Dataset Information

A Pilot Study of the Effects of Individualized Home Dual Task Training by Mobile Health Technology in People with Dementia.

ABSTRACT: The objective of this pilot study was to evaluate the effects of dual-task training implemented by mobile health technology on performance on motor and dual-task tests in subjects with dementia. Nineteen subjects with a medical diagnosis of dementia were assigned to an experimental group (EG, n = 12) or control group (CG, n = 7). The EG participated in 24 sessions (3/week) of a homebase dual-task exercises program, in addition to their ongoing cognitive and physiotherapy treatment. The training program was implemented individually in the patient's home by caregivers or relatives through electronic devices controlled by a mobile application. Before (Pre) and after (Post) the program, performance on motor and motor/cognitive (dual-task) tests were evaluated. Motor evaluation included gait at preferred and maximal speed, the Up and Go, and the Handgrip Strength test. Dual-task tests included gait with subtraction 3 s from 100 and naming animals (verbal fluency). The CG only performed the evaluations in addition to their cognitive and physiotherapy treatment. The statistical analysis (ANOVA Group*Test) showed a statically significant improvement for both dual-task tests in the EG after the training program, while the CG showed an impairment in the verbal fluency test. Conclusion: the implementation of a home exercise program carried out with mobile technology in people with dementia is feasible and positively affects their performance on dual tasks.

SUBMITTER: Villamil-Cabello E

PROVIDER: S-EPMC10138825 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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A Pilot Study of the Effects of Individualized Home Dual Task Training by Mobile Health Technology in People with Dementia.

Villamil-Cabello Eduardo E Meneses-Domínguez Mercedes M Fernández-Rodríguez Ángela Á Ontoria-Álvarez Patricia P Jiménez-Gutiérrez Alfonso A Fernández-Del-Olmo Miguel M

International journal of environmental research and public health 20230411 8

The objective of this pilot study was to evaluate the effects of dual-task training implemented by mobile health technology on performance on motor and dual-task tests in subjects with dementia. Nineteen subjects with a medical diagnosis of dementia were assigned to an experimental group (EG, <i>n</i> = 12) or control group (CG, <i>n</i> = 7). The EG participated in 24 sessions (3/week) of a homebase dual-task exercises program, in addition to their ongoing cognitive and physiotherapy treatment. ...[more]

PMID: 37107746

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Project description:BackgroundStepping impairments are associated with physical and cognitive decline in older adults and increased fall risk. Exercise interventions can reduce fall risk, but adherence is often low. A new exergame involving step training may provide an enjoyable exercise alternative for preventing falls in older people.PurposeTo assess the feasibility and safety of unsupervised, home-based step pad training and determine the effectiveness of this intervention on stepping performance and associated fall risk in older people.DesignSingle-blinded two-arm randomized controlled trial comparing step pad training with control (no-intervention).Setting/participantsThirty-seven older adults residing in independent-living units of a retirement village in Sydney, Australia.InterventionIntervention group (IG) participants were provided with a computerized step pad system connected to their TVs and played a step game as often as they liked (with a recommended dose of 2-3 sessions per week for 15-20 minutes each) for eight weeks. In addition, IG participants were asked to complete a choice stepping reaction time (CSRT) task once each week.Main outcome measuresCSRT, the Physiological Profile Assessment (PPA), neuropsychological and functional mobility measures were assessed at baseline and eight week follow-up.ResultsThirty-two participants completed the study (86.5%). IG participants played a median 2.75 sessions/week and no adverse events were reported. Compared to the control group, the IG significantly improved their CSRT (F31,1?=?18.203, p<.001), PPA composite scores (F31,1?=?12.706, p?=?0.001), as well as the postural sway (F31,1?=?4.226, p?=?0.049) and contrast sensitivity (F31,1?=?4.415, p?=?0.044) PPA sub-component scores. In addition, the IG improved significantly in their dual-task ability as assessed by a timed up and go test/verbal fluency task (F31,1?=?4.226, p?=?0.049).ConclusionsStep pad training can be safely undertaken at home to improve physical and cognitive parameters of fall risk in older people without major cognitive and physical impairments.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12611001081909.

Project description:BackgroundAssistive technologies for people with dementia and their relatives have the potential to ensure, improve, and facilitate home care and thereby enhance the health of the people caring or being cared for. The number and diversity of technologies and research have continuously increased over the past few decades. As a result, the research field has become complex.ObjectiveThe goal of this scoping review was to provide an overview of the research on technology-assisted home care for people with dementia and their relatives in order to guide further research and technology development.MethodsA scoping review was conducted following a published framework and by searching 4 databases (MEDLINE, CINAHL, PsycInfo, and CENTRAL) for studies published between 2013 and 2018. We included qualitative and quantitative studies in English or German focusing on technologies that support people with dementia or their informal carers in the home care setting. Studies that targeted exclusively people with mild cognitive impairment, delirium, or health professionals were excluded as well as studies that solely consisted of assessments without implication for the people with dementia or their relatives and prototype developments. We mapped the research field regarding study design, study aim, setting, sample size, technology type, and technology aim, and we report relative and absolute frequencies.ResultsFrom an initial 5328 records, we included 175 studies. We identified a variety of technology types including computers, telephones, smartphones, televisions, gaming consoles, monitoring devices, ambient assisted living, and robots. Assistive technologies were most commonly used by people with dementia (77/175, 44.0%), followed by relatives (68/175, 38.9%), and both target groups (30/175, 17.1%). Their most frequent goals were to enable or improve care, provide therapy, or positively influence symptoms of people with dementia (eg, disorientation). The greatest proportions of studies were case studies and case series (72/175, 41.1%) and randomized controlled trials (44/175, 25.1%). The majority of studies reported small sample sizes of between 1 and 50 participants (122/175, 69.7%). Furthermore, most of the studies analyzed the effectiveness (85/233, 36.5%) of the technology, while others targeted feasibility or usability or were explorative.ConclusionsThis review demonstrated the variety of technologies that support people with dementia and their relatives in the home care setting. Whereas this diversity provides the opportunity for needs-oriented technical solutions that fit individual care arrangements, it complicates the choice of the right technology. Therefore, research on the users' informational needs is required. Moreover, there is a need for larger studies on the technologies' effectiveness that could contribute to a higher acceptance and thus to a transition of technologies from research into the daily lives of people with dementia and their relatives.

Project description:There is a growing interest in using technology to provide meaningful activities for people living with dementia. The aim of this systematic review was to identify and explore the different types of digital technologies used in creating individualized, meaningful activities for people living with dementia. From 1414 articles identified from searches in four databases, 29 articles were included in the review. The inclusion criteria were the study used digital technology to deliver an individually tailored activity to participants with dementia, the process of individualization was described, and findings relating to the mental, physical, social, and/or emotional well-being of the participant were reported. Data extracted from the included studies included participant demographics, aims, methods, and outcomes. The following information on the technology was also extracted: purpose, type, training, facilitation, and the individualization process. A narrative synthesis of the results grouped the various technologies into four main purposes: reminiscence/memory support, behavior management, stimulating engagement, and conversation/communication support. A broad range of technologies were studied, with varying methods of evaluation implemented to assess their effect. Overall, the use of technology in creating individualized, meaningful activities seems to be promising in terms of improving behavior and promoting relationships with others. Furthermore, most studies in this review involved the person with dementia in the individualization process of the technology, indicating that research in this area is adopting a more co-creative and inclusive approach. However, sample sizes of the included studies were small, and there was a lack of standardized outcome measures. Future studies should aim to build a more concrete evidence base by improving the methodological quality of research in this area. Findings from the review indicate that there is also a need for more evidence concerning the feasibility of implementing these technologies into care environments.

Project description:ImportanceHome-delivered meals promote food security and independence among homebound older adults. However, it is unclear which of the 2 predominant modes of meal delivery, daily-delivered vs mailed (or drop-shipped) frozen meals, promotes community living for homebound older adults with dementia.ObjectiveTo assess the risk of nursing home admission within 6 months between homebound individuals receiving daily-delivered vs drop-shipped frozen meals.Design, setting, and participantsThis pilot, multisite, 2-arm, pragmatic clinical trial included older adults with self-reported dementia on waiting lists for meals at 3 Meals on Wheels (MOW) programs in Texas and Florida between April 7 and October 8, 2021, to assess time to nursing home placement.InterventionsParticipants were randomized to receive either meals delivered by an MOW driver or frozen meals that were mailed to participants' homes every 2 weeks. Participants received their assigned intervention for up to 6 months.Main outcomes and measuresThe primary study outcome was days from randomization to a Minimum Data Set nursing home admission assessment within 6 months. Feasibility of conducting this type of study was examined by tracking enrollment, examining baseline characteristics, monitoring participants' intervention fidelity, measuring the proportion of participants linked with Centers for Medicare & Medicaid Services (CMS) data, and analyzing the primary study outcome.ResultsAmong 325 eligible participants who were randomized, 243 enrolled in the study (mean [SD] age, 81 [8.0] years; 152 (62.6%) were female): 128 to the daily-delivered meals group and 115 to the drop-shipped frozen meals group; 119 participants (49.0%) lived alone. Among the total participants enrolled, 227 (93.4%) were linked deterministically to their CMS data; probabilistic methods were used to link the remaining 16 participants (6.6%). At 6 months from randomization, 160 participants (65.8%) were still receiving meals, and 25 (10.1%; 95% CI, 6.3%-14.0%) were admitted to a nursing home. After adjusting for sex, race and ethnicity, age, program, and living arrangement and the use of death as a censoring event, the adjusted log hazard ratio of nursing home placement between daily-delivered and drop-shipped frozen meals was -0.67 (95% CI, -1.52 to 0.19).Conclusions and relevanceThis pilot randomized clinical trial demonstrated the feasibility of enrolling participants with self-reported dementia on waiting lists at MOW programs, linking their data, and evaluating outcomes. While this pilot study was not powered to detect meaningful, statistically significant differences in nursing home placement, its feasibility and initial results warrant exploration in a follow-on, adequately powered trial.Trial registrationClinicalTrials.gov Identifier: NCT04850781.

Dataset Information

A Pilot Study of the Effects of Individualized Home Dual Task Training by Mobile Health Technology in People with Dementia.

Publications

A Pilot Study of the Effects of Individualized Home Dual Task Training by Mobile Health Technology in People with Dementia.

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