Nonpharmacological Interventions for Anxiety and Dementia in Nursing Homes: A Systematic Review

Wilson, Christine Brown; Arendt, Lars; Nguyen, Mynhi; Scott, Theresa; Neville, Christine; Pachana, Nancy A.

doi:10.1093/geront/gnz020

Cited by 35 publications

(28 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present study did not measure levels of anxiety or apathy. Anxiety has been identified as an under-researched outcome in nonpharmacological interventions for PLWD in nursing homes [56]. While carer burden has been measured previously for carers participating with PLWD in an art gallery intervention [48], an evaluation of respite received when not attending the NGA would have been valuable.…”

Section: Implications and Future Directionsmentioning

confidence: 99%

Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study

D’Cunha

McKune

Isbel

et al. 2019

JAD

View full text Add to dashboard Cite

The use of existing public spaces by people living with dementia, such as museums and art galleries, are becoming popular due to their ability to facilitate programs which promote social engagement and inclusion. However, few studies have investigated physiological outcomes of art gallery-based programs. Using a quasi-experimental design, the present study aimed to investigate the levels of salivary biomarkers of cortisol and interleukin-6, quality of life (QoL), depressive symptoms, cognition, and wellbeing, after attending the National Gallery of Australia (NGA) Art and Dementia program. Twenty-eight people living with dementia, each supported by a carer or family member, were recruited for a six-week program and were followed up at twelve weeks. In total, 25 participants (17 female; mean age 84.6 ± 7.27 years) completed the study, and 22 provided viable saliva samples. The waking to evening salivary cortisol ratio was higher post-intervention (p = 0.033), and returned to baseline levels at follow-up (p = 1.00), indicating a more dynamic salivary cortisol rhythm in response to the six-week program. Interleukin-6 levels remained unchanged (p = 0.664). No improvements in QoL (DEMQOL-Carer) were observed between baseline and post-intervention (p = 0.076). However, self-reported depressive symptoms decreased postintervention compared with baseline (p = 0.015), and memory (immediate recall) (p = 0.009) and verbal fluency (p = 0.027) improved between the same timepoints. The NGA Art and Dementia program appears to have quantifiable benefits, including improved hypothalamic-pituitary-adrenal axis function, justifying a need for longer controlled trial inclusive of physiological outcomes.

show abstract

Section: Implications and Future Directionsmentioning

confidence: 99%

Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study

D’Cunha

McKune

Isbel

et al. 2019

JAD

View full text Add to dashboard Cite

show abstract

“…Also, the prevalence of anxiety in persons with MCI and dementia ranges from 8 to 71%, resulting in poor outcomes (Kwak et al, 2017 ). Persons with MCI and dementia with co-morbid anxiety have more difficulties with activities of daily living, leading to greater functional impairment and resulting in early long-term care (Cummings et al, 2015 ; Brown Wilson et al, 2019 ). It is also associated with having poor quality of life (Livingston et al, 2014 ; Kwak et al, 2017 ), problematic behaviors, nighttime awakenings, worse neuropsychological performance (Seignourel et al, 2008 ), and increased mortality (Tatsumi et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Dance-Based Interventions on Depression for Persons With MCI and Dementia: A Systematic Review and Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

Background: There is a growing need to offer appropriate services to persons with mild cognitive impairment (MCI) and dementia who are faced with depression and anxiety distresses beyond traditional pharmacological treatment. Dance-based interventions as multi-dimensional interventions address persons' physical, emotional, social, and spiritual aspects of well-being. However, no meta-analysis of randomized controlled treatment trials (RCTs) has examined the effectiveness of dance-based interventions on depression and anxiety among persons with MCI and dementia, and the results of RCTs are inconsistent. The study aimed to examine the effectiveness of dance-based interventions on depression (a primary outcome) and anxiety (a secondary outcome) among persons with MCI and dementia.Methods: A systematic review with meta-analysis was conducted. The inclusion criteria were: population: people of all ages with MCI and dementia; intervention: dance-based interventions; control group: no treatment, usual care, or waiting list group; outcome: depression and anxiety; study design: published or unpublished RCTs. Seven electronic databases (Cochrane, PsycINFO, Web of Science, PubMed, EBSCO, CNKI, WanFang) were searched from 1970 to March 2021. Grey literature and reference lists from relevant articles were also searched and reviewed. The Cochrane “Risk of Bias” tool was used to assess study quality. RevMan 5.4 was used for meta-analysis and heterogeneity was investigated by subgroup and sensitivity analysis. GRADE was applied to assess the evidence quality of depression and anxiety outcomes.Results: Five randomized controlled trials were identified. Sample sizes ranged from 21 to 204. The risk of bias was low, except for being rated as high or unclear for most included studies in two domains: allocation concealment, blinding participants and personnel. Meta-analysis of depression outcome showed no heterogeneity (I2 = 0%), indicating that the variation in study outcomes did not influence the interpretation of results. There were significant differences in decreasing depression in favor of dance-based interventions compared with controls [SMD = −0.42, 95% CI (−0.60, −0.23), p < 0.0001] with a small effect size (Cohen's d = 0.3669); Compared with the post-intervention data, the follow-up data indicated diminishing effects (Cohen's d = 0.1355). Dance-based interventions were more effective in reducing depression for persons with dementia than with those having MCI, and were more effective with the delivery frequency of 1 h twice a week than 35 min 2–3 times a week. Also, one included RCT study showed no significant benefit on anxiety rating scores, which demonstrated small effect sizes at 6 weeks and 12 weeks (Cohen's d = 0.1378, 0.1675, respectively). GRADE analysis indicated the evidence quality of depression was moderate, and the evidence quality of anxiety was low.Conclusions: Dance-based interventions are beneficial to alleviate depression among persons with MCI and dementia. More trials of high quality, large sample sizes are needed to gain more profound insight into dance-based interventions, such as their effects of alleviating anxiety, and the best approaches to perform dance-based interventions.

show abstract

“…The incorporation of virtual experiences with familiar outdoors locations may reduce depressive symptoms, anxiety, improve quality of life and promote social connectedness without going outside (Musselwhite, 2017; Neal et al, 2019). Findings from systematic reviews highlight the importance of non-pharmacological options that are low cost and interesting to residents and staff to promote the emotional well-being of people living in the RACF (Brown Wilson et al, 2019; Chen et al, 2019; Quan et al, 2019). Uniquely, the VCE enabled participants to enjoy viewing familiar local locations and demonstrated the potential to reduce social isolation.…”

Section: Discussionmentioning

confidence: 99%

Effects of a virtual group cycling experience on people living with dementia: A mixed method pilot study

et al. 2020

View full text Add to dashboard Cite

Social isolation and sedentary behaviour are common in residential aged care facilities (also known as nursing homes or long-term care). Use of new technologies such as virtual and augmented reality are currently under investigation for their potential to provide exciting and engaging activities for older people in residential aged care facilities. However, there is limited evidence on whether these technologies can promote physical activity in a small group setting for people with cognitive impairment. Using mixed methods, we examined the use of a virtual cycling experience in a sample of 10 participants with cognitive impairment living in residential aged care facilities. In a randomised crossover design, participants engaged in a 25-minute, self-paced, facilitated seated virtual cycling experience and a time-matched seated physical activity session in groups of five. All participants completed a brief pre- and post-intervention mood questionnaire. Video analysis was used for both conditions to compare levels of environmental stimulation, apathy and engagement using both the Person–Environment Apathy Rating Scale and the Engagement of a Person with Dementia Scale. A thematic analysis of semi-structured interviews following the virtual cycling experience was also performed. No differences were observed between conditions for all outcomes except for environmental stimulation, where there was a lower response in the intervention than the control condition ( p = 0.032). This was primarily driven by lower scores for the virtual cycling experience than control in physical accessibility ( p = 0.012). Participants reported the virtual cycling experience to be immersive and challenging and reminisced about cycling earlier in life. The activity manager observed that the virtual cycling experience was an overall positive experience and emphasised benefits of safety screening and preparation prior to the activities. The findings of this study support the use of the virtual cycling experience as an immersive and engaging alternative to usual activities, which might encourage higher levels of physical activity in residential aged care facilities.

show abstract

Nonpharmacological Interventions for Anxiety and Dementia in Nursing Homes: A Systematic Review

Cited by 35 publications

References 46 publications

Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study

Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study

Effectiveness of Dance-Based Interventions on Depression for Persons With MCI and Dementia: A Systematic Review and Meta-Analysis

Effects of a virtual group cycling experience on people living with dementia: A mixed method pilot study

Contact Info

Product

Resources

About