Walking programs may provide benefits in some aspects of cognition, QOL, and functional capacity including social interaction in elderly community members. This study could serve as the basis for implementation of a community-based intervention to prevent mental decline.

Non-pharmacological interventions for dementia are likely to have an important role in delaying disease progression and functional decline. Research into non-pharmacological interventions has focused on the differentiation of each approach and a comparison of their effects. However, Cochrane Reviews on non-pharmacological interventions have noted the paucity of evidence regarding the effects of these interventions. The essence of nonpharmacological intervention is dependent of the patients, families, and therapists involved, with each situation inevitably being different. To obtain good results with non-pharmacological therapy, the core is not 'what' approach is taken but 'how' the therapists communicate with their patients. Here, we propose a new type of rehabilitation for dementia, namely brainactivating rehabilitation, that consists of five principles: (i) enjoyable and comfortable activities in an accepting atmosphere; (ii) activities associated with empathetic two-way communication between the therapist and patient, as well as between patients; (iii) therapists should praise patients to enhance motivation; (iv) therapists should try to offer each patient some social role that takes advantage of his/her remaining abilities; and (v) the activities should be based on errorless learning to ensure a pleasant atmosphere and to maintain a patient's dignity. The behavioral and cognitive status is not necessarily a reflection of pathological lesions in the brain; there is cognitive reserve for improvement. The aim of brain-activating rehabilitation is to enhance patients' motivation and maximize the use of their remaining function, recruiting a compensatory network, and preventing the disuse of brain function. The primary expected effect is that patients recover a desire for life, as well as their self-respect. Enhanced motivation can lead to improvements in cognitive function. Amelioration of the behavioral and psychological symptoms of dementia and improvements in activities of daily living can also be expected due to the renewed positive attitude towards life. In addition, improvements in the quality of life for both patients and caregivers is an expected outcome. To establish evidence for non-pharmacological interventions, research protocols and outcome measures should be standardized to facilitate comparison among studies, as well as meta-analysis.

Background: Preventing the progression of dementia is a widespread challenge. However, currently there is limited evidence supporting the effectiveness of dementia rehabilitation. Methods: We practiced activity reminiscence therapy (ART) as brainactivating rehabilitation for both lucid and demented persons (n = 18) in a day-service setting as well as in a group home. The ART sessions were conducted 1 hour every week for 12 weeks (intervention period). We compared the results of three cognitive tests (the Mini-Mental State Examination, the Kana Pick-out test and the 'logical memory' component of the Wechsler Memory Scale-Revised) and four behavior and caregiver s burden scales (the Clinical Dementia Rating, the Multidimensional Observation Scale for Elderly Subjects, the Dementia Behavior Disturbance scale and the Zarit Caregiver Burden Interview) conducted during the control period with those taken during the intervention period. At the end of the intervention period, we interviewed the staff and families individually to assess whether the participants seemed to have changed after intervention and, if so, how. Results: In cognitive tests, only immediate and delayed recall of the Wechsler Memory Scale-Revised showed significant improvement. None of the four behavior and caregiver s burden scales showed any significant changes after intervention. However, the interviews showed improvements in subjective aspects of communication, interaction and behavior. Conclusion: ART uses old-style tools. The nostalgia brought about by using these familiar tools led to effective recall of experiences, in which the participants taught the staff how to use the tools, which were unfamiliar to the staff. Through this role-reversal, they gained a sense of self-worth and a desire to live. Due to the reconstructed relationship between participants and caregivers, we consider ART to be effective in maintaining and improving emotional functions, activities of daily living and memory. ART should be useful for both lucid and mildly demented persons as brain-activating rehabilitation therapy.

Background/Aims: We aimed to prove the effectiveness of brain-activating rehabilitation for dementia, which consisted of 5 principles: pleasant atmosphere, communication, praising, social role, and supportive care. Methods: The design was a randomized controlled trial that was not blinded. Fifty-four elderly participants with dementia (mean age: 85.2 years) were selected. Intervention based on the 5 principles of brain-activating rehabilitation was conducted for 1 h, twice a week, for 12 weeks (24 sessions). The control group had no treatment. Outcome measures consisted of two observation scales, namely sum of boxes in clinical dementia rating (CDR-SB) and the multidimensional observation scale for elderly subjects (MOSES), and two cognitive tests: the Hasegawa dementia scale revised (HDS-R) and trail making test A. Results: Repeated measure ANCOVA showed a significant interaction for total score of CDR-SB (F = 7.190, p = 0.015) and MOSES (F = 4.525, p = 0.038). There were no significant changes in the two cognitive test scores. Conclusion: Intervention based on the principles of brain-activating rehabilitation was effective in maintaining and improving daily life functions in elderly participants with dementia in residential care homes.