Feasibility of Conducting Nonpharmacological Interventions to Manage Dementia Symptoms in Community-Dwelling Older Adults: A Cluster Randomized Controlled Trial

Abstract

This study assessed the feasibility of conducting 3 nonpharmacological interventions with older adults in dementia, exploring the effects of chair yoga (CY), compared to music intervention (MI) and chair-based exercise (CBE) in this population. Using a cluster randomized controlled trial (RCT), 3 community sites were randomly assigned 1:1:1 to CY, MI, or CBE. Participants attended twice-weekly 45-minute sessions for 12 weeks. Thirty-one participants were enrolled; 27 safely completed the interventions and final data collection (retention rate of 87%). Linear mixed modeling was performed to examine baseline and longitudinal group differences. The CY group improved significantly in quality of life compared to the MI group (CY mean = 35.6, standard deviation [SD] = 3.8; MI mean = 29.9, SD = 5.3, P = .010). However, no significant group differences were observed in physical function, behavioral, or psychological symptoms (eg, for mini-PPT: slopetime = 0.01, standard error [SE] = 0.3, P = .984 in the CBE group; slopetime = −0.1, SE = 0.3, P = .869 in the MI group; slopetime = −0.3, SE = 0.3, P = .361 in the CY group) over the 12-week intervention period. Overall, this pilot study is notable as the first cluster RCT of a range of nonpharmacological interventions to examine the feasibility of such interventions in older adults, most with moderate-to-severe dementia. Future clinical trials should be conducted to examine the effects of nonpharmacological interventions for older adults with dementia on health outcomes.

Effect of yoga on health-related quality of life in central nervous system disorders: A systematic review

“…23–31 In the remaining 12 studies, 4 did not find significant differences between groups after treatment (3 studies compared yoga with an inactive control group and 1 compared it with acceptance and commitment therapy). 32–37 The other eight studies found a significant difference between groups after treatment on at least one subscale or summary score. 22–35 When yoga was compared to no intervention, the results were generally in favour of the yoga group, only one study found results in favour of the control group (subscales ‘sleep’ and ‘outlook’).…”

“…32–37 The other eight studies found a significant difference between groups after treatment on at least one subscale or summary score. 22–35 When yoga was compared to no intervention, the results were generally in favour of the yoga group, only one study found results in favour of the control group (subscales ‘sleep’ and ‘outlook’). 28 When yoga was compared to another active intervention, there was generally no significant difference between groups, only one study found results in favour of the yoga group, 29 and one study found some subscales in favour of the active control group (subscales ‘pain’ and ‘health perception’) and another sub-score in favour of yoga (subscale ‘cognition’).…”

“…one was a follow-up 21 ), thus resulting in 16 studies and a total sample of 963 participants. Six studies were found for multiple sclerosis, 22–27 five for Parkinson’s disease, 28–32 two for stoke, 33,34 one for dementia, 35 one for epilepsy 36 and one for brain tumour. 37 A summary of the characteristics of these 16 randomized controlled trials are available in Table 1.…”

“…28–37 Out of the remaining studies, only five performed a sample calculation to ensure the reliability of their results 25–30 and only three of them were able to recruit the required sample size. 25–29 As for the other six studies, three acknowledged that their small sample size was a limitation for the interpretation of the results 32–36 without justifying the small sample size, and the other three never mentioned the justification of the sample size, nor its implication for the interpretation of the results. 22–24…”

Effects of music participation for mild cognitive impairment and dementia: A systematic review and meta‐analysis

“…The results for the effects of active music making and anxiety were unclear. Five studies measured anxiety, and two 28,40 found a positive effects, one small (d = À0.12), one large (d = À1.71). The two studies by Giovagnoli et al utilized the same music protocol (using Improvisation), so more diverse protocol utilizing active music-making activities are needed to understand music's effect on anxiety.…”