Effects of multiple training modalities in patients with Alzheimer's disease: a pilot study.

OBJECTIVE: This pilot study investigated the effects of multiple training modalities on cognition, neuropsychiatric symptoms, caregivers' burden, and quality of life in patients with Alzheimer's disease (AD). PATIENTS AND METHODS: This intervention study was conducted in 24 patients with AD aged ≥65 years with a Clinical Dementia Rating (CDR) score of 0.5-1. The patients were assigned to receive multiple training modalities (1 hour for each training: Tai Chi, calligraphy, and drawing) over a 6-week period in either the experimental group (n=14) or the comparison group (n=10). A series of neuropsychological tests - namely the Traditional Chinese version Mini-Mental Status Examination, Cognitive Assessment Screening Instrument (CASI), Neuropsychiatric Inventory and the Neuropsychiatric Inventory Caregiver Distress Scale, and the Clinical Dementia Rating Sum of Boxes scale - were conducted at the baseline and after the intervention. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) and Zarit Caregiver Burden Scale were used to assess the quality of life and caregivers' burden, respectively. Independent sample t-test and paired sample t-test were used to analyze the data. RESULTS: After the intervention, the experimental group reported higher scores in the orientation domain of CASI (P=0.007) and in the psychiatry domain of WHOQOL-BREF (P=0.042) compared with the comparison group. Caregivers' distress was significantly decreased in the experimental group (P=0.035) but not in the comparison group (P=0.430). CONCLUSION: The multiple training modalities improved scores in the orientation domain of CASI and psychiatry domain of WHOQOL-BREF in patients with AD. Moreover, the intervention reduced caregivers' distress.

Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital.

BACKGROUND: The sudden emergence of severe acute respiratory syndrome (SARS) caused international anxiety owing to its highly contagious and pandemic transmission. Health workers are vulnerable and are at high risk of infection. AIMS: To assess SARS-related stress and its immediate psychological impact and responses among health workers. METHOD: Health workers in a tertiary hospital affected by SARS were invited to complete a questionnaire designed to evaluate exposure experience, psychological impact and psychiatric morbidity. The risk and rates of psychiatric morbidity were estimated for exposure experience. RESULTS: Altogether, 1257 health workers successfully completed the survey. In the initial phase of the outbreak, when the infection was spreading rapidly, feelings of extreme vulnerability, uncertainty and threat to life were perceived, dominated by somatic and cognitive symptoms of anxiety. During the 'repair' phase, when the infection was being brought under control, depression and avoidance were evident. The estimated prevalence of psychiatric morbidity measured by the Chinese Health Questionnaire was about 75%. CONCLUSIONS: The outbreak of SARS could be regarded as an acute episode of a bio-disaster, leading to a significantly high rate of psychiatric morbidity.