There is growing evidence that people with mild dementia can benefit from using tablets and apps. Due to their cognitive decline, people with dementia need support in learning how to use these devices. The objective of this review was to identify which training interventions work best to help people with mild dementia (re)learn how to use technologies, including handheld touchscreen devices. Because the uptake of these devices in people with dementia is quite new, training interventions for the use of other technologies were also included, such as technologies assisting people in Instrumental Activities of Daily Living (IADL).

An electronic search was conducted in the following databases: PubMed, APA PsycInfo (EBSCO), and CINAHL (EBSCO). Themes discussed include the learning effects; training method (e.g. errorful (EF) and errorless (EL) learning); training intensity and setting; technology task type; dementia type and severity; and study design and outcome measures.

In total, 16 studies were included. All studies reported positive learning effects and improved task performance in people with dementia, regardless of dementia severity, training intensity, setting, and the method used. Although the EL training method was successful more often than the EF training method, it would be inappropriate to conclude that the EL method is more effective, because the majority of studies only investigated EL training interventions with (multiple) single-case study designs.

Future research should consider using more robust study designs, such as RCTs, to evaluate the effectiveness of training interventions for (re)learning technology-orientated tasks, including operating handheld touchscreen devices.

To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia.

Cluster-randomized controlled trial.

Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units).

N = 162 residents with dementia.

Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks.

Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models.

Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group.

Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

Virtual reality (VR) is a promising tool with the potential to enhance care of cognitive and affective disorders in the aging population. VR has been implemented in clinical settings with adolescents and children; however, it has been less studied in the geriatric population.

The objective of this study is to determine the existing levels of evidence for VR use in clinical settings and identify areas where more evidence may guide translation of existing VR interventions for older adults.

We conducted a systematic review in PubMed and Web of Science in November 2019 for peer-reviewed journal articles on VR technology and its applications in older adults. We reviewed article content and extracted the number of study participants, study population, goal of the investigation, the level of evidence, and categorized articles based on the indication of the VR technology and the study population.

The database search yielded 1554 total results, and 55 articles were included in the final synthesis. The most represented study design was cross-sectional, and the most common study population was subjects with cognitive impairment. Articles fell into three categories for VR Indication: Testing, Training, and Screening. There was a wide variety of VR environments used across studies.

Existing evidence offers support for VR as a screening and training tool for cognitive impairment in older adults. VR-based tasks demonstrated validity comparable to some paper-based assessments of cognition, though more work is needed to refine diagnostic specificity. The variety of VR environments used shows a need for standardization before comparisons can be made across VR simulations. Future studies should address key issues such as usability, data privacy, and confidentiality. Since most literature was generated from high-income countries (HICs), it remains unclear how this may be translated to other parts of the world.

To date, there is a controversy on effects of cognitive intervention to maintain or improve hippocampal function for older adults with mild cognitive impairment (MCI).

The main objective of this study was to exam effects of virtual reality-based spatial cognitive training (VR-SCT) using VR on hippocampal function of older adults with MCI.

Fifty-six older adults with MCI were randomly allocated to the experimental group (EG) that received the VR-SCT or the waitlist control group (CG) for a total of 24 sessions. To investigate effects of the VR-SCT on spatial cognition and episodic memory, the Weschsler Adult Intelligence Scale-Revised Block Design Test (WAIS-BDT) and the Seoul Verbal Learning Test (SVLT) were used.

During the sessions, the training performances gradually increased (p < .001). After the intervention, the EG showed significant greater improvements in the WAIS-BDT (p < .001, η2 = .667) and recall of the SVLT (p < .05, η2 =.094) compared to the CG but in recognition of the SVLT (p > .05, η2 =.001).

These results suggest that the VR-SCT might be clinically beneficial to enhance spatial cognition and episodic memory of older adults with MCI.

Veterans enrolled in Veterans Health Administration (VHA) Home Based Primary Care (HBPC), a program providing in-home medical and mental health care by an interdisciplinary care team, often face substantial physical, cognitive, and mental health challenges. This program evaluation examined the impact of a brief problem-solving intervention on depressive symptoms, quality of life, and problem-solving abilities for Veterans enrolled in HBPC.

Pre- and post-intervention outcomes for Veterans, and qualitative feedback from Veterans and clinicians regarding program satisfaction.

A total of 230 HBPC patients (mean age in years = 72.1, SD = 11.6) within the U.S. national VHA health care system.

Six-session, individual Problem-Solving Training (PST-HBPC).

Licensed psychologists and social workers (n = 115) completed training and administered the treatment with HBPC Veterans between 2014 and 2017.

From baseline to post-intervention, Veterans completing five or more PST-HBPC sessions (n = 199) reported significant reductions in depressive symptoms on the Patient Health Questionnaire 9-item (PHQ-9), in difficulty functioning due to depressive symptoms (PHQ-9 item 10), and in thoughts of death (PHQ-9 item 9). They also reported more effective problem-solving on the Social Problem-Solving Inventory – Revised: Short form (total score and subscales), and improved quality of life across life domains on the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale. Both clinicians and Veterans also reported satisfaction with the program.

Preliminary findings support the continued dissemination and implementation of this brief PST intervention for HBPC Veterans, and its potential for use with non-VA home care populations with complex comorbidities.

The management of neuropsychiatric symptoms (NPS) in patients with dementia is a major challenge. Since no effective therapy has been found to date and drug treatments are associatedwith significant side effects, there seems to be a pressing need for alternative non-pharmacological interventions.

The current study aims to investigate and compare the effect of different types of physical exercise on the NPS.

A systematic review of the literature was conducted according to the PRISMA guidelines. Five databases (SCOPUS, PubMed, SPORT Discus, Web of science and ScienceDirect) were searched using the appropriate algorithm. What was sought out was randomized control trials (RCTs) that applied physical activity interventions with specific characteristics (type, frequency, intensity, and duration) in patients with dementia or mild cognitive impairment, studied the effect of exercise on their NPS and compared this effect with a control group that did not follow an exercise program.

From 512 articles, 13 studies were included in this review, involving a total of 1,925 patients. The results were analyzed and synthesized according to the type of exercise applied – aerobic exercise, multidimensional interventions and muscular strength training programs. In particular, the results showed that repetitive aerobic exercise three to five times a week had a positive effect on NPS, whereas multidimensional interventions combining different types of exercise did not appear to be as effective. Strength training programs have been found to significantly reduce depression symptoms and behavioral problems in demented patients with mobility problems.

There is clear evidence that physical activity and especially aerobic exercise may be effective in the management of NPS. However, it is necessary to apply specific practical recommendations and specially designed programs to incorporate physical exercise into the daily routine of these patients.

To investigate potential risk factors for mild behavioral impairment (MBI) among non-demented geriatrics.

Population-based, cross-sectional survey.

Taiwan Alzheimer Disease Association (TADA) Database.

Participants were selected by multistage random sampling of all Taiwan counties. They received in-person interviews between December 2011 and March 2013.

Demographic data, lifestyle and habits, medical comorbidities, cognitive status measured by the Taiwanese Mini-Mental Status Examination (TMSE) and presence of MCI of the participants were collected. Subjects were distributed to the MBI and non-MBI groups. These factors had been evaluated for their effects on MBI in the univariate and multivariable logistic regression models.

In total, 6,196 non-demented participants aged 65 years or older, including 409 MBI and 5,787 non-MBI participants, were recruited. After adjustment for age, sex, education, body mass index, lifestyle and habits, medical comorbidities, and MCI, good sleep was associated with lower risk of MBI (OR 0.09, 95% CI 0.07 – 0.12). Low body weight (OR 2.01, 95% CI 1.21–3.33), low-to-medium education (OR 1.40, 95%CI 1.06–1.85; OR 2.32, 95% CI 1.67–3.21), medical comorbidities of hypertension (OR 1.56, 95% CI 1.25–1.95), hyperlipidemia (OR 1.29, 95% CI 1.00–1.67), cancer (OR 2.05, 95% CI 1.37–3.06) were significantly associated with increased MBI risk. MCI neither increased nor decreased risk of MBI (OR 1.00, 95% CI 0.76–1.32).

Good sleep was associated with lower MBI risk. Underweight, lower education, medical comorbidities of cancer, hypertension, hyperlipidemia were predictive of MBI.