Effects of a Cooking Program Based on Brain-activating Rehabilitation for Elderly Residents with Dementia in a Roken Facility: A Randomized Controlled Trial.

OBJECTIVE: Rehabilitation for dementia is important in Roken Geriatric Health Service Facilities in Japan. This study evaluated the effects of a cooking program as rehabilitation for elderly residents with dementia. METHODS: We carried out a 12-week cooking program based on the five principles of brain-activating rehabilitation (BAR): fostering a pleasant atmosphere, interactive communication, establishing social roles, giving and receiving praise, and errorless learning. The program was carried out in small groups and consisted of 90-min classes once a week. Participants were 36 elderly residents with dementia (mean 85.4 ± 6.5 years) who were randomly divided into intervention (n = 18) and control (n = 18) groups. The control group participated in recreation and both groups received individual conventional rehabilitation twice a week for 30 min. The effects of intervention were evaluated using nine outcome measures. RESULTS: A total of 29 participants were included in the analysis (two-way analysis of variance). The attendance rate was 86.6% in the intervention group (n = 13). The Yamaguchi Kanji Symbol Substitution Test (executive function) showed significant interaction (F(1, 27) = 4.305, P = 0.048) between the two groups: the control group (n = 16) showed significant deterioration (pre 4.9 ± 5.6 to post 3.0 ± 4.9; P = 0.032). The dementia behavior disturbance scale also showed significant interaction (F(1, 29) = 13.298, P = 0.001): the intervention group (n = 16) showed significant improvement (pre 21.6 ± 12.2 to post 11.4 ± 11.5; P < 0.001). No significant differences were observed in the other outcome measures. CONCLUSIONS: Our findings suggest that a cooking program based on BAR can reduce the behavioral and psychological symptoms of dementia and maintain executive function.

Prevention of cognitive and physical decline by enjoyable walking-habituation program based on brain-activating rehabilitation.

AIM: Evaluating effects of an enjoyable walking-habituation program. METHODS: We carried out a 12-week intervention, consisting of an enjoyable walking-habituation program based on five principles of brain-activating rehabilitation: pleasant atmosphere, interactive communication, social roles, praising each other and errorless support. The program, once a week for 90 min, was carried out in small groups. Participants were 71 community-dwelling people (72.2 ± 4.3) without dementia. Cognitive function was evaluated in five cognitive domains: memory, executive function, word fluency, visuospatial abilities and sustained attention. Additionally, quality of life, depressive state, functional capacity, range of activities, social network and subjective memory complaints were assessed using questionnaires. Motor function was also evaluated. Measurement was carried out before the observation period, after observation and after intervention. RESULTS: A total of 63 participants were included in the analysis. Daily steps, executive function, subjective memory complaints, functional capacity and 5-m maximum walking time significantly improved during the intervention period (after observation to after intervention) compared with the observation period (before the observation period to after observation). No significant differences were seen in other evaluations. At 6 months after the intervention, 52 of 63 participants (82.5%) continued to walk once a week or more, and all of them were confident about continuing to walk in the future. Furthermore, all participants were satisfied with our walking-habituation program and all replied that they felt delighted. CONCLUSION: The intervention program, based on the five principles of brain-activating rehabilitation, resulted in improvement of some cognitive and physical functions, as well as a high walking-habituation rate at 6 months' follow up. Geriatr Gerontol Int 2015; ●●: ●●-●●.

The impact of subjective memory complaints on quality of life in community-dwelling older adults.

PURPOSE: The aim of this study was to evaluate the impact of memory complaints on quality of life (QOL) in elderly community dwellers with or without mild cognitive impairment (MCI). METHODS: Participants included 120 normal controls (NC) and 37 with MCI aged 65 and over. QOL was measured using the Japanese version of Satisfaction in Daily Life, and memory complaints were measured using a questionnaire consisting of four items. The relevance of QOL was evaluated with psychological factors of personality traits, sense of self-efficacy, depressive mood, self-evaluation of daily functioning, range of social activities (Life-Space Assessment), social network size, and cognitive functions including memory. The predictors of QOL were analyzed by multiple linear regression analysis. RESULTS: QOL was not significantly different between the NC and MCI groups. In both groups, QOL was positively correlated with self-efficacy, daily functioning, social network size, Life-Space Assessment, and the personality traits of extraversion and agreeableness; QOL was negatively correlated with memory complaints, depressive mood, and the personality trait of neuroticism. In regression analysis, memory complaints were a negative predictor of QOL in the MCI group, but not in the NC group. The partial correlation coefficient between QOL and memory complaints was -0.623 (P < 0.05), after scores of depressive mood and self-efficacy were controlled. Depressive mood was a common negative predictor in both groups. Positive predictors were Life-Space Assessment in the NC group and sense of self-efficacy in the MCI group. CONCLUSIONS: Memory complaints exerted a negative impact on self-rated QOL in the MCI group, whereas a negative correlation was weak in the NC group. Memory training has been widely practised in individuals with MCI to prevent the development of dementia. However, such approaches inevitably identify their memory deficits and could aggravate their awareness of memory decline. Thus, it is critical to give sufficient consideration not to reduce QOL in the intervention for those with MCI.

Pleasant physical exercise program for prevention of cognitive decline in community-dwelling elderly with subjective memory complaints.

AIM: Japan is one of the most rapidly aging societies in the world. Measures to prevent dementia are urgently required in Japan, although such strategies have not yet been established. This study investigated the effectiveness of a pleasant physical exercise intervention on the prevention of cognitive decline in community-dwelling elderly participants with subjective memory complaints. In this intervention, a pleasant atmosphere was emphasized to enhance the participants' motivation. METHOD: We administered a 12-week intervention program consisting of pleasant physical exercise. This program for the prevention of cognitive decline was carried out as a service of Maebashi city. The service targeted elderly residents aged 65 years and older who had subjective memory complaints. After a control period of 12 weeks, 42 participants, aged between 65-86 years, received intervention once a week at community centers. Participants carried out group exercise, and were encouraged to perform home exercise and walking during the intervention period. The program was carried out by co-medical professional staff, with the help of senior citizen volunteers. RESULTS: A total of 30 participants were included in the analysis. There was significant improvement on the Wechsler digit symbol substitution test (P = 0.01). CONCLUSION: Participants with subjective memory complaints who continued the pleasant physical exercise programs for 12 weeks showed improvement in some aspects of cognitive function. Participation of senior citizen volunteers enabled smooth implementation of the program, and alleviated the burden on the professional staff. The pleasant physical exercise intervention described in the present study could be regarded as a community-led intervention to prevent cognitive decline.

Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial.

OBJECTIVES: To evaluate the efficacy of a municipality-led walking program under the Japanese public Long-Term Care Insurance Act to prevent mental decline. DESIGN: Randomized controlled trial. SETTING: The city of Takasaki. PARTICIPANTS: One hundred fifty community members aged 72.0 ± 4.0 were randomly divided into intervention (n = 75) and control (n = 75) groups. INTERVENTION: A walking program was conducted once a week for 90 minutes for 3 months. The program encouraged participants to walk on a regular basis and to increase their steps per day gradually. The intervention was conducted in small groups of approximately six, so combined benefits of exercise and social interaction were expected. MEASUREMENTS: Cognitive function was evaluated focusing on nine tests in five domains: memory, executive function, word fluency, visuospatial abilities, and sustained attention. Quality of life (QOL), depressive state, functional capacity, range of activities, and social network were assessed using questionnaires, and motor function was evaluated. RESULTS: Significant differences between the intervention and control groups were shown in word fluency related to frontal lobe function (F(1, 128) = 6.833, P = .01), QOL (F(1,128) = 9.751, P = .002), functional capacity including social interaction (F(1,128) = 13.055, P < .001), and motor function (Timed Up and Go Test: F(1,127) = 10.117, P = .002). No significant differences were observed in other cognitive tests. CONCLUSION: Walking programs may provide benefits in some aspects of cognition, QOL, and functional capacity including social interaction in elderly community members. This study could serve as the basis for implementation of a community-based intervention to prevent mental decline.