The Effect of Telehealth Interventions on Function and Quality of Life for Older Adults with Pre-Frailty or Frailty: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 073346482098363
Author(s):  
Elham Esfandiari ◽  
William C. Miller ◽  
Maureen C. Ashe

Telehealth interventions improve health outcomes by increasing access to care. We conducted a systematic review to synthesize evidence on the effect of telehealth interventions compared with no intervention or usual care for older adults with pre-frailty or frailty for physical function, quality of life (QOL), and frailty. We searched for randomized controlled trials (RCTs) in MEDLINE, PubMed, Embase, CINAHL, Cochrane, PsycINFO, and SPORTDiscus. Two authors reviewed records and assessed risk of bias. A narrative synthesis of findings was conducted. When appropriate, the standard mean difference (SMD) was used to compare telehealth interventions with control conditions. We used GRADE to determine the certainty of the evidence. Twelve RCTs were included. Low certainty evidence highlighted positive effects for the function and mental component of QOL favoring telehealth interventions (SMD = 0.31, 95% CI = [0.15, 0.47]; and SMD = 0.43, 95% CI = [0.22, 0.64], respectively). Despite a small positive effect of telehealth interventions, insufficient, and low certainty evidence precludes making definitive recommendations.

2019 ◽  
Vol 39 (10) ◽  
pp. 1144-1152 ◽  
Author(s):  
Meng-Chin Chen ◽  
Li-Yen Yang ◽  
Kuei-Min Chen ◽  
Hui-Fen Hsu

Acupressure is noninvasive, safe, and appropriate for use among older adults. However, there remains little evidence of the common elements that contribute to the effectiveness of acupressure in promoting the health of older adults. A systematic review using meta-analysis was designed to examine the effects of acupressure on the health promotion in older adults. Studies published between 2012 and 2017 were searched for in 11 electronic databases. Acupressure was highly effective for improving sleep quality and cognitive functioning (0.85, 95% confidence interval [CI] = [0.49, 1.22]; 1.23, 95% CI = [0.88, 1.59]). A slight to moderate effect was found in alleviating constipation (0.37, 95% CI = [0.03, 0.71]), and a moderate effect was found for alleviating pain and improving quality of life (0.71, 95% CI = [0.09, 1.32]; 0.59 95% CI = [0.36, 0.82]).


2021 ◽  
Vol 12 ◽  
Author(s):  
Zhuo Liu ◽  
Fan Yang ◽  
Yifan Lou ◽  
Wei Zhou ◽  
Feng Tong

Objective: Depression is one of the most common problems faced by older adults. Reminiscence therapy, defined as using the recall of past events, feelings, and thoughts facilitating pleasure, is one type of psychotherapy that could alleviate depressive feelings among older adults, improve their quality of life, and help them live independently. Reminiscence therapy originated from geriatric psychiatry, and is an effective non-pharmacological intervention that could be structured or unstructured and be conducted individually or in a group. The current systematic review was designed to summarize and review existing evidence on the effect of reminiscence therapy on depression in older adults.Methods: We conducted a systematic review from January 2000 to Mar 2021 using 10 electronic databases in English and Chinese languages, including Medline, Embase, Cinahl, PsychInfo, Cochrane, Web of Science, Google Scholar, Science Direct, CNKI, and WANFANG. We excluded studies that didn't use randomized controlled trials (RCT) from the meta-analysis. The selected studies were scored using the Cochrane Risk of Bias tool. The RevMan 5.0 was used in subgroup analysis depending on how the interventions were classified.Results: We extracted 527 studies based on keyword searches, of which 10 RCTs met inclusion criteria were included in the meta-analysis. The meta-analysis yielded high heterogeneity, and the analyses of significant subgroups showed that reminiscence therapy has a significant effect on relieving depressive symptoms in older adults. Reminiscence therapy benefits older adults with chronic illness and those on antidepressants as well. The effect and cost-effectiveness of group reminiscence therapy were higher than individual reminiscence therapy. And some specific types of group reminiscence therapy have a significant effect on improving depression and secondary outcomes, including life satisfaction. Although the effectiveness of structured and unstructured group reminiscence on depression has no significant differences according to current evidence, the structured therapy is more replicable, generalizable, and user-friendly due to its detailed protocol for new therapists. Furthermore, reminiscence therapy is more effective for older women and older adults with more severe depressive symptoms.Conclusion: Reminiscence therapy significantly increased older adults' remission from depression and quality of life immediately after the intervention. However, the evidence-based protocol and implementation of reminiscence interventions need to be further developed and standardized to facilitate global use. Moreover, it remains unclear on the long-term effect of reminiscence therapy. Based on the limitations of the current study, more rigorous evidence is needed from studies with large sample sizes, RCT design, and longer follow-up periods. Future studies could also explore the effect of different types of reminiscence therapy. Furthermore, qualitative data should be included to better understand older adults' narrative and experiences with reminiscence therapy. Future studies could also investigate the impact of reminiscence therapy on older relatives as a part of outcome measure to explore the efficacious mechanism of reminiscence therapy in alleviating older adults' depressive symptoms.


2020 ◽  
pp. 1-12
Author(s):  
Wally J. Bartfay ◽  
Andra Duff-Woskosky ◽  
Julie Earle ◽  
Marina Ali ◽  
Sheri Horsburgh ◽  
...  

Introduction: There are over 100 different forms of dementia which is a broad term employed to describe symptoms effecting the brain caused by neurological and vascular diseases. It is a neurological disease that results in a decline in cognitive, social and physical disability which currently has no cure. The prevalence is expected to triple by 2050, due to the aging population trends in Canada. It has been estimated that 24.3 million people have dementia, and there are 4.6 million new cases annually, which accounts for one case every 3 seconds globally. Objectives: This systematic review examines the effects of music therapy on behavioral psychological symptoms of dementia and the quality of life. Methods: A systematic literature search was performed in Ovid Medline, CINAHL and PsycINFO from January 2000 until August 2019. A data abstraction template was employed to for data management and organization. We included all peer reviewed, English articles, RCT’s, systematic reviews, meta-analysis, abstract pool and all or some key words. Results: From 968 potentially relevant records, 55 studies were evaluated for eligibility, and 20 met the inclusion criteria. Overall the studies showed a significant impact on mitigating agitation, reducing BPSD and improving memory, cognition, QOL and decreasing anxiety and symptoms associated with depression. Conclusion: The role of musical interventions found in the literature demonstrates the benefits of music therapy on dementia patients due to its positive effects on BPSD, quality of life and other behavioral symptoms.


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