Effectiveness of digital technologies to engage and support the wellbeing of people with dementia and family carers at home and in care homes: A scoping review.

Use of digital technologies to support meaningful engagement of people with dementia and carers increased during the COVID-19 pandemic. The purpose of this scoping review was to determine the effectiveness of digital technologies in supporting the engagement and wellbeing of people with dementia and family carers at home and in care homes. Studies published in peer reviewed literature were identified across four databases (CINAHL, Medline, PUBMED, PsychINFO). Sixteen studies met the inclusion criteria. Findings indicate that digital technologies can potentially support the wellbeing of people with dementia and family carers, although only a few studies had measured impact on wellbeing, as many were reporting on technology at proof-of-concept stage rather than commercially ready products. Moreover, current studies lacked meaningful involvement of people with dementia, family carers, and care professionals in the design of the technology. Future research should bring together people with dementia, family carers, care professionals and designers to coproduce digital technologies with researchers and evaluate them using robust methodologies. Codesign should start early in the intervention development phase and continue until implementation. There is a need for real world applications that nurture social relationships by focusing on how digital technologies can support more personalised, adaptive forms of care. Developing the evidence base to identify what makes digital technologies effective in supporting the wellbeing of people with dementia is crucial. Future interventions should therefore consider the needs and preferences of people with dementia, their families, and professional carers, as well as the suitability and sensitivity of wellbeing outcome measures.

What type of inhibition underpins performance on Luria's Fist-Edge-Palm task?

OBJECTIVE: The Fist-Edge-Palm task is a motor sequencing task believed to be sensitive to frontal lobe impairment. The present study aimed to investigate the inhibitory processes underlying successful execution of this task. METHOD: Seventy-two healthy participants were asked to perform the Fist-Edge-Palm task paced at 120 bpms, 60 bpms and self-paced. They also completed assessments sensitive to recently dissociated forms of inhibition (the Hayling Sentence Completion Test and the Stroop Color-Word Test) that have recently been shown to be differentially lateralized (the right and left Prefrontal Cortex, respectively), and Cattell's Culture Fair Intelligence test. RESULTS: Analysis revealed that performance on the Hayling Sentence Completion Test predicted the amount of crude errors and the overall score on the Fist-Edge-Palm task, and that pacing condition had no effect on this outcome. Neither the Stroop Color-Word Test nor Cattell's Culture Fair Intelligence Test predicted performance on the Fist-Edge-Palm task. CONCLUSIONS: Consistent with some previous neuroimaging findings, the present findings suggest that Fist-Edge-Palm task performance relies on right lateralized inhibitory processes.

The contribution of visual attention and declining verbal memory abilities to age-related route learning deficits.

Our ability to learn unfamiliar routes declines in typical and atypical ageing. The reasons for this decline, however, are not well understood. Here we used eye-tracking to investigate how ageing affects people's ability to attend to navigationally relevant information and to select unique objects as landmarks. We created short routes through a virtual environment, each comprised of four intersections with two objects each, and we systematically manipulated the saliency and uniqueness of these objects. While salient objects might be easier to memorise than non-salient objects, they cannot be used as reliable landmarks if they appear more than once along the route. As cognitive ageing affects executive functions and control of attention, we hypothesised that the process of selecting navigationally relevant objects as landmarks might be affected as well. The behavioural data showed that younger participants outperformed the older participants and the eye-movement data revealed some systematic differences between age groups. Specifically, older adults spent less time looking at the unique, and therefore navigationally relevant, landmark objects. Both young and older participants, however, effectively directed gaze towards the unique and away from the non-unique objects, even if these were more salient. These findings highlight specific age-related differences in the control of attention that could contribute to declining route learning abilities in older age. Interestingly, route-learning performance in the older age group was more variable than in the young age group with some older adults showing performance similar to the young group. These individual differences in route learning performance were strongly associated with verbal and episodic memory abilities.

'Well I'm still the Diva!' Enabling people with dementia to express their identity through graffiti arts: Innovative practice.

This article reports on a pilot study that investigated the use of graffiti arts as a medium for promoting self-expression in people with dementia. Two people with dementia attended a series of workshops with a graffiti artist where they explored their feelings of changing identity following their dementia diagnoses. As part of the workshops, they were encouraged to develop a personal 'tag' or signature to portray their sense of identity and a piece of street art to express 'their message'. These completed artworks were displayed in a public space in Bournemouth, UK.

Emotion-based learning: insights from the Iowa Gambling Task.

Interest in the cognitive and/or emotional basis of complex decision-making, and the related phenomenon of emotion-based learning, has been heavily influenced by the Iowa Gambling Task. A number of psychological variables have been investigated as potentially important in understanding emotion-based learning. This paper reviews the extent to which humans are explicitly aware of how we make such decisions; the biasing influence of pre-existing emotional labels; and the extent to which emotion-based systems are anatomically and functionally independent of episodic memory. Review of literature suggests that (i) an aspect of conscious awareness does appear to be readily achieved during the IGT, but as a relatively unfocused emotion-based "gut-feeling," akin to intuition; (ii) Several studies have manipulated the affective pre-loading of IGT tasks, and make it clear that such labeling has a substantial influence on performance, an experimental manipulation similar to the phenomenon of prejudice. (iii) Finally, it appears that complex emotion-based learning can remain intact despite profound amnesia, at least in some neurological patients, a finding with a range of potentially important clinical implications: in the management of dementia; in explaining infantile amnesia; and in understanding of the possible mechanisms of psychotherapy.

Neural priming in human frontal cortex: multiple forms of learning reduce demands on the prefrontal executive system.

Past experience is hypothesized to reduce computational demands in PFC by providing bottom-up predictive information that informs subsequent stimulus-action mapping. The present fMRI study measured cortical activity reductions ("neural priming"/"repetition suppression") during repeated stimulus classification to investigate the mechanisms through which learning from the past decreases demands on the prefrontal executive system. Manipulation of learning at three levels of representation-stimulus, decision, and response-revealed dissociable neural priming effects in distinct frontotemporal regions, supporting a multiprocess model of neural priming. Critically, three distinct patterns of neural priming were identified in lateral frontal cortex, indicating that frontal computational demands are reduced by three forms of learning: (a) cortical tuning of stimulus-specific representations, (b) retrieval of learned stimulus-decision mappings, and (c) retrieval of learned stimulus-response mappings. The topographic distribution of these neural priming effects suggests a rostrocaudal organization of executive function in lateral frontal cortex.