The aim of this study was to assess the efficacy of cognitive training, specifically computerized cognitive training (CCT) and virtual reality cognitive training (VRCT), programs for individuals living with mild cognitive impairment (MCI) or dementia and therefore at high risk of cognitive decline. After searching a range of academic databases (CINHAL, PSYCinfo, and Web of Science), the studies evaluated (N = 16) were categorized as CCT (N = 10), VRCT (N = 3), and multimodal interventions (N = 3). Effect sizes were calculated, but a meta-analysis was not possible because of the large variability of study design and outcome measures adopted. The cognitive domains of attention, executive function, and memory (visual and verbal) showed the most consistent improvements. The positive effects on psychological outcomes (N = 6) were significant reductions on depressive symptoms (N = 3) and anxiety (N = 2) and improved perceived use of memory strategy (N = 1). Assessments of activities of daily living demonstrated no significant improvements (N = 8). Follow-up studies (N = 5) demonstrated long-term improvements in cognitive and psychological outcomes (N = 3), and the intervention groups showed a plateau effect of cognitive functioning compared with the cognitive decline experienced by control groups (N = 2). CCT and VRCT were moderately effective in long-term improvement of cognition for those at high risk of cognitive decline. Total intervention time did not mediate efficacy. Future research needs to improve study design by including larger samples, longitudinal designs, and a greater range of outcome measures, including functional and quality of life measures, to assess the wider effect of cognitive training on individuals at high risk of cognitive decline.

Background Physical exercise interventions have benefits for older individuals and improve the health and well-being of individuals living with a dementia, specifically those living in nursing homes. Purpose Report evidence from randomized controlled trials and cluster randomized control trials that evaluated the effects of physical exercise interventions on individuals living with a dementia in nursing homes. Data sources Web of Science, Scopus, Science Direct, Academic Search Complete, Proquest Central, British Medical Journal Database, PubMed, Cochrane Library, PEDro, Informit, Informa, and Nursing Consult were searched for relevant clinical trials and snowballing of recommended studies. Study selection One reviewer screened articles on inclusion criteria and identified relevant studies. Data extraction Data extraction was performed by 1 reviewer and checked by second and third reviewers. Two authors assessed the methodological quality and risk of bias of the relevant studies. Data synthesis Twelve study populations consisting of individuals living with a dementia in nursing homes were included (n = 901). Different types of physical exercises were undertaken: multimodal (n = 6), walking (n = 5), music and movement (n = 2), and hand exercises (n = 1). The parameters of the interventions varied across the studies. Most of the studies reported significant positive effects of physical exercise on cognition, agitation, mood, mobility, and functional ability for individuals living with dementia in nursing homes. Limitations The main limitations were the heterogeneity of design, small samples, and short interventions. Conclusions There is emerging evidence that physical exercise significantly benefits individuals living with a dementia in nursing homes. Higher quality research is required adopting more rigorous methods, including longer interventions and larger samples to determine optimum parameters of the physical exercise interventions evaluated.

Richards, R. (2017). Consumption of anthocyanin-rich cherry juice for 12 weeks improves memory and cognition in older adults with mild-to-moderate dementia. European Journal of Nutrition, 56 (1), 333-341.Consumption of anthocyanin-rich cherry juice for 12 weeks improves memory and cognition in older adults with mild-to-moderate dementia AbstractPurpose Dietary flavonoids, including anthocyanins, may positively influence cognition and may be beneficial for the prevention and treatment of dementia. We aimed to assess whether daily consumption of anthocyanin-rich cherry juice changed cognitive function in older adults with dementia. Blood pressure and anti-inflammatory effects were examined as secondary outcomes. Methods A 12-week randomised controlled trial assessed cognitive outcomes in older adults (+70 year) with mild-to-moderate dementia (n = 49) after consumption of 200 ml/day of either a cherry juice or a control juice with negligible anthocyanin content. Blood pressure and inflammatory markers (CRP and IL-6) were measured at 6 and 12 weeks. ANCOVA controlling for baseline and RMANOVA assessed change in cognition and blood pressure. Results Improvements in verbal fluency (p = 0.014), short-term memory (p = 0.014) and long-term memory (p ≤ 0.001) were found in the cherry juice group. A significant reduction in systolic (p = 0.038) blood pressure and a trend for diastolic (p = 0.160) blood pressure reduction was evident in the intervention group. Markers of inflammation (CRP and IL-6) were not altered. Conclusion Inclusion of an anthocyanin-rich beverage may be a practical and feasible way to improve total anthocyanin consumption in older adults with mild-tomoderate dementia, with potential to improve specific cognitive outcomes. Methods: A 12-week randomised controlled trial assessed cognitive outcomes in older adults (+70y) with mild to moderate dementia (n=49) after consumption of 200ml/day of either a cherry juice or a control juice with negligible anthocyanin content. Blood pressure and inflammatory markers (CRP, IL-6) were measured at 6 and 12 weeks. ANCOVA controlling for baseline and RMANOVA assessed change in cognition and blood pressure.Results: Improvements in verbal fluency (P=0.014), short term memory (P=0.014) and long term memory (P=<0.001) were found in the cherry juice group. A significant reduction in systolic (P=0.038) blood pressure and a trend for diastolic (P=0.160) blood pressure reduction was evident in the intervention group. Markers of inflammation were not altered. Conclusion:Inclusion of an anthocyanin-rich beverage may be a practical and feasible way to improve total anthocyanin consumption in older adults with mild to moderate dementia, with potential to improve specific cognitive outcomes.3

AimThe aim of this study was to complete a pilot project to ascertain if the research design was appropriate to determine whether a daily oral dose of probiotics can reduce the rate of vaginal group B streptococcal (GBS) colonisation in pregnancy. MethodologyA pilot randomised controlled trial was performed which recruited 34 GBS-positive women who were approximately 36 weeks pregnant. The participants were randomly allocated to the control group, who continued with standard antenatal care, or to the intervention group, which continued with standard antenatal care and received a daily oral dose of probiotics for three weeks or until the birth of their infant. A lower vaginal swab to detect the presence of GBS was collected three weeks post consent or when a participant was in labour. ResultsNo significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21 days of probiotics. A subgroup analysis, including only those who had completed 14 days or more of probiotics (n=16), also showed no significant difference in vaginal GBS when compared to the control. As a secondary finding of the analysis did show significantly more vaginal commensals in the probiotics group (p=0.048).iii DiscussionThere are five possible reasons for the lack of significant results: The length of the intervention was too short. The dosage of the probiotics was too low. The wrong strains of probiotics were used. The sample size was inadequate. Oral probiotics are ineffective in impacting vaginal GBS. ImplicationsThe secondary finding of a significant increase of vaginal commensals (normal

Aims and objectives. The aim of this study was to review dementia nursing competencies. The objectives were to explain the relevancy of dementia competencies across care settings and levels of practice. Background. Dementia is strongly associated with increasing age and as the world population ages there is an imperative to ensure the healthcare workforce is fully equipped to meet the needs of people with dementia and their carers. Design. A literature review study addressed the research aim and objectives. Method. Literature sources were (i) academic databases, (ii) the internet and (iii) snowballing. Search terms were 'dementia', 'care standards', 'training and education' and 'competency'. Results. The sample consisted of 59 reviewed publications. A synthesis of the findings generated 10 dementia competencies: ( Conclusion. Government initiatives demonstrate commitments to dementia, such as Australia's adoption of dementia as a National Health Priority and the UK National Dementia Strategy. Registration boards for the nursing workforce in Japan and the UK included dementia competencies in generalist frameworks to emphasise the importance of dementia as a healthcare issue. This study demonstrated that there is no dementia competency framework relevant across care settings or levels of practice. Relevance to clinical practice. An empirical study will develop a multi-disciplinary dementia competency framework relevant across care settings and levels of practice to ensure the healthcare workforce can effectively deliver services to people with dementia and their carers. Journal of Clinical Nursing, 20 (13-14), 1948-1960. ABSTRACT AIMS AND OBJECTIVESThe aim of this study was to review dementia nursing competencies. The objectives were to explain the relevancy of dementia competencies across care settings and levels of practice.