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Results for 'systematic reviews'

Results 1 - 10 of 40

Impact of individualised music listening intervention on persons with dementia: A systematic review of randomised controlled trials

GAVIOLA Minah Amor, et al
2019

Objective: To summarise the evidence regarding the impact of individualised music listening on persons with dementia. Methods: Six electronic databases (CINAHL, Medline, ProQuest, PsycINFO, Music Periodicals and Cochrane) were searched up to July 2018 for randomised controlled trials (RCTs) evaluating the efficacy of individualised music listening compared to other music and non–music‐based interventions. Results: Four studies were included. Results showed evidence of a positive impact of individualised music listening on behavioural and psychological symptoms of dementia (BPSDs) including agitation, anxiety and depression and physiological outcomes. Evidence for other outcomes such as cognitive function and quality of life was limited. Conclusions: The limited evidence suggests individualised music listening has comparable efficacy to more resource‐intensive interventions. However, there was a small number of RCTs and some outcomes were evaluated by a single study. This limits the conclusions drawn, warranting more RCTs evaluating other outcomes beyond the BPSDs.

Combatting social isolation and increasing social participation of older adults through the use of technology: a systematic review of existing evidence

BAKER Steven, et al
2018

Objectives: There are growing concerns that social isolation presents risks to older people's health and well‐being. Thus, the objective of the review was to explore how technology is currently being utilised to combat social isolation and increase social participation, hence improving social outcomes for older people. Methods: A systematic review of the literature was conducted across the social science and human‐computer interaction databases. Results: A total of 36 papers met the inclusion criteria and were analysed using a four‐step process. Findings were threefold, suggesting that: (i) technologies principally utilised social network services and touch‐screen technologies; (ii) social outcomes are often ill‐defined or not defined at all; and (iii) methodologies used to evaluate interventions were often limited and small‐scale. Conclusion: Results suggest a need for studies that examine new and innovative forms of technology, evaluated with rigorous methodologies, and drawing on clear definitions about how these technologies address social isolation/participation. Policy Impact: This systematic review explores how technology is currently being utilised to combat social isolation and increase social participation for older people. A unique aspect of this review is that it incorporates smaller design studies and prototypes. These insights will benefit those considering the potential for information and communication technologies to contribute to older adults’ health and well‐being. Practice Impact: This systematic review explores how technology is currently being utilised to combat social isolation and increase social participation for older people. Insights from the review will benefit practitioners seeking to understand the broad range of technologies that are being applied to these issues, and the common benefits and challenges associated with each approach.

The effectiveness of mindfulness- and acceptance-based interventions for informal caregivers of people with dementia: a meta-analysis

COLLINS Rebecca N., KISHITA Naoko
2019

Background and Objectives: The application of mindfulness- and acceptance-based interventions (MABIs) for informal caregivers of people with dementia (PwD) is relatively novel, and the current state of the evidence base is unclear. This meta-analysis examined the effectiveness of MABIs on reducing symptoms of depression and burden in informal caregivers of PwD. The quality of included studies was evaluated and moderator variables explored. Research Design and Methods: A literature search of six electronic databases (PsycARTICLES, PsycINFO, MEDLINE Complete, SCOPUS, Web of Science, and ProQuest) was conducted from the first available date to 20 December 2016. Inclusion criteria involved studies that quantitatively investigated the impact of MABIs on depression and/or burden in informal caregivers of PwD. Results: Twelve studies, providing data on 321 caregivers, were included. Most used mindfulness-based stress reduction and were conducted in the United States. The average attrition among participants was 15.83%. The pre–post effect of MABIs was large for depression and moderate for burden. These effects were largely maintained at follow-up. Significant heterogeneity of effect sizes was observed, with no significant moderators identified. Study quality varied from very poor to moderately good. Discussion and Implications: The low attrition and moderate to large effects suggest that MABIs are acceptable and beneficial for informal caregivers of PwD. The lack of significant moderators could advocate services using more cost-effective forms of MABIs. Further higher-quality research is needed to improve the robustness of the evidence base and enable a meta-analysis to thoroughly examine and quantify moderator variables.

Acceptance and use of innovative assistive technologies among people with cognitive impairment and their caregivers: a systematic review

THORDARDOTTIR Bjorg, et al
2019

Cognitive impairments (CI), associated with the consequences of Alzheimer’s disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.

Physical activity programs for older people in the community receiving home care services: systematic review and meta-analysis

BURTON Elissa, et al
2019

The proportion of older adults is increasing around the world and most wish to live in their home until they die. To achieve this, many will require services in the home to remain living independently. To maintain function (ie, strength, balance, and endurance), physical activity needs to be undertaken on a regular basis, and is essential as a person ages. Unfortunately, as people age there is a tendency to reduce activity levels, which often leads to loss of function and frailty, and the need for home care services. This updated systematic review includes a mix of study methodologies and meta-analysis, and investigated the effectiveness of physical activity/exercise interventions for older adults receiving home care services. Eighteen studies including ten randomized controlled trials meeting the selection criteria were identified. Many of the studies were multi-factorial interventions with the majority reporting aims beyond solely trying to improve the physical function of home care clients. The meta-analysis showed limited evidence for effectiveness of physical activity for older adults receiving home care services. Future exercise/physical activity studies working with home care populations should consider focusing solely on physical improvements, and need to include a process evaluation of the intervention to gain a better understanding of the association between adherence to the exercise program and other factors influencing effectiveness.

Electronic assistive technology for community-dwelling solo-living older adults: a systematic review

SONG Yu, van der CAMMEN Tischa J.M.
2019

The proportion of older adults who live alone in single households is growing continuously. In the care of these solo-living older adults, electronic assistive technology (EAT) can play an important role. The objective of this review is to investigate the effects of EAT on the wellbeing of community-dwelling older adults living alone in single households. A systematic review of English articles was conducted based on PMC, Scopus, Web of Science and the Cochrane database. Additional studies were identified from the references. In total, 16 studies were identified, six of them with follow-up. There is evidence that EAT can improve the physical and mental wellbeing of older adults. There was little evidence that EAT can improve social wellbeing. We conclude that more personalized designs and interventions, and more user engagement could be embedded in the design of EAT for solo-living community-dwelling older adults and that more evidence is needed regarding the effects of those interventions.

How do “robopets” impact the health and well‐being of residents in care homes? A systematic review of qualitative and quantitative evidence

ABBOTT Rebecca, et al
2019

BACKGROUND: Robopets are small animal-like robots which have the appearance and behavioural characteristics of pets. OBJECTIVE(S): To bring together the evidence of the experiences of staff, residents and family members of interacting with robopets and the effects of robopets on the health and well-being of older people living in care homes. DESIGN: Systematic review of qualitative and quantitative research. DATA SOURCES: This study searched 13 electronic databases from inception to July 2018 and undertook forward and backward citation chasing. METHOD(S): Eligible studies reported the views and experiences of robopets from residents, family members and staff (qualitative studies using recognised methods of qualitative data collection and analysis) and the effects of robopets on the health and well-being of care home residents (randomised controlled trials, randomised crossover trials and cluster randomised trials). Study selection was undertaken independently by two reviewers. This study used the Wallace criteria and the Cochrane Risk of Bias tool to assess the quality of the evidence. This study developed a logic model with stakeholders and used this as a framework to guide data extraction and synthesis. Where appropriate, meta-analysis were used to combine effect estimates from quantitative studies. RESULT(S): Nineteen studies (10 qualitative, 2 mixed methods and 7 randomised trials) met the inclusion criteria. Interactions with robopets were described as having a positive impact on aspects of well-being including loneliness, depression and quality of life by residents and staff, although there was no corresponding statistically significant evidence from meta-analysis for these outcomes. Meta-analysis showed evidence of a reduction in agitation with the robopet "Paro" compared to control (-0.32 [95% CI -0.61 to -0.04, p = 0.03]). Not everyone had a positive experience of robopets. CONCLUSION(S): Engagement with robopets appears to have beneficial effects on the health and well-being of older adults living in care homes, but not all chose to engage. Whether the benefits can be sustained are yet to be investigated. IMPLICATIONS FOR PRACTICE: Robopets have the potential to benefit people living in care homes, through increasing engagement and interaction. With the robopet acting as a catalyst, this engagement and interaction may afford comfort and help reduce agitation and loneliness.

Non-pharmacological interventions for people with dementia: a review of reviews

MEYER Claudia, O'KEEFE Fleur
2018

Objective: Aged care services increasingly respond to the needs of people with dementia. Non-pharmacological approaches are preferable to reduce responsive behaviours, improve/maintain functional capacity and reduce emotional disorders. This rapid review of systematic reviews aimed to consolidate the evidence for non-pharmacological interventions and determine outcome effectiveness. Methods: Systematic review literature was comprehensively searched for non-pharmacological interventions for dementia in residential care. Quality ratings used adapted GRADE methodology, and ease of implementation assessed. Results: Of 629 abstracts screened, 81 full-text articles were retrieved, 38 articles included. The strongest evidence for reducing responsive behaviours was music, sensory stimulation, simulated presence and validation therapies. Exercise and light therapy improved/maintained activities of daily living, while cognitive stimulation and reminiscence improved cognition. Strongest evidence for reducing emotional disorders was music, psychological interventions and reminiscence. Conclusion: Much evidence of varying quality exists, with resource-constrained residential care providers now able to make evidence-based decisions about non-pharmacological interventions.

Are acceptance and mindfulness‐based interventions ‘value for money’? Evidence from a systematic literature review

DUARTE Rui, et al
2019

Objectives: Acceptance and mindfulness‐based interventions (A/MBIs) are recommended for people with mental health conditions. Although there is a growing evidence base supporting the effectiveness of different A/MBIs for mental health conditions, the economic case for these interventions has not been fully explored. The aim of this systematic review was to identify and appraise all available economic evidence of A/MBIs for the management of mental health conditions. Methods: Eight electronic bibliographic databases (MEDLINE, MEDLINE In‐Process & Other Non‐Indexed Citations, EMBASE, Web of Science, NHS Economic Evaluation Database (EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) database, and EconLit) were searched for relevant economic evaluations published from each database's inception date until November 2017. Study selection, quality assessment, and data extraction were carried out according to published guidelines. Results: Ten relevant economic evaluations presented in 11 papers were identified. Seven of the included studies were full economic evaluations (i.e., costs and effects assessed), and three studies were partial economic evaluations (i.e., only costs were considered in the analysis). The A/MBIs that had been subjected to economic evaluation were acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT), mindfulness‐based cognitive therapy (MBCT), and mindfulness‐based stress reduction (MBSR). In terms of clinical presentations, the evaluation of cost‐effectiveness of A/MBIs has been more focused on depression and emotional unstable personality disorder with three and four economic evaluations, respectively. Three out of seven full economic evaluations observed that A/MBIs were cost‐effective for the management of mental health conditions. Nevertheless, the heterogeneity of included populations, interventions, and economic evaluation study types limits the extent to which firm conclusions can currently be made. Conclusion: This first substantive review of economic evaluations of A/MBIs indicates that more research is needed before firm conclusions can be reached on the cost‐effectiveness of A/MBIs for mental health conditions.

Interventions to improve adherence to exercise therapy for falls prevention in community-dwelling older adults: systematic review and meta-analysis

HUGHES Katie J., et al
2019

Background: exercise therapy is highly recommended for falls prevention in older adults; however, poor exercise adherence may limit treatment effectiveness. Objective: to assess the effectiveness of interventions to improve exercise adherence for community-dwelling adults (aged over 65 years), at risk of falling. Methods: eight databases were searched to identify randomised/quasi-randomised trials. The Capability, Opportunity, Motivation model of behaviour (COM-B) was used to categorise the identified adherence interventions. Studies with similar interventions that provided adherence outcome data per group were analysed to establish pooled intervention effect. Protocol registration with Propsero: (CRD42016033677). Results: of the 20 trials included (n = 4419), five provided data per group for adherence outcome. Meta-analysis of four studies (n = 482), containing interventions exploring the way exercise is delivered, demonstrated significantly better adherence in the intervention group (n = 166 experimental, n = 161 control Fixed effects model (FEM), SMD = 0.48 95% CI [0.26–0.70] P < 0.0001 I2 = 0%, very low GRADE evidence). Within this limited evidence base, interventions using telecommunication and the integration of exercise into activities of daily living appear most promising when delivering exercise at home. Meta-analysis to explore the effect that these interventions to improve adherence had on balance (n = 166 experimental, n = 161 control Random-effects model (REM), SMD = 0.82, 95% CI [−1.20–2.84] P = 0.43 I2 = 52%) and gait (n = 59 experimental, n = 56 control REM, SMD = 0.29, 95% CI [−1.62–2.20] P = 0.77 I2= 48%), found no statistically significant effect. Conclusions: adherence to exercise can be positively influenced; however, insufficient data exists to support any single intervention that also achieves effective outcomes for balance and gait.

Results 1 - 10 of 40

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Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

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Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

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LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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