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      The effect of digital reminiscence therapy on people with dementia: a pilot randomized controlled trial

      research-article
      1 , 2 ,
      BMC Geriatrics
      BioMed Central
      Dementia, Depression, Mobile applications, Memory, Randomized controlled trial

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          Abstract

          Background

          Reminiscence therapy (RT) can improve various dysfunctions in people with dementia (PWD), but it may not be a cost-effective intervention. Digital RT allows multiple users to participate in a therapy simultaneously. Moreover, digital RT offers convenience, such as for uploading personal materials and presenting individual triggers of personal memories. This pilot study aimed to evaluate the effect of digital RT through a comparison with conventional RT and to develop a strategy for designing larger RCTs.

          Methods

          An Android application and digital content were developed for digital RT. Overall, 49 PWD enrolled in nine daycare centers in Korea met the inclusion criteria. Eight sessions of digital RT in an intervention group ( n = 25) and storytelling in a control group ( n = 24) with no digital materials were performed over 4 weeks from February to June 2019. Cognition, depression, behavioral and psychological symptoms of dementia (BPSD), and engagement were measured as the primary outcomes to evaluate the effect of digital RT. All outcomes except for engagement were evaluated at baseline before the intervention (T0), post-intervention (T1), and 4 weeks after the intervention (T2). Engagement was measured at the first and last intervention sessions. Differences in cognition, depression and BPSD between groups and across time points (T0, T1, and T2) were analyzed by repeated measures ANOVA. Differences in engagement between the groups and time points (the first and last sessions) were analyzed by independent t-tests. This study adhered to the CONSORT guidelines.

          Results

          Depression (F = 7.62, p = .001, partial η 2 = .17) was significantly decreased at T1 and T2, and engagement (t = − 2.71, p = .011) was significantly increased at the last session in the digital RT group compared to the control group. However, cognition (F = 0.13, p = .821) and BPSD (F = 0.67, p = .485) were not significantly different between groups and time points.

          Conclusions

          Digital RT proved an innovative approach to manage PWD and will thus help PWD achieve a better mood and have more opportunities to engage in social interactions.

          Trial registration

          KCT0003446 in the Clinical Research Information Service. Registered 24 January 2019, https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=14391

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          Most cited references32

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          Korean Version of Mini Mental Status Examination for Dementia Screening and Its' Short Form

          Objective We developed a Korean version of Mini-Mental Status Examination (MMSE) optimized for screening dementia (MMSE-DS) and its' short form (SMMSE-DS). Methods We constructed the MMSE-DS using the items of the two current Korean versions of MMSE and then construct the SMMSE-DS consisted of 13 items from the MMSE-DS based on the diagnostic accuracy of individual items for dementia. We investigated reliability and validity of MMSE-DS and SMMSE-DS on 1,555 subjects (1,222 nondemented controls, 333 dementia patients). We compared the diagnostic accuracy of the SMMSE-DS with that of the three full Korean versions of MMSE, and examined its' age- and education-specific optimal cutoff scores for dementia. Results The internal consistency obtained by Cronbach's coefficient alpha was 0.826. The inter-rater reliability and test-retest reliability were 0.968 (p<0.001) and 0.825 (p<0.001), respectively. It showed significant correlation with the Clinical Dementia Rating (CDR) (r=-0.698, p<0.05) and the three full Korean versions of MMSE (r=0.839-0.938, p<0.001). The area under the receiver operator curve for dementia of the SMMSE-DS was larger than those of the three full Korean versions of MMSE (p<0.001). Age, education and gender explained 19.4% of the total variance of SMMSE-DS scores. The optimal cutoff scores for dementia of the SMMSE-DS were estimated differently by age and educational attainment of the subjects. Conclusion The SMMSE-DS was found to be accurate, brief and portable instrument for screening dementia in Korean elders, and may be particularly useful for screening dementia in elderly populations with wide variation in educational levels.
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            The Korean version of the neuropsychiatric inventory: a scoring tool for neuropsychiatric disturbance in dementia patients.

            The Neuropsychiatric Inventory (NPI) is a standardized, validated, and reliable tool to assess neuropsychiatric derangements in dementia patients. The aim of this study is to develop the Korean version of the NPI (K-NPI) and to test its reliability and usefulness in dementia patients. The subjects were 49 normal controls and 92 patients with Alzheimer's disease (43), vascular dementia (32), frontotemporal lobar degeneration (11), and other causes (6). Their caregivers familiar with the subjects' everyday behavior were interviewed with the K-NPI. In a subgroup (29/141) of the caregivers, the K-NPI was repeated for test-retest reliability, average of 23.1 days after the initial test. Prevalence rates of 12 behavioral domains in dementia patients were comparable to those of the original NPI; apathy was the most common and hallucination was the least common behavior. Total K-NPI scores correlated positively with dementia severity assessed with the Korean Mini-Mental State Examination. Test-retest reliabilities of frequencies and severities of all subscales were significantly high. Depression, anxiety, apathy, irritability, night-time behavior, and eating change were identified at very low rates in normal controls and were significantly less than those in dementia patients (p<0.001). The K-NPI, whose reliability and competency are comparable to those of the original version, may be a reliable and useful tool for measuring neuropsychiatric disturbances in Korean dementia patients.
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              Clinical practice guidelines for dementia in Australia.

              About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings. The guidelines have been approved by the National Health and Medical Research Council. The guidelines emphasise timely diagnosis; living well with dementia and delaying functional decline; managing symptoms through training staff in how to provide person-centred care and using non-pharmacological approaches in the first instance; and training and supporting families and carers to provide care.
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                Author and article information

                Contributors
                99seora@naver.com
                kopark@gwnu.ac.kr
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                6 May 2020
                6 May 2020
                2020
                : 20
                : 166
                Affiliations
                [1 ]GRID grid.49606.3d, ISNI 0000 0001 1364 9317, College of Nursing, , Hanyang University, ; 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763 Korea
                [2 ]GRID grid.411733.3, ISNI 0000 0004 0532 811X, Department of Nursing, , Gangneung-Wonju National University, ; 150 Namwon-ro, Heungeop-myeon, Wonju-si, Gangwon-do 26403 Korea
                Author information
                http://orcid.org/0000-0002-5222-1927
                Article
                1563
                10.1186/s12877-020-01563-2
                7204054
                32375661
                8403c8d6-7859-49bf-bc88-da2de81f7dd6
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 31 December 2019
                : 20 April 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002701, Ministry of Education;
                Award ID: NRF-2018R1D1A1B07042203
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Geriatric medicine
                dementia,depression,mobile applications,memory,randomized controlled trial
                Geriatric medicine
                dementia, depression, mobile applications, memory, randomized controlled trial

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