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- Effects of caregiver-provided individual cognitive interventions on cognition, social functioning and quality of life in older adults with major neurocognitive disorders: a systematic reviewPublication . Silva, Rosa; Bobrowicz-Campos, Elzbieta; Cardoso, Daniela; Costa, Paulo; Couto, Filipa; Camarneiro, Ana Paula; Abrunheiro, Sérgio; Almeida, Maria; Apóstolo, JoãoObjective: The objective of this review was to investigate the effectiveness of caregiver-provided individual cognitive interventions for improving cognition, social functioning and quality of life in older adults with major neurocognitive disorders. Introduction: A large number of people with major neurocognitive disorders live in their homes, requiring ongoing community care. Different individual cognitive intervention programs have been explored as a potential approach for implementation by caregivers on a one-to-one basis. These programs have the advantage of being implemented in a home setting and in the real-life context of the older adult, in a society that is increasingly aging and where aging in place is being fostered. Inclusion criteria: This review considered experimental studies that included older adults aged 60 years and over with major neurocognitive disorders who were receiving individual cognitive interventions (e.g. cognitive stimulation, cognitive training or cognitive rehabilitation) provided by their caregivers. The comparator was usual care, waitlist control or alternative therapeutic intervention. The primary outcomes of interest included cognition, social functioning and quality of life. Additionally, behavior, mood and activities of daily living were considered. Methods: A comprehensive search strategy was used to identify relevant published and unpublished studies from January 1995 to March 2018, written in English, Spanish and Portuguese. Studies meeting the inclusion criteria were retrieved and their methodological quality was assessed by two independent reviewers using the JBI critical appraisal checklists for randomized controlled trials and quasi-experimental studies. Quantitative data were extracted using the standardized data extraction tool from the JBI System for the Unified Management, Assessment and Review of Information. Due to the clinical and methodological heterogeneity in the included studies, statistical pooling was not possible. Therefore, findings are presented in a narrative format. Results: Eight randomized controlled trials and two quasi-experimental studies were included, with a total sample of 844 dyads (older adults and caregivers). The number of dyads included in the studies ranged from 16 to 356. Beneficial effects of the caregiver-provided individual cognitive interventions were observed in various cognitive domains, including memory, attention, verbalfluency and problem-solving. Two studies additionally reported the positive impact of the intervention of interest on general cognitive functioning. None of the reviewed studies revealed significant changes in quality of life. Social functioning was not analyzed in any of the included studies. Beneficial effects were also reported in relation to behavior and activities of daily living, despite the low level of evidence. Conclusions: This review responds to a gap in current international literature on the synthesis of evidence on the use of caregiver-provided individual cognitive interventions. The intervention of interest is associated with improvement in cognitive performance, revealing some benefits for the stabilization of neuropsychiatric symptoms and an increase in autonomy in activities of daily living. Further research on the impact of sociodemographic and clinical factors on the intervention effects is needed, as these factors seem to interfere with successful intervention implementation. To reinforce current evidence, the methodological quality of future studies should be improved.
- Cognitive stimulation in older adults: an innovative good practice supporting successful aging and self-carePublication . Apóstolo, J.; Bobrowicz-Campos, E.; Gil, I.; Silva, R.; Costa, P.; Couto, F.; Cardoso, D.; Barata, A.; Almeida, M.The project Cognitive Stimulation in Older Adults: Intervention on Cognitive Frailty and Promotion of Self-Care (in brief the ECOG project) arises in a context of worldwide demographic aging, and is fostered by the need to provide a sustainable solution to the progressive increase in the prevalence of age-related cognitive impairment. The main goal of the ECOG project is to promote active citizenship in old age through the empowerment for autonomy and self-care. Namely, the ECOG team is working on the development of evidence-based programs and tools that promote gains in health in cognitively frail and cognitively impaired older adults from the community. It is also working on the transfer of ECOG products to the practice of health and social care, promoting active involvement of geriatric care institutions in the implementation of the ECOG programs and tools, and ensuring appropriate training of professionals. Finally, the ECOG team is deploying a digital platform to reach out to the broadest audience possible and support the remote access and scaling up of the ECOG products. The impacts expected at an individual level include improvements in cognition, functionality, and autonomy of older adults, with simultaneous reduction of depressive symptomatology, and increase in quality of life of both person cared and his/her caregiver. Regarding societal gains, we anticipate an increase in life expectancy and significant postponement of institutionalization associated with geriatric problems. We also believe that the wide implementation of the ECOG products will reduce the costs of interventions for cognitively impaired citizens, contributing to sustainability and efficiency of health systems.
- Use of innovative technologies in group-based reminiscence interventions in older adults’ with dementia: a scoping reviewPublication . Gil, Isabel; Santos-Costa, Paulo; Bobrowicz-Campos, Elzbieta; Santos, Eduardo; Silva, Rosa Carla; Sousa, Liliana B.; Almeida, Maria de Lurdes; Apóstolo, JoãoBackground: Reminiscence therapy (RT) emerges in the literature as a non-pharmacological intervention commonly implemented in groups of older adults with dementia, and which has significant positive results in outcomes such as cognition and depressive symptomatology. Simultaneously, we witness the gradual addition of innovative technologies in non-pharmacological interventions in this population segment. However, no studies have synthesized the main contributions of the use of technology in group-based RT sessions. Aim: To map the available evidence on group-based RT sessions/activities aided by technological innovations, and critically discussed the potentialities and weaknesses of its use. Methods: Scoping review following the Joanna Briggs Institute methodology. Two independent reviewers analyzed the relevance of the studies, extracted and synthesized data. Results: Seven studies were included. Overall, the use of technological aids potentiates the interaction and communication between older adults with dementia, staff, and relatives. Nevertheless, issues related to ergonomics, connectivity, and intention of use emerge as recurrent pitfalls. Conclusion: While technological aids can foster a more personalized and dynamic group-based RT session, the development of such innovations must follow an user-centered approach that involves older adults with different stages of dementia in order to create solutions with significance and applicability to its end-users.