was defined as the proportion of BP reading prompts for which a reading was submitted, tracked over successive 2-week monitoring periods. Study BP data were acquired independently of MyBP from all participants by single-blind, phone-supervised home BP measurements. Results: Participants (N=62; 40 women, 33 Blacks, 38 without a college degree, mean age 66, mean office BP 164/91, mean # BP medications 2.6) were randomized to MyBP (41) vs. control (n=21). In the MyBP group, engagement with HBPM averaged over 80%, without notable attrition over the 5-month study period. Regression analyses revealed an interaction between baseline systolic BP and group assignment on change in systolic BP [interaction effect estimate -0.59 (-1.00, -0.19)], such that patients who had a higher baseline systolic BP and were assigned to MyBP showed a greater decline in systolic BP when compared to control patients. Hypertension self-efficacy also improved in the intervention group compared to controls [estimate 0.556 (0.104,1.008)]. Conclusions: In this pragmatic, pilot clinical trial, older adults with hypertension used a novel mHealth technology at high levels, reported improved hypertension self-efficacy, and experienced a decline in BP if home BP was elevated at baseline.

scholarly journals “Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9514
Author(s):  
Shefaly Shorey ◽  
Ee Heok Kua ◽  
Wilson Tam ◽  
Valerie Chan ◽  
Yong Shian Goh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Pilot Study ◽  
Intervention Group ◽  
Well Being ◽  
Small Sample ◽  
Community Dwelling ◽  
Control Group ◽  
Community Dwelling Older Adults

In Singapore, many older adults suffer from subsyndromal depression and/or subsyndromal anxiety, which can negatively impact their physical and mental well-being if left untreated. Due to the general public’s reluctance to seek psychological help and the low psychiatrist-to-population ratio in Singapore, this study aims to examine the preliminary efficacy, perceptions, and acceptability of a trained volunteer-led community-based intervention on community-dwelling older adults. Twenty-one participants (control: n = 11; intervention: n = 10) completed the randomized pilot study. A mixed-methods approach (questionnaires, semistructured interviews, examining blood samples, intervention fidelity) was adopted. No significant differences were found between the intervention and the control groups in depression, anxiety, life satisfaction, friendship, and quality of life. However, there was a positive change in quality-of-life scores from baseline to 6 months in the intervention group. The control group had significantly higher cortisol levels and lower annexin-A1 levels at 6 months, while the intervention group did not. Three themes emerged from the interviews: (1) impact of the intervention on older adults’ well-being, (2) attitudes toward intervention, and (3) a way forward. However, intervention efficacy could not be established due to small sample size caused by the coronavirus pandemic. Future randomized controlled trials should evaluate volunteer-led, technology-based psychosocial interventions to support these older adults.

scholarly journals A Community Choir Intervention to Promote Well-Being Among Diverse Older Adults: Results From the Community of Voices Trial

2018 ◽  
Vol 75 (3) ◽  
pp. 549-559 ◽  
Author(s):  
Julene K Johnson ◽  
Anita L Stewart ◽  
Michael Acree ◽  
Anna M Nápoles ◽  
Jason D Flatt ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Costs ◽  
Intervention Group ◽  
Well Being ◽  
Community Dwelling ◽  
Care Utilization ◽  
Control Group ◽  
Significant Group ◽  
Care Costs

Abstract Objectives To test effects of the Community of Voices choir intervention on the health, well-being, and health care costs of racial/ethnically diverse older adults. Method Twelve Administration-on-Aging-supported senior centers were cluster randomized into two groups: the intervention group started the choir immediately and a wait-list control group began the choir 6 months later. The choir program was designed for community-dwelling adults aged 60 years and older. The multimodal intervention comprises activities that engage participants cognitively, physically, and socially. Outcome measures assessed these three domains as well as health care utilization and costs. The intention-to-treat comparison was at 6 months. Results The sample (N = 390) had a mean age of 71.3 years (SD = 7.2); 65% were nonwhite. Six-month retention was 92%. Compared to controls, intervention group members experienced significantly greater improvements in loneliness (p = .02; standardized effect size [ES = 0.34] and interest in life (p = .008, ES = 0.39). No significant group differences were observed for cognitive or physical outcomes or for health care costs. Discussion Findings support adoption of community choirs for reducing loneliness and increasing interest in life among diverse older adults. Further efforts need to examine the mechanisms by which engagement in choirs improves aspects of well-being and reduces health disparities among older adults, including potential longer-term effects. ClinicalTrials.gov Registration NCT01869179 registered January 9, 2013.

scholarly journals A Digital Intervention to Alleviate Loneliness and Depression Among Older Persons During the COVID-19 Outbreak

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 933-934
Author(s):  
Stav Shapira ◽  
Ella Cohn-Schwartz ◽  
Daphna Yeshua-Katz ◽  
Limor Aharonson-Daniel ◽  
A Mark Clarfield ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Wait List ◽  
Wait List Control Group ◽  
Post Intervention ◽  
Wait List Control

Abstract Social distancing has been proven to be effective in reducing infections but may cause ill effects on the mental health of older adults. We evaluated the effects of a short-term virtual group intervention that provided tools to promote better coping, and mitigate adverse mental health effects during the outbreak of the covid-19 pandemic. A Randomized controlled trial tested the effects of a guided intervention comprised of seven online group sessions in which cognitive-behavioral techniques targeting maladaptive beliefs and appraisals were learned and practiced via ZOOM. A total of 82 community-dwelling adults from Israel, aged between 65 - 90 were randomized to either an intervention group (n=64) or a wait-list control group (n=18). Loneliness (UCLA loneliness scale) and depressive symptoms (PHQ-9) were measured pre-intervention, post-intervention, and at 1-month follow-up. The findings showed a significant decrease in loneliness and depression scores in the intervention group with results maintained at 1-month follow-up. There were no significant changes in the wait-list control group. In addition, ten participants (16%) from the intervention group demonstrated a clinically meaningful decrease in depression between baseline and post-intervention, and this was maintained among 7 participants (10%) at 1-month follow-up, compared to only 1 participant (5%) in the control group. Our intervention presents a simple and easy-to-implement tool. Its relevance extends beyond the current pandemic as the skills acquired can be applied in other forms of social crises and during routine life, in order to promote the mental health of older adults who live alone and/or reside in remote areas.

Lighting and Alzheimer’s disease and related dementias: Spotlight on sleep and depression

2021 ◽  
Vol 53 (5) ◽  
pp. 405-422
Author(s):  
MG Figueiro ◽  
HC Kales
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Neurodegenerative Disease ◽  
Sleep Disturbances ◽  
Well Being ◽  
Pharmacological Intervention ◽  
Negative Effects ◽  
Health And Well Being ◽  
Positive Results

Alzheimer’s disease and related dementias is the collective term for a progressive neurodegenerative disease for which there is presently no cure. This paper focuses on two symptoms of the disease, sleep disturbances and depression, and discusses how light can be used as a non-pharmacological intervention to mitigate their negative effects. Bright days and dark nights are needed for health and well-being, but the present components of the built environment, especially those places where older adults spend most of their days, are too dimly illuminated during the day and too bright at night. To be effective light needs to be correctly specified, implemented and measured. Yet, without the appropriate specification and measurement of the stimulus, researchers will not be able to successfully demonstrate positive results in the field, nor will lighting designers and specifiers have the confidence to implement lighting solutions for promoting better sleep and mood in this population.

Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Comparison Group ◽  
Care Delivery ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Positive Effects ◽  
Repeated Measures Design ◽  
Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

scholarly journals Older Adults’ Subjective Well-being Following an Exergame Intervention “Bandit the Dolphin”: Focus Group Findings

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 169-170
Author(s):  
Brittany Drazich ◽  
Breanna Crane ◽  
Kyle Moored ◽  
Karl Shieh ◽  
Janiece Taylor ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Focus Groups ◽  
Well Being ◽  
Community Dwelling ◽  
Mental Illness Stigma ◽  
Subjective Well Being ◽  
Future Health ◽  
Adult Participants

Abstract Due to generational mental illness stigma and under diagnosis of mental illness, older adults do not always receive the mental health help that they need. One unique technology that has the potential to improve mood in older adults is exergames, or exercise video games. The objective of this sub-study (main study: Stimulation With Intricate Movements “SWIM” Study) was to explore older adults’ mood following an exergame intervention called “Bandit the Dolphin,” created by the Johns Hopkins KATA Studio. Researchers conducted three focus groups with 14 community-dwelling older adult participants who took part in the SWIM Study exergame intervention. The semi-structured focus groups were transcribed, coded, and analyzed using deductive and inductive techniques described by Ray Maietta’s “sort and sift, think and shift” method. Three themes related to playing “Bandit the Dolphin” and mood emerged. First, participants described their perceived association between activity and mood. Participants felt that both active and passive activities, “Bandit the Dolphin” and otherwise, improved their mood through the “fun” factor, and through feelings of achievement. Second, the participants described that the competition and frustration of playing “Bandit the Dolphin” increased eventual feelings of achievement. Third, participants described how feelings of immersion, or being absorbed in the game, helped them forget their other life concerns. These findings provide a better understanding of older adults’ perceived relationship between an exergame intervention, “Bandit the Dolphin,” and short-term improved mood. Future health and engineering researchers should explore exergames as a potential tool to improve the mental health of older adults.

Adjunctive Therapy to Manage Neuropsychiatric Symptoms in Moderate and Severe Dementia: Randomized Clinical Trial Using an Outpatient Version of Tailored Activity Program

2021 ◽  
pp. 1-12
Author(s):  
Alexandra Martini Oliveira ◽  
Marcia Radanovic ◽  
Patricia Cotting Homem de Mello ◽  
Patricia Cardoso Buchain ◽  
Adriana Dias Barbosa Vizzotto ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sleep Disturbances ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Caregiver Training ◽  
Controlled Clinical Trial ◽  
Post Intervention ◽  
Double Blind ◽  
Activity Program ◽  
Experimental Group

Background: Neuropsychiatric symptoms (NPS) such as aggression, apathy, agitation, and wandering may occur in up to 90%of dementia cases. International guidelines have suggested that non-pharmacological interventions are as effective as pharmacological treatments, however without the side effects and risks of medications. An occupational therapy method, called Tailored Activity Program (TAP), was developed with the objective to treat NPS in the elderly with dementia and has been shown to be effective. Objective: Evaluate the efficacy of the TAP method (outpatient version) in the treatment of NPS in individuals with dementia and in the burden reduction of their caregivers. Methods: This is a randomized, double-blind, controlled clinical trial for the treatment of NPS in dementia. Outcome measures consisted of assessing the NPS of individuals with dementia, through the Neuropsychiatric Inventory-Clinician rating scale (NPI-C), and assessing the burden on their caregivers, using the Zarit Scale. All the participants were evaluated pre-and post-intervention. Results: 54 individuals with dementia and caregivers were allocated to the experimental (n = 28) and control (n = 26) groups. There was improvement of the following NPS in the experimental group: delusions, agitation, aggressiveness, depression, anxiety, euphoria, apathy, disinhibition, irritability, motor disturbance, and aberrant vocalization. No improvement was observed in hallucinations, sleep disturbances, and appetite disorders. The TAP method for outpatient settings was also clinically effective in reducing burden between caregivers of the experimental group. Conclusion: The use of personalized prescribed activities, coupled with the caregiver training, may be a clinically effective approach to reduce NPS and caregiver burden of individuals with dementia.

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