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Schwartz, Ken, Madan, Robert, Kates, Nick, Kates, Nick, Rajji, Tarek, Rajji, Tarek, Kates, Nick, Aelick, Katelynn, Bretzlaff, Monica, Colborne, Debbie Hewitt, Judd, Teresa, McConnell, Jillian, Seguin, Jacquie, Turcotte, Kylie, Liu, Linda, Colborne, Debbie Hewitt, Fortin, Natasha, McConnell, Jillian, Lesiuk, Nancy, Glover, Terri, Koop, Jennifer, Judd, Teresa, Madan, Robert, Schwartz, Kenneth, Colman, Sarah, Tau, Michael, Stanley, Claire, Colman, Sarah, Stanley, Claire, Tau, Michael, Colman, Sarah, Seitz, Dallas, Checkland, Claire, Benjamin, Sophiya, Bruneau, Marie-Andree, Cappella, Antonia, Cassidy, Beverley, Conn, David, Grief, Cindy, Keng, Alvin, Iaboni, Andrea, Grigorovich, Alisa, Kontoa, Pia, Astell, Arlene, McMurray, Josephine, Chu, Charlene, Rodrigues, Kevin, Barned, Claudia, Dementia Isolation Toolkit, Team, Thoo, Vanessa, Giddens-Zuker, Leslie, Benjamin, Sophiya, Ho, Joanne, Carthew, Julie, Cox, Lindsay, Rofaiel, Rymon, Burhan, Amer, Guseva, Elena, Iaboni, Andrea, Herrmann, Nathan, Seitz, Dallas, Burhan, Amer M.; Lanctot, Krista, Lim, Andrew, Wilchesky, Machelle, Iaboni, Andrea, Spasojevic, Sofija, Newman, Kristine, Schindel-Martin, Lori, Ye, Bing, Soltan, Aurelia, Blair, Mervin, McGregor, Carolyn, Burhan, Amer M.; Skosireva, Anna, Gobessi, Linda, Douglass, Alan, Kirkham, Julia, Seitz, Dallas, Goodarzi, Zahra, Denis, Emily St, Malvern, Riley, Sivanthanan, Saskia, Christie, Nathan, Canfield, Amanda, Rowa, Karen, Cassidy, Beverley, Eskes, Gail, Wilson, Ryan, Cassidy, Beverley, Wilton, Steven, Zamora, Nick, Alders, Ashley, Cassidy, Beverley, Wilton, Steven, Checkland, Claire, Zamora, Nick, Alders, Ashley, Kirkham, Julia, Freeland, Alison, Wilkes, Chris, Urness, Doug, Conn, David, Rabheru, Kiran, Checkland, Claire, Cassidy, Keri-Leigh, Rabheru, Kiran, Conn, David, Checkland, Claire, Seitz, Dallas, Abdool, Petal, Mulsant, Benoit H.; Rajji, Tarek K.; Kinjal, Patel, Thitiporn, Supasitthumrong, Seitz, Dallas, Rej, Soham, Clemens, Sara, Heer, Carrie, Devitt, Audrey, Yu, Song Yang, Rostas, Aviva, Cumberbatch, Simonne, Tafler, Melissa, Iroanyah, Ngozi Faith, Sivananthan, Saskia, Apostolides, Haridos, Jaggers, Kaitlyn, Badali, Jocelyn, Guimond, Josée, Sivananthan, Saskia, Martin-Zement, Isabelle, Nadeau-Lessard, Marie-Isabelle, Davies, Kelly, Schryburt-Brown, Kim, Benjamin, Sophiya, Morrison, Adam, Kay, Kelly, Young, Kevin, Kim, Doyoung, Kiss, Alex, Bronskill, Susan E.; Lanctot, Krista L.; Herrmann, Nathan, Gallagher, Damien, Kumar, Sanjeev, Joseph, Shaylyn, Patterson, Rachel, Wang, Wei, Blumberger, Daniel, Rajji, Tarek, Nunes, Paula Villela, Haidar, Atmis Medeiros, Mancine, Livia, Neves, Beatriz Astolfi, Leite, Renata Elaine Paraizo, Pasqualucci, Carlos Augusto, Lafer, Beny, Salvini, Rogerio, Suemoto, Claudia Kimie, King, Annalee, Daniel, Geoff, Hooper, Nancy, Easson-Bruno, Sandra, Lennard, Tamara Nowak, Greco, Martina, Greco, Martina, Veri, Sabrina, Bol, Alexa, Mullaly, Laura, Ostrom, Caroline, Huynh, Dan, Kong, Alice, Thorpe, Lilian, Payne, Sarah, Saperson, Karen, Brown, Michael, Levinson, Anthony, Levinson, Anthony, Payne, Sarah, Hategan, Ana, Esliger, Mandy, Singh, Kathleen, Hickey, Catherine, Chisholm, Terry, Sokoloff, Lisa, Checkland, Claire, Guraya, Jasmeen, Conn, David, Rabheru, Kiran, Seitz, Dallas, Feldman, Sid, Ewa, Vivian, Hunter, Andrea, Conn, David, Rabheru, Kiran, Checkland, Claire, Lee-Cheong, Stephen, Amanullah, Shabbir, Jarvie, Ann, Van Berkum, Amy, Graf, Shauna, Mansour, Reham, Amanallah, Shabbir, Golas, Angela C.; Elgallab, Bishoy M.; Abdool, Petal S.; Bowie, Christopher R.; Rajji, Tarek K.; Cuperfain, Ari, Furqan, Zainab, Sinyor, Mark, Shulman, Kenneth, Zaheer, Juveria, Wathra, Rafae, Mulsant, Benoit, Reynolds, Charles, Lenze, Eric, Karp, Jordan, Daskalakis, Zafiris, Blumberger, Daniel, Gough, Amy, Cassidy, Keri-Leigh, Vallis, Michael, Robinson-Dexter, Jean, Jasrai, Ashitija, Amanullah, Shabbir, Bolshin, Lisa, Khatri, Nasreen, Ryan, Jennifer.
Canadian geriatrics journal : CGJ ; 25(1):88-109, 2022.
Article in English | EuropePMC | ID: covidwho-1749133
2.
The American Journal of Geriatric Psychiatry ; 30(4, Supplement):S92, 2022.
Article in English | ScienceDirect | ID: covidwho-1739856

ABSTRACT

Introduction Over 700,000 Canadians are affected by dementia, costing the health care system approximately $10 billion/year. Due to COVID-19, the government has urged individuals over the age of 70 to stay home, putting this population at risk of becoming socially isolated. Those with dementia or mild cognitive impairments (MCIs) and their caregivers are at an even higher risk of becoming stressed, anxious, and agitated while in lockdown. Unsurprisingly, caregiver burden is extremely common, and often precedes institutionalization of the patient, as the demands of the illness begin to exceed that which the caregiver can sustainably provide. Since social distancing measures have shut down activities and support groups for these individuals, there is an urgent need for scalable, cost-effective, non-pharmacological interventions that can be delivered remotely to improve stress and loneliness. There are positive preliminary results examining the effects of yoga on stress suggesting it may be suitable for individuals with dementia and their caregivers. For this reason, we are conducting a randomized clinical trial (RCT) to assess the efficacy of an 8-week virtual chair yoga program. This would be the first virtual chair yoga study to engage both older adults with dementia/MCI and caregivers during COVID-19, which is consistent with the need for decreasing costs and increasing accessibility of novel health interventions during and beyond the pandemic. This study may be one viable solution to address the stress associated with the growing prevalence of dementia and the physical distancing measured associated with the COVID-19 health crisis. Methods A mixed-methods randomized controlled trial was used to assess the efficacy of an 8-week group Chair Yoga program on Zoom for older adults (60+) with dementia/MCI and their caregivers. Participants were assigned to either the treatment or waitlist control group and completed assessments at baseline and week 8. Quantitative assessments were measured at baseline and week 8, and qualitative assessments will be measured post-intervention. The primary and secondary outcomes are changes in stress and loneliness after the 8-week program, respectively. We also explored changes in anxiety, depression, caregiver burnout, fear of COVID-19, mindfulness, and self-compassion. Changes in all continuous variables from pre- to post-program will be evaluated by a Two-Way Mixed Analysis of Variance (ANOVA) with the within-subjects factor of time (baseline and week 8) and between-subjects factor of condition (chair yoga treatment or control). For the qualitative component, a descriptive phenomenological approach will be used to code data into themes based on key words and on frequency/importance of these words. Results We are in the final stages of data collection. Results will be ready by December 2021. Preliminary observations suggest that this program is feasible and acceptable based on positive feedback from older adults and caregivers. Some difficulties encountered were lack of internet access, lack of devices, and scheduling conflicts, which led to individuals not participating in the study. Surprisingly, many older adults were aware and knowledgeable of the Zoom software;we experienced very minor difficulties in using this software for this population. Conclusions We expect this study to validate our hypotheses that the severity of stress, loneliness, caregiver burden, and other self-reported outcomes will significantly decrease in the treatment group compared to the waitlist control group. As such, this intervention may decrease the economic burden on the healthcare system, as it can be delivered to large groups online and is easily scalable and cost-effective. It may also be a benefit to society by potentially decreasing the number of Canadians suffering from chronic stress. Additionally, it will potentially reduce caregiver burden and delay institutionalization of individuals with dementia, the latter of which may be particularly impactful given the rapid spread of COVID-19 through long-term care facilities in Canada. Regardless of the outcome, this study will provide essential pilot data for future large RCTs to improve stress and mental health in both older adults with dementia/MCI and caregivers. This research was funded by Katie Bodenstein received a Canada Graduate Scholarship SSHRC MSc Award and McGill Faculty of Medicine Internal Studentship.

3.
The American Journal of Geriatric Psychiatry ; 30(4, Supplement):S79-S80, 2022.
Article in English | ScienceDirect | ID: covidwho-1739853

ABSTRACT

Introduction Prior to COVID-19, psychiatric disorders affected over 10–15% of older adults (>1,000,000 Canadians aged 60+) with estimated costs of $15 billion/year. The pandemic has increased social isolation and limited resources for this vulnerable population, potentially increasing the risk of stress, anxiety, and depression, thus creating an urgent need for support for isolated older adults. To help prevent the development or worsening of mental illness and improve mental health in older adults, we developed an innovative volunteer-based Telehealth Intervention Program for Older Adults (TIP-OA), where volunteers provide weekly friendly phone calls to older adults (clients). TIP-OA has already served 500+ clients in 10+ languages. Although volunteer-based phoning programs may be affordable, scalable, and accessible, there is limited data about their real-world effectiveness and predictors of response. Seeing as TIP-OA is a novel and ongoing intervention program, we aim to identify predictors of treatment response based on client baseline risk ratings and demographic characteristics to help maximize the program's efficacy and benefits, and to detect vulnerable sub-groups of clients who need additional or alternate support. Methods To identify predictors of treatment response, we conducted a longitudinal study. Participants (n=114) were TIP-OA program users (age ≥ 60) who were screened and assigned a risk rating, were living in Montreal, and consented to take part in research. Clients with no/mild ratings were coded as green (low risk), 2+ moderate ratings as orange (medium risk) and 1+ severe rating as red (high risk). Demographic information and the outcome measure responses were collected via phone at baseline, 4- and 8-weeks after receiving their first call. Our primary objective is to identify whether baseline risk level (green: low risk, orange: medium risk, red: high risk) is associated with improved mental health outcomes at 8-week follow-up for stress (primary outcome), depression, anxiety, and COVID fear (secondary outcomes). Our secondary objective is to identify whether baseline demographic characteristics (age, gender, living environment, ethnicity, neighbourhood, languages spoken) are associated with improvement in primary and secondary outcomes. We will compare outcome scores between groups with different baseline risk levels using two-way ANOVA. Additional analysis of covariance (ANCOVAs) will control for variables that differ between groups at baseline. Additional linear mixed-effect regression models, adjusting for covariates such as age, sex, etc., will analyze the effect of TIP-OA in all outcomes collected at baseline and 8-week follow-up. Results We are currently in the process of analyzing the data, and anticipate results by December 2021. Conclusions We anticipate that TIP-OA will be particularly beneficial for improving stress, depression and anxiety symptoms, and fear of COVID-19 over 8-weeks in participants with higher baseline risk levels. If this study is successful, our potential scientific findings will allow us to further refine the intervention and focus future related interventions to patient populations who could benefit most. High-quality, real-time evidence about the predictors of response to this novel intervention for older adults will be generated, allowing for the translation of these findings to the application and further development of TIP-OA or related interventions on a larger scale. Another benefit is that our findings can contribute to a next step in this line of research: as older adults are becoming more familiar/comfortable with technology, there is possibility for future high-impact research examining other telehealth and digital health interventions for older adults. This research was funded by TIP-OA received funding support from the Canadian Institutes of Health Research (CIHR#201909PJ8-432903), the Lady Davis Institute, and charitable donations to the Jewish General Hospital Division of Geriatric Psychiatry. The initial training of TIP-OA volunteers through the Touch-Volunteer in Partnership program was funded in part by the What connects us-Ce qui nous lie Dementia Community Investment Public Health Agency of Canada (PI: Park Co-PIs: Belchior, Valente #1920-HQ-000092). Development and adaptation of the Touch-Volunteer in Partnership manual for telehealth was funded in part by The Canadian Institute of Health Research (PI: Park, Primary Knowledge Users: Rouleau, Stewart, PHSI #293636 & PI: Park, Looper, Stewart, SPOR #397525) and the Jewish General Hospital Foundation (PI: Looper).

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312129

ABSTRACT

Background: The worldwide prevalence of anxiety in older adults is estimated at between 6% and 10%. In Canada, adults 65 and older experience anxiety at a rate of 6.4%, affecting more than 300,000 people. Anxiety in older adults has been linked to difficulties retaining new information and engaging in instrumental daily activities of living. Due to COVID-19 restrictions, novel methods of delivering therapy programs remotely are needed, however data is limited. There is some evidence that older adults prefer non-pharmacological approaches for anxiety that can be delivered in the community. Emotion-Focused Mindfulness Therapy (EFMT) is a mindfulness-based intervention that emphasizes meditation and observing thoughts and emotions as they arise. This emphasis has been demonstrated to reduce symptoms of anxiety in general populations. This study aims to evaluate the feasibility of EFMT with older adults. Methods: : This pilot feasibility randomized controlled trial will use a wait list control trial design. Due to COVID-19 restrictions, we will use telehealth delivery via Zoom rather than in-person delivery. The first 48 people to meet the eligibility criteria will be randomly allocated to either receive EFMT immediately, or in approximately eight weeks time from enrollment (1:1 allocation ratio). Data will be collected at baseline, eight weeks following baseline, and sixteen weeks following baseline. The primary outcomes will determine the feasibility of the intervention based on recruitment, enrolment, retention and adherence to all components of the intervention. The secondary outcome will be changes to anxiety over time. Discussion: The results of this trial will determine the feasibility and potential effectiveness of video-delivered EFMT for late-life anxiety compared to no treatment. If the results are promising, a larger randomized controlled trial may be conducted. Trial registration: ClinicalTrials.gov: NCT04415528. Registered on June 4, 2020 Protocol version: Protocol version 2, January 2, 2021

5.
Front Neurol ; 12: 761965, 2021.
Article in English | MEDLINE | ID: covidwho-1593074

ABSTRACT

Introduction: Older adults with dementia have been significantly at more risk for not receiving the care needed and for developing further mental health problems during COVID-19. Although the rise in telemedicine adoption in the healthcare system has made it possible for patients to connect with their healthcare providers virtually, little is known about its use and effects among older adults with dementia and their mental health. Objective: This systematic review aimed to explore the use, accessibility, and feasibility of telemedicine in older adults with dementia, as well as examine the potential mental health impacts of these technologies, through reviewing evidence from studies conducted during COVID-19. Methods: PubMed, Scopus, and Web of Science databases were searched with the following keywords: (COVID* OR SARS-CoV-2 OR Coronavirus) AND ("mental health" OR Depression OR Stress) AND (Dementia OR Multi-Infarct Dementia OR Vascular Dementia OR Frontotemporal Dementia) AND (elder OR Aging OR Aging OR Aged) AND (Telemedicine OR "Remote Consultation" OR telehealth OR technology). Results: A total of 7 articles from Asia, Europe, and the United States were included in this review. Throughout the studies cognitive and mental health assessments (e.g., MoCA, FAST, etc.) were performed. Despite the barriers, telemedicine was noted as a feasible approach to assist individuals with dementia in connecting with their service providers and family while reducing complications related to travel (e.g., difficulty moving, traffic, distance). Conclusions: Due to the COVID-19 pandemic, finding alternative ways to provide services to older adults with dementia through technology may continue to become more necessary as time goes on.

6.
Pilot Feasibility Stud ; 7(1): 169, 2021 Sep 03.
Article in English | MEDLINE | ID: covidwho-1581986

ABSTRACT

BACKGROUND: The worldwide prevalence of anxiety in older adults is estimated at between 6 and 10%. In Canada, adults 65 and older experience anxiety at a rate of 6.4%, affecting more than 300,000 people. Anxiety in older adults has been linked to difficulties retaining new information and engaging in instrumental daily activities of living. Due to COVID-19 restrictions, novel methods of delivering therapy programs remotely are needed; however, data is limited. There is some evidence that older adults prefer non-pharmacological approaches for anxiety that can be delivered in the community. Emotion-focused mindfulness therapy (EFMT) is a mindfulness-based intervention that emphasizes meditation and observing thoughts and emotions as they arise. This emphasis has been demonstrated to reduce symptoms of anxiety in general populations. This study aims to evaluate the feasibility of EFMT with older adults. METHODS: This pilot feasibility randomized controlled trial will use a wait list control trial design. Due to COVID-19 restrictions, we will use telehealth delivery via Zoom rather than in-person delivery. The first 48 people to meet the eligibility criteria will be randomly allocated to either receive EFMT immediately, or in approximately 8 weeks time from enrollment (1:1 allocation ratio). Data will be collected at baseline, 8 weeks following baseline, and 16 weeks following baseline. The primary outcomes will determine the feasibility of the intervention based on recruitment, enrolment, retention, and adherence to all components of the intervention. The secondary outcome will be changes to anxiety over time. DISCUSSION: The results of this trial will determine the feasibility and potential effectiveness of video-delivered EFMT for late-life anxiety compared to no treatment. If the results are promising, a larger randomized controlled trial may be conducted. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04415528 . Registered on June 4, 2020 PROTOCOL VERSION: Protocol version 2, January 2, 2021.

7.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-295743

ABSTRACT

Objective We examine the feasibility of an Artificial Intelligence (AI)-powered clinical decision support system (CDSS), which combines the operationalized 2016 Canadian Network for Mood and Anxiety Treatments guidelines with a neural-network based individualized treatment remission prediction. Methods Due to COVID-19, the study was adapted to be completed entirely at a distance. Seven physicians recruited outpatients diagnosed with major depressive disorder (MDD) as per DSM-V criteria. Patients completed a minimum of one visit without the CDSS (baseline) and two subsequent visits where the CDSS was used by the physician (visit 1 and 2). The primary outcome of interest was change in session length after CDSS introduction, as a proxy for feasibility. Feasibility and acceptability data were collected through self-report questionnaires and semi-structured interviews. Results Seventeen patients enrolled in the study;14 completed. There was no significant difference between appointment length between visits (introduction of the tool did not increase session length). 92.31% of patients and 71.43% of physicians felt that the tool was easy to use. 61.54% of the patients and 71.43% of the physicians rated that they trusted the CDSS. 46.15% of patients felt that the patient-clinician relationship significantly or somewhat improved, while the other 53.85% felt that it did not change. Conclusions Our results confirm the primary hypothesis that the integration of the tool does not increase appointment length. Findings suggest the CDSS is easy to use and may have some positive effects on the patient-physician relationship. The CDSS is feasible and ready for effectiveness studies.

8.
Healthcare (Basel) ; 9(11)2021 Nov 02.
Article in English | MEDLINE | ID: covidwho-1533902

ABSTRACT

(1) Introduction: Undergraduate (UG) nursing students are vulnerable to stress throughout their education, known to result in burnout, with high attrition rates of up to 33%. There is a growing body of evidence to suggest that mindfulness-based interventions are effective for the management of anxiety, depression and wellbeing, thereby reducing stress in healthcare provider populations. The aim of this narrative review was to synthesize and provide a critical overview of the current evidence in relation to mindfulness-based interventions for UG nursing students in a university setting. (2) Methods: A review of the literature was conducted in March 2020 and updated in May 2021, utilising the databases CINAHL, Medline and PsycINFO. (3) Results: Fifteen studies were included in the review, with three common themes identified: (i) the positive impact of mindfulness on holistic wellbeing, (ii) mindfulness-based techniques as a positive coping mechanism within academic and clinical practice, and (iii) approaches to the delivery of mindfulness-based interventions. (4) Conclusions: Mindfulness-based interventions are effective strategies for the management of stress, development of self-awareness and enhanced academic and clinical performance in undergraduate nursing students. No ideal approach to delivery or duration of these interventions was evident from the literature. Best practice in relation to delivery of mindfulness-based interventions for nursing students is recommended for future studies.

9.
JMIR Form Res ; 5(10): e31862, 2021 Oct 25.
Article in English | MEDLINE | ID: covidwho-1484964

ABSTRACT

BACKGROUND: Approximately two-thirds of patients with major depressive disorder do not achieve remission during their first treatment. There has been increasing interest in the use of digital, artificial intelligence-powered clinical decision support systems (CDSSs) to assist physicians in their treatment selection and management, improving the personalization and use of best practices such as measurement-based care. Previous literature shows that for digital mental health tools to be successful, the tool must be easy for patients and physicians to use and feasible within existing clinical workflows. OBJECTIVE: This study aims to examine the feasibility of an artificial intelligence-powered CDSS, which combines the operationalized 2016 Canadian Network for Mood and Anxiety Treatments guidelines with a neural network-based individualized treatment remission prediction. METHODS: Owing to the COVID-19 pandemic, the study was adapted to be completed entirely remotely. A total of 7 physicians recruited outpatients diagnosed with major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Patients completed a minimum of one visit without the CDSS (baseline) and 2 subsequent visits where the CDSS was used by the physician (visits 1 and 2). The primary outcome of interest was change in appointment length after the introduction of the CDSS as a proxy for feasibility. Feasibility and acceptability data were collected through self-report questionnaires and semistructured interviews. RESULTS: Data were collected between January and November 2020. A total of 17 patients were enrolled in the study; of the 17 patients, 14 (82%) completed the study. There was no significant difference in appointment length between visits (introduction of the tool did not increase appointment length; F2,24=0.805; mean squared error 58.08; P=.46). In total, 92% (12/13) of patients and 71% (5/7) of physicians felt that the tool was easy to use; 62% (8/13) of patients and 71% (5/7) of physicians rated that they trusted the CDSS. Of the 13 patients, 6 (46%) felt that the patient-clinician relationship significantly or somewhat improved, whereas 7 (54%) felt that it did not change. CONCLUSIONS: Our findings confirm that the integration of the tool does not significantly increase appointment length and suggest that the CDSS is easy to use and may have positive effects on the patient-physician relationship for some patients. The CDSS is feasible and ready for effectiveness studies. TRIAL REGISTRATION: ClinicalTrials.gov NCT04061642; http://clinicaltrials.gov/ct2/show/NCT04061642.

11.
Front Psychiatry ; 11: 598356, 2020.
Article in English | MEDLINE | ID: covidwho-993450

ABSTRACT

Introduction: Social-distancing due to COVID-19 has led to social isolation, stress, and mental health issues in older adults, while overwhelming healthcare systems worldwide. Telehealth involving phone calls by trained volunteers is understudied and may be a low-cost, scalable, and valuable preventive tool for mental health. In this context, from patient participatory volunteer initiatives, we have adapted and developed an innovative volunteer-based telehealth intervention program for older adults (TIP-OA). Methods and analysis: To evaluate TIP-OA, we are conducting a mixed-methods longitudinal observational study. Participants: TIP-OA clients are older adults (age ≥ 60) recruited in Montreal, Quebec. Intervention: TIP-OA volunteers make weekly friendly phone calls to seniors to check in, form connections, provide information about COVID-19, and connect clients to community resources as needed. Measurements: Perceived stress, fear surrounding COVID-19, depression, and anxiety will be assessed at baseline, and at 4- and 8-weeks. Semi-structured interviews and focus groups will be conducted to assess the experiences of clients, volunteers, and stakeholders. Results: As of October 15th, 2020, 150 volunteers have been trained to provide TIP-OA to 305 older clients. We will consecutively select 200 clients receiving TIP-OA for quantitative data collection, plus 16 volunteers and 8 clinicians for focus groups, and 15 volunteers, 10 stakeholders, and 25 clients for semi-structured interviews. Discussion: During COVID-19, healthcare professionals' decreased availability and increased needs related to geriatric mental health are expected. If successful and scalable, volunteer-based TIP-OA may help prevent and improve mental health concerns, improve community participation, and decrease healthcare utilization. Clinical Trial Registration: ClinicalTrials.gov NCT04523610; https://clinicaltrials.gov/ct2/show/NCT04523610?term=NCT04523610&draw=2&rank=1.

12.
Maturitas ; 143: 105-114, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-793432

ABSTRACT

BACKGROUND: Telemedicine is a timely solution for the restrictions that COVID-19 social distancing places upon conventional modalities of healthcare provision. Geriatric populations affected by dementia require greater access to healthcare services, particularly in rural areas. As such, the aim of this systematic review is to examine the impact of telemedicine on health outcomes in elderly individuals with dementia living in rural areas. METHODS: A systematic review was completed using Ovid Medline, Web of Science and ACM Digital Libraries. The keywords for the selection of articles were: (telemedicine OR Telehealth) AND (Rural) AND (Age* OR Eld*) AND (Dementia) and (Telemedicine) AND (Rural Health OR Rural Population OR Hospitals, Rural OR Rural Health Services) AND (Aged OR Aging) AND (Dementia OR Multi-Infarct Dementia OR Vascular Dementia OR Frontotemporal Dementia). Among the 94 articles identified, 79 (84.0 %) were screened, 58 (61.7 %) were assessed and 12 (12.8 %) were included. RESULTS: The studies had diverse populations. Two were conducted in Australia, five in Canada, one in Korea, and four in the United States of America. The studies used a variety of cognitive tests and reported mixed results regarding the differences in patient performance when assessed in-person as compared to telemedicine consultation. Overall, both patients and physicians reported satisfaction with telemedicine; however, there were mixed results regarding the reliability of cognitive tests and the infrastructure required. Convenience, satisfaction, comfort and recommending telemedicine were reported to be high in the telemedicine group and physicians reported they would use telemedicine again. CONCLUSION: The testing conditions and the accessibility of telemedicine yield inconclusive results as to whether telemedicine can improve the management of dementia in geriatric individuals.


Subject(s)
COVID-19/prevention & control , Dementia/therapy , Health Services Accessibility , Rural Population , Telemedicine , Aged , Attitude of Health Personnel , Humans , Neuropsychological Tests , Patient Satisfaction , Reproducibility of Results , SARS-CoV-2
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