ABSTRACT
Background@#The number of individuals with mild cognitive impairment (MCI), or those people without dementia who are experiencing age-related cognitive decline, has increased in recent years. Conveniently, several interventions to delay cognitive decline exist, where cognitively stimulating activities (CSA) have been receiving too much attention. However, its beneficial effects have not been well established among older people with MCI due to conflicting findings. @*Objectives@#This study aimed to assess and summarize the available evidence on the effects of CSA on the overall cognitive functioning of older people with MCI. Specifically, it sought to answer the PICO question, “In older people with MCI, does engagement in cognitively stimulating activities improve cognitive function?”@*Methods@#A systematic review and meta-analysis of randomized controlled trials examining the effects of CSA on older people with MCI were conducted. Three studies met the inclusion criteria from the 1,328 records from BioMed Central, CINAHL, Cochrane Library, Health Source: Nursing/Academic Edition, MEDLINE, and PubMed databases and 156 articles from WorldCat, DSpace Saint Louis University, and Google Scholar databases and catalogs. Effect size values were inspected using the random-effects model. Data were summarized as standardized mean difference (SMD) with corresponding 95% confidence intervals in the forest plot. @*Results@#This meta-analysis which compared studies that employed similar methodologies, found that CSA has a significant, large effect in improving cognitive functioning among older people with MCI, evidenced by an SMD of 0.798 (95% CI = 0.510-1.085, p = 0.001). While its superiority over other interventions that improve cognitive function was not observed in this study, it was still found that using CSA was helpful in terms of its cost-effectiveness. Also, heterogeneity across studies was non-significant (Cochran’s Q = 0.151, df = 2, p = 0.927, I2 = 0.00%). These results mean that clinical heterogeneity was absent even though a diverse range of CSA was employed. Additionally, methodological diversity was not present since there were no variations in the study design and minimal variability in the risk of bias assessment. @*Conclusion@#Overall, it is acknowledged that CSA are effective and practical, inexpensive, non-pharmacologic cognitive training approaches to delay cognitive decline among older people with MCI. However, interpreting this study’s significant, large effect, and non-significant heterogeneity warrants caution.
Subject(s)
Cognition , Cognitive Dysfunction , Meta-AnalysisABSTRACT
Objective@#This study ascertained the effects of brain games on global cognition among older Filipinos.@*Methods@#A quasi-experimental design was used. The participants were 60 elderly Filipinos, aged 60 to 93 years, residing in Baguio City, and were not engaging in any physical or nutritional interventions to improve cognitive function. None have subclinical cognitive impairments as screened using the Mini-Cognitive Examination. The Addenbrooke's Cognitive Examination-III (ACE-III) tool which correlated significantly with standard neuropsychological tests, and provided a high internal reliability score of 0.88, was used. Data were analyzed using descriptive and inferential statistics.@*Results@#Pretest mean scores of both active control and experimental groups increased in the posttest. Additionally, both coloring and brain games had extremely significant effects on global cognition (p=0.0001). Lastly, the unrelated t-test revealed extremely significant difference between the effects of brain games and coloring on global cognition (p=0.0001).@*conclusions@#Based on the results, brain games showed evidence of effectiveness in improving global cognition, and that compared to coloring, it is more effective in improving global cognition among older Filipinos. Variables like motivation and expectancy effects influence the improvement in global cognition among older Filipinos. Lastly, cognitive training using brain games show promise as a non-pharmacologic intervention to address cognitive decline.
ABSTRACT
Purpose@#The number of older Filipinos continues to rise resulting in increasing numbers of people who live in a modernized world which offers numerous options to prepare for the End-of-Life (EoL). Henceforth, EoLplanning among older Filipinos and the factors which could potentially influence the propensity to plan ahead needs further investigation. This study ascertained the level of health, relationship, funerary, legal and financial-related EoL planning among older Filipinos, and established the association between EoL planning and sex, chronologic age, religious affiliation, ethnicity, health and financial status.@*Methods@#The study utilized a descriptive survey design, including 400 respondents, chosen through purposive sampling and met the inclusion of Filipino, Baguio residents, aged 60 and above, able to read and understand English, Filipino or Ilokano, and without psychological disturbances or cognitive deficits. The researchers used a self-made questionnaire after establishing validity (0.96) and reliability (0.82). The Saint Louis University Research Ethics Committee ensured the ethical conduct of this research. Data were treated with statistics using frequency, mean and Chi-square test.@*Findings@#The responses indicated moderate levels of EoL planning overall. Moreover, statistical tests revealed that only health status has a significant association with EoLplanning.@*Conclusions@#Based on the findings, the researchers conclude that EoL planning remains not widely used in the Philippines, thus, intensifying the call for more aggressive interventions to make EoL planning salient and acceptable to older people. In addition, health status affects EoL planning considerably, and that knowing the sex, chronologic age, religious affiliation, ethnicity and financial status did not help predict EoLplanning.