scholarly journals Biodynamic Lighting and Functional Disability: A Single-Case Experimental Design in Three Community Dwelling People with Dementia

2021 ◽  
Vol 11 (20) ◽  
pp. 9433
Author(s):  
Noortje Aarden-van Delft ◽  
Manon Peeters ◽  
Liselore Snaphaan
Keyword(s):  
Experimental Design ◽  
Functional Activity ◽  
Functional Disability ◽  
Single Case ◽  
Community Dwelling ◽  
Term Care ◽  
Functional Activities ◽  
People With Dementia ◽  
Over Time ◽  
At Home

Functional disability in people with dementia is associated with placement in long-term care facilities, feelings of depression and caregiver burden. As there is currently no cure for dementia, more attention is needed for personalised support for people living with dementia at home. A promising non-pharmacological innovation for reducing problems in functional activities is biodynamic lighting. This type of artificial lighting resembles a normal daylight curve, including changes in light intensity and colour during the day. The aim of this pilot study with three participants is to explore the possible influence of biodynamic lighting on functional activities over time on people with dementia living at home. The study used an A-B-A-B withdrawal single-case experimental design. In the intervention phases, the participants were exposed to biodynamic lighting, while in the placebo phases, the participants were exposed to placebo light. Both light phases came from the same light system. Based on this study protocol, the quantitative effects of biodynamic light related with functional activity did not reach significance. However, the qualitative results of lighting seem promising with a stabilisation of functional activity experienced over time. Future research should examine the effects that light may have on functional activity more in-depth. This study offers recommendations for longitudinal research.

Respiratory Function and Upper Extremity Functional Activity Performance in People With Dementia: A Shout for Attention

2020 ◽  
pp. 1-10
Author(s):  
Cátia Paixão ◽  
Ana Tavares ◽  
Alda Marques
Keyword(s):  
Cognitive Function ◽  
Older People ◽  
Upper Extremity ◽  
Functional Activity ◽  
Respiratory Function ◽  
Care Facility ◽  
Community Dwelling ◽  
Term Care ◽  
Long Term Care Facility ◽  
People With Dementia

The aim of this study was to explore respiratory function and upper extremity functional activity in people with dementia (PWD) and the associations between these variables and cognitive function (n = 22 institutionalized PWD, 28 community-dwelling PWD, and 26 healthy older people). All measures were significantly lower in PWD who live in an institution, such as a nursing home or long-term care facility or who attend adult daycare than PWD who live in a community dwelling . The values from these two groups were significantly lower than those from healthy older people. Moderate to high negative correlations between upper extremity functional activity and respiratory function (−.73 < rs < −.49) and cognitive function (rs = −.83), and between cognitive function and respiratory function (−.74 < rs < −.58) were identified (p < .001). When adjusted for cognitive function (−.38 < rs < −.29; p < .05), the association between upper limb functional activity and respiratory function decreased. The decline demonstrates the importance of physical activity and cognitive and respiratory function in PWD.

scholarly journals Testing a Single-Case Experimental Design to Study Dynamic Light Exposure in People with Dementia Living at Home

2021 ◽  
Vol 11 (21) ◽  
pp. 10221
Author(s):  
Ellen van Lieshout-van Dal ◽  
Liselore Snaphaan ◽  
Samantha Bouwmeester ◽  
Yvonne de Kort ◽  
Inge Bongers
Keyword(s):  
Experimental Design ◽  
Light Exposure ◽  
Single Case ◽  
Informal Caregivers ◽  
Real Life ◽  
Well Being ◽  
Lessons Learned ◽  
Lighting System ◽  
People With Dementia ◽  
At Home

Most people with dementia live at home supported by informal caregivers, but disturbed sleep patterns may induce a heavy burden of care. The beneficial effects of bright light on their sleep, health, and well-being have been demonstrated in clinical settings, but not in a home situation. We evaluated a dynamic lighting system in a real-life longitudinal single-case experimental design (SCED) with people with dementia living at home. Eleven people with dementia and their informal caregivers were included in this study with four 4-week periods of alternating exposure and nonexposure in an introduction–withdrawal setup (ABAB). Objective light exposure data were collected and analyzed. The used study design seems applicable for this population and suitable for home use. Participant dropout did occur, but was due to health conditions rather than participant burden. The lighting system led to more light in the homes of the participants, as well as to higher actual individual light exposures, although the latter increased only moderately and not consistently across all participants, seasons, and times of day. The participants appreciated the lighting system even after 6 months. We reflect on individual differences, seasonal and daypart influences, and differential light effects. Recommendations and lessons learned are discussed.

scholarly journals Impact of oral self-care on incident functional disability in elderly Japanese: the Ohsaki Cohort 2006 study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017946 ◽  
Author(s):  
Shino Bando ◽  
Yasutake Tomata ◽  
Jun Aida ◽  
Kemmyo Sugiyama ◽  
Yumi Sugawara ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Functional Disability ◽  
Self Care ◽  
Community Dwelling ◽  
Tooth Brushing ◽  
Term Care ◽  
Increased Risk ◽  
Long Term Care Insurance ◽  
Elderly Japanese

ObjectivesTo assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss.DesignA 5.7-year prospective cohort study.SettingOhsaki City, Japan.Participants12 370 community-dwelling individuals aged 65 years and older.Primary outcome measuresIncident functional disability (new long-term care insurance certification).ResultsThe 5.7-year incidence rate of disability was 18.8%. In comparison with participants who had ≥20 teeth, the HRs (95% CIs) for incident functional disability among participants who had 10–19 and 0–9 teeth were 1.15 (1.01–1.30) and 1.20 (1.07–1.34), respectively (p trend<0.05). However, the corresponding values for those who brushed their teeth ≥2 times per day were not significantly higher in the ‘10–19 teeth’ and ‘0–9 teeth’ groups (HRs (95% CI) 1.05 (0.91–1.21) for participants with 10–19 teeth, and 1.09 (0.96–1.23) for participants with 0–9 teeth), although HRs for those who brushed their teeth <2 times per day were significantly higher (HRs (95% CI) 1.32 (1.12–1.55) for participants with 10–19 teeth, and 1.33 (1.17–1.51) for participants with 0–9 teeth). Such a negating association was not observed for other forms of oral self-care.ConclusionsTooth brushing may partially negate the increased risk of incident functional disability associated with having fewer remaining teeth.

scholarly journals Combination of diabetes mellitus and lack of habitual physical activity is a risk factor for functional disability in Japanese

2020 ◽  
Vol 8 (1) ◽  
pp. e000901
Author(s):  
Kazuya Fujihara ◽  
Yasuhiro Matsubayashi ◽  
Mayuko Harada Yamada ◽  
Masaru Kitazawa ◽  
Masahiko Yamamoto ◽  
...  
Keyword(s):  
Physical Activity ◽  
Functional Disability ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Habitual Physical Activity ◽  
Term Care ◽  
Patients With Diabetes ◽  
The Impact

ObjectiveDeclining healthy life expectancy due to functional disability is relevant and urgent because of its association with decreased quality of life and also for its enormous socioeconomic impact. The aim of this study is to examine the impact of diabetes, hypertension, dyslipidemia and physical activity habits on functional disability among community-dwelling Japanese adults.Research design and methodsThis is a population-based retrospective cohort study including 9673 people aged 39–98 years in Japan (4420, men). Functional disability was defined as a condition meeting Japan’s new long-term care insurance certification requirements for the need of assistance in the activities of daily living whether by caregivers or assistive devices. Cox proportional-hazards regression model identified variables related to functional disability.ResultsMedian follow-up was 3.7 years. During the study period, 165 disabilities occurred in the overall study population. Multivariate analysis showed that diabetes (HR 1.74 (95% CI 1.12 to 2.68)) and no physical activity habit (HR 1.83 (1.27 to 2.65)) presented increased risks for disability. HR for disability increased with the number of risk factors (HR of individuals with four conditions, 3.96 (1.59 to 9.99) vs individuals with none of those conditions as a reference). HR for disability among patients with diabetes with and without a physical activity habit was 1.68 (0.70 to 4.04) and 3.19 (1.79 to 5.70), respectively, compared with individuals without diabetes with a physical activity habit.ConclusionsThe combination of diabetes and lack of habitual physical activity is predictive of functional disability in Japanese. Habitual physical activity attenuates the risk of functional disability in patients with diabetes.

scholarly journals Managing behavioural and psychological symptoms in community dwelling older people with dementia: 2. A systematic review of qualitative studies

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2950-2970 ◽  
Author(s):  
Andreas Braun ◽  
Daksha P Trivedi ◽  
Angela Dickinson ◽  
Laura Hamilton ◽  
Claire Goodman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Symptoms ◽  
Community Dwelling ◽  
Qualitative Studies ◽  
Future Research ◽  
Care Providers ◽  
Family Carers ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
At Home

Background People living with dementia often develop distressing behavioural and psychological symptoms (BPSD) that can affect their quality of life and the capacity of family carers and staff providing support at home. This systematic review of qualitative studies considers the views and experiences of people living with dementia and care providers about these symptoms and what helps to reduce their impact. Methods The two-stage review involved (a) An initial mapping of the literature to understand the range of BPSD, and how it is operationalised by different groups, to develop a search strategy; (b) A search of electronic databases from January 2000 to March 2015, updated in October 2016. Included studies focused on people living in their own homes. Data extraction and thematic analysis were structured to provide a narrative synthesis of the evidence. Results We retrieved 17, 871 records and included relevant qualitative papers (n = 58) targeting community-dwelling people with dementia and family carers around the management of BPSD. Five key themes were identified: (1) Helpful interventions/support for BPSD management, (2) Barriers to support services for BPSD management, (3) Challenges around recognition/diagnosis of BPSD, (4) Difficulties in responding to aggression and other BPSD, and (5) Impact of BPSD on family carers and people living with dementia. Conclusions Family carers sometimes feel that their experiences of BPSD may not be evident to professionals until a crisis point is reached. Some helpful services exist but access to support, lack of knowledge and skills, and limited information are consistently identified as barriers to their uptake. The lack of common terminology to identify and monitor the range of BPSD that people with dementia living at home may experience means that closer attention should be paid to family carer accounts. Future research should include qualitative studies to evaluate the relevance of interventions.

scholarly journals An individualised, non-pharmacological treatment strategy associated with an improvement in neuropsychiatric symptoms in a man with dementia living at home

2019 ◽  
Vol 12 (5) ◽  
pp. e229048 ◽  
Author(s):  
Mark McLean Carter ◽  
Angelina Wei ◽  
Xinlei Li
Keyword(s):  
Neuropsychiatric Symptoms ◽  
Emergency Department Visits ◽  
Pharmacological Interventions ◽  
First Line ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities ◽  
At Home

More than 90% of people with dementia experience neuropsychiatric symptoms which are often distressing and can result in early institutionalisation, diminished quality of life, increased frequency of emergency department visits along with stress and ill-health in caregivers. Non-pharmacological interventions are recommended as first-line treatment for neuropsychiatric symptoms, instead of medications such as atypical antipsychotics which have significant side effects. Most systematic reviews of non-pharmacological interventions for neuropsychiatric symptoms of dementia focus on patients in long-term care facilities and there are a limited number of research studies assessing the use of non-pharmacological interventions for patient’s living at home. In this case report, we discuss an elderly man with dementia whose cognitive symptoms were accompanied by significant neuropsychiatric symptoms of suspicion, delusions, agitation and aggression. We describe how a programme of individualised, non-pharmacological interventions was associated with an improvement in neuropsychiatric symptoms within 3 months.

scholarly journals Association between Food Store Availability and the Incidence of Functional Disability among Community-Dwelling Older Adults: Results from the Japanese Gerontological Evaluation Cohort Study

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2369 ◽  
Author(s):  
Momosaki ◽  
Wakabayashi ◽  
Maeda ◽  
Shamoto ◽  
Nishioka ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Functional Disability ◽  
Evaluation Study ◽  
Community Dwelling ◽  
Food Store ◽  
Term Care ◽  
Food Stores ◽  
Food Store Availability

This study sought to clarify the association between food store availability and the incidence of disability in older adults. This study utilized a population-based cohort study of independent Japanese adults aged ≥65 years, which was a 6 year follow-up of participants in the Japan Gerontological Evaluation Study. A total of 31,273 respondents were extracted. Food store availability was evaluated based on the existence of food stores within 500/1000 m of the home. We utilized participant-reported subjective measurement as well as geographic information system-based objective measurement for the evaluation. The incidence of disability was determined using municipal data on eligibility for long-term care insurance benefits. There were 7643 (24.4%) community-dwelling participants with low subjective food store availability and 5673 (18.1%) with low objective food store availability. During the follow-up period of 6 years, the cumulative incidence of disability was 20.9%, with a significant association between low subjective food store availability and increased disability. Participants who reported low subjective food store availability had a significantly higher likelihood of developing disability (hazard ratio = 1.18, 95% confidence interval: 1.11–1.25) than those who reported high subjective food store availability after adjusting for age, sex, sociodemographic status, environmental status, walking and going out, dietary food intake, body mass index, and comorbidities. Low subjective food store availability was associated with early onset of disability. Accessibility of food stores might contribute to maintaining a disability-free life.

scholarly journals Occupational performance coaching for stroke survivors delivered via telerehabilitation using a single-case experimental design

2021 ◽  
pp. 030802262098847
Author(s):  
Dorothy Kessler ◽  
Nicole D Anderson ◽  
Deirdre R Dawson
Keyword(s):  
Experimental Design ◽  
Single Case ◽  
Community Dwelling ◽  
Stroke Survivors ◽  
Occupational Performance ◽  
Effective Interventions ◽  
Performance Coaching ◽  
Potential Efficacy ◽  
High Satisfaction ◽  
Long Term Impact

Introduction Sustaining a stroke has a devastating, long-term impact on participation in everyday life. Despite the recognition of participation as a key outcome of stroke rehabilitation, there are few effective interventions that address participation. Occupational performance coaching is a promising intervention designed to improve participation among stroke survivors. Delivery of occupational performance coaching using telerehabilitation could improve access. This study examined the feasibility, acceptability and potential efficacy of telerehabilitation occupational performance coaching. Method A single-case experimental design was used. Six community-dwelling stroke survivors received 10 sessions of telerehabilitation occupational performance coaching over 16 weeks. We examined the feasibility and acceptability of telerehabilitation occupational performance coaching, improvement in performance and satisfaction with identified goals. Results Telerehabilitation occupational performance coaching was feasible and acceptable to deliver; participants who started the intervention completed it and reported high satisfaction and a strong therapeutic relationship. All participants experienced technological issues that required resolution. Goal-performance and/or satisfaction improved for five of six participants. Sixty-four percent of goals showed trends for improvement and 43% showed significant improvements. Conclusions Findings support the feasibility and acceptability of telerehabilitation occupational performance coaching, along with its efficacy for improving performance and satisfaction with performance of goals. Further research is needed to prove the effectiveness of telerehabilitation occupational performance coaching and to determine who may benefit most.

scholarly journals Monitoring changes in the organization of Dutch long-term care and their effects on the mental health and wellbeing of people with dementia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H van der Roest ◽  
M Prins ◽  
J van Erp ◽  
E Hartstra ◽  
A van der Schot
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Long Term Care ◽  
Behavioral Symptoms ◽  
Term Care ◽  
People With Dementia ◽  
Over Time

Abstract Background The 'Living Arrangements for People with Dementia (LAFD)' monitor-study aims to provide insight into effects of changes in the organization of Dutch long-term care for people with dementia. The objective of this study is to evaluate changes over time in the level of cognitive impairment, the frequency and severity of behavioral symptoms, and quality of life of residents with dementia, and changes in staffing levels. The study allows for detection of trends and developments that are relevant for the quality of nursing home care. Methods The LAFD-study is a repeated cross-sectional study. Since 2008, assessments have been conducted in participating nursing homes every two year. Up to 2020, five assessments have been completed. The number of participating nursing homes over time ranged from 47 to 144 and a sample of one third of residents was included in the study. Data collection was performed by care professionals. Cognitive impairment was assessed with the Cognitive Performance Scale, frequency and severity of behavioral symptoms were assessed with the Neuropsychiatric Inventory; quality of life was assessed with de Qualidem. Per nursing home, the amount of direct provided care was inventoried. Results Assessments up to 2017/2018 showed an improvement in cognitive functioning and quality of life in Dutch nursing homes. The amount of behavioral problems did not change, as did the amount of direct care. However, the level of professional caregivers increased slightly. In the last assessment, 53 nursing homes participated, and 668 residents were included. The fast majority of participants was over 80 years of age (67.1%) and 68.5% were female. The data are currently being further analyzed and presented at the conference. Conclusions There is a trend of improvement in cognitive functioning and quality of life up to 2018. The most recent assessment will indicate whether these positive trends continue.

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