BackgroundNumerous daily activities require simultaneous application of motor and cognitive skills (dual-tasking). The execution of such tasks is especially difficult for the elderly and for people with (neuro-) degenerative disorders. Training of physical and cognitive abilities helps prevent or slow down the age-related decline of cognition. The aim of this review is to summarise and assess the role of combined physical-and-cognitive-training characteristics in improving cognitive performance and to propose an effective training scheme within the frame of a suitable experimental design.MethodsA systematic electronic literature search was conducted in selected databases. The following criteria were compulsory for inclusion in the study: 1. A (Randomized) Controlled Trial (RCT or CT) design; 2. Implementation of combined physical and cognitive training, either simultaneously (dual task) or subsequently - at least one hour per weekly over four weeks or more; 3. Cognitive outcomes as a study’s endpoint.ResultsTwenty articles met the inclusion criteria. It appears that either simultaneous or subsequently combined physical and cognitive training is more successful compared to single physical or single cognitive exercise. Training characteristics like length, frequency, duration, intensity and level of task difficulty seem to determine cognitive performance. However, the articles show that cognitive improvement seems to remain somewhat confined to trained cognitive functions rather than generalising to other cognitive or daily-living skills.ConclusionDue to methodological heterogeneity among studies, results need to be treated with caution. We critically discuss the role of training characteristics and propose a potentially effective training intervention within an appropriate experimental design.

Aim Τo validate the Greek version of the Dementia Knowledge Assessment Tool 2, the Dementia Attitudes Scale and Confidence in Dementia Scale. Design A quantitative cross‐sectional design was applied for translation and validation. The STROBE checklist for observational research has been followed to this survey. Method Two hundred and twelve students from the School of Psychology (Aristotle University of Thessaloniki). Psychometric properties were assessed through construct validity (principal component analysis), internal consistency (Cronbach's alpha) and convergent validity. Results High internal reliability was found for Confidence in Dementia Scale (α = 0.85), adequate reliability for Dementia Attitudes Scale (α = 0.74) and acceptable reliability for Dementia Knowledge Assessment Tool 2 (α = 0.68). Construct validity was satisfactory for Dementia Attitudes Scale (two factors: social comfort and knowledge). The convergent validity was supported to this survey. All three tools are reliable and valid to measure knowledge, confidence and attitudes towards dementia in Greek research context.

Background: People with dementia (PwD) are frequently admitted to hospital settings. The lack of proper dementia knowledge, poor communication skills, negative attitudes toward dementia, and lack of confidence affects the quality of care, thus development of dementia trainings has increased. Nevertheless, literature regarding the effectiveness of training implementation is limited. Objective: The aim of this narrative synthesis is to 1) identify the characteristics of training programs and 2) explore the effectiveness of these training programs in everyday clinical practice. Methods: A systematic search in PubMed, PsycINFO, CINAHL, and Cochrane was conducted, including qualitative and quantitative peer-reviewed studies. Holton’s evaluation model with its three outcome levels (learning, individual performance, and organizational results) was adopted. 14 studies were included. Results: The synthesis of the results was divided into two parts: 1) to describe the characteristics and content of trainings 2) to evaluate the effectiveness of training programs according to the three outcome levels of Holton’s model, taking into consideration its construct domains: ability, motivation, and environment. Learning outcomes were assessed in all selected studies: 13 studies observed changes in individual performance, four studies reported changes within the organizational level, and only five showed sustainable changes over time. Conclusion: Person-centered care (PCC) approaches, interactive and varied teaching methods, supporting conditions like champions, action plans, and setting care policies, are all characteristics of effective trainings. Successful programs should be sustainable over time, demonstrating positive outcomes across the organization. Based on current findings, there is a lack of adequate evaluation with regard to training programs on the organizational level.

Background: The outcomes of hospitalized People with Dementia (PwD) are likely to be negative due to, among other key causes, negative staff attitudes and limited staff knowledge regarding dementia. Targeted interventions have been shown to positively change the attitudes of the hospital staff while also increasing their overall knowledge of dementia. However, training effects are often short-lived and frequently long-term effects are not examined in studies. Objective: To examine whether attending a dementia training program changes the attitudes of hospital staff toward PwD and/or increases their knowledge levels about dementia, and whether or not these changes are stable. Methods: The training program lasted two days and N = 60 attending hospital staff members agreed to participate in the study. Data were assessed with questionnaires prior to the training, 3 months, and 6 months after the training. German versions of the Dementia Attitude Scale (DAS-D) and the Knowledge in Dementia (KIDE) scale were used. Additionally, data about perception of PwD and confidence in dealing with challenging behavior were collected and analyzed. Results: After the training program, participants showed a significantly better attitude toward PwD as measured by DAS-D. These time-effects occurred in both DAS-D subscales (“dementia knowledge” and “social comfort”). Although a positive trend could be seen in the KIDE scale, no statistically significant increase occurred over time. Conclusion: Specialist training programs seem to be promising in positively changing attitudes toward and increasing knowledge about PwD with long-term effects. Further research should address the effects of attitude change in patient care.

Background: There are almost no validated tools in German that assess dementia knowledge, attitude toward dementia, and confidence in the general population. Objective: Translation and validation of the German version of the Dementia Knowledge Assessment Tool 2 (DKAT2), the Dementia Attitude Scale (DAS), and the Confidence in Dementia Scale (CODE). Methods: Instruments were translated into German and adapted for the general public. A convenience sample of 263 persons was recruited via an online platform. Validation of the tools’ psychometric properties consisted of an assessment of its reliability (internal consistency and 4-week test-retest reliability of a subgroup with n = 110), an analysis of its construct validity through principal component analysis and known-group analysis, convergent validity, and an item analysis for DKAT2-D. This study used the STROBE checklist for reporting. Results: Acceptable to excellent internal reliability was found for DAS-D (α= 0.90), DKAT2-D (α= 0.78), and CODE-D (α= 0.93). The principal component analysis confirmed the two-factor model for the DAS-D as well as the one-factor solution for CODE-D. Intra-class correlation coefficient between the first and the 4-week retest was good (CODE-D: 0.897; 0.849–0.929) to excellent (DKAT2-D: 0.918; 0.879–0.945 and DAS-D: 0.940; 0.910–0.960). Known-group analysis revealed that DAS-D, DKAT-D, and CODE-D could distinguish between individuals with or without experience with people with dementia and with or without participation in a dementia course. Conclusion: The German versions DAS-D, DKAT2-D, and CODE-D are reliable and valid tools to measure knowledge, attitude, and confidence in dementia in the German-speaking general population.

Background: Assessing dementia knowledge is critical for developing and improving effective interventions. There are many different tools to assess dementia knowledge, but only one has been validated in German so far. Objective: To validate two tools for assessing dementia knowledge—the Dementia Knowledge Assessment Scale (DKAS-D) and the Knowledge in Dementia Scale (KIDE-D) for the German general population—and compare their psychometric properties with the Dementia Knowledge Assessment Tool 2 (DKAT2-D). Methods: A convenience sample of 272 participants completed online surveys. Analyses included internal consistency, structural validity, construct validity through the known-groups method, retest-reliability with a subgroup of n = 88, and floor and ceiling effects. This study used the STROBE checklist. Results: Internal consistency was acceptable for DKAT2-D (α= 0.780), very good for DKAS-D (α= 0.873), and poor for KIDE-D (α= 0.506). Construct validity was confirmed for all questionnaires. Retest-reliability was good for DKAT2-D (0.886; 0.825–0.926) and KIDE-D (0.813; 0.714–0.878), while it was great for DKAS-D (0.928; 0.891–0.953). Trends toward ceiling effects were observed for DKAT2-D and KIDE-D, but not for DKAS-D. The principal component analysis did not reveal a coherent structure for DKAT2-D or KIDE-D, while the confirmatory factor analysis proposed the removal of 5 items for DKAS-D resulting in the shortened DKAS20-D, which had nearly identical properties. Conclusion: Both DKAS-D and its shortened version, DKAS20-D, are reliable instruments for evaluating programs intended for the general population, as they were found to be convincing in all aspects.

BackgroundCognitive disorders such as dementia are common among older adults admitted to general hospitals. They can complicate treatment leading to longer hospitalization and worse outcomes. They often remain underdiagnosed as the busy routine of the hospital does not enable efficient screening and available screening instruments are not suitable for the hospital environment. Computerized cognitive testing (CCT) has been proposed as an efficient screening method as it can be employed by nonspecialists, such as nurses while featuring automatic scoring and interpretation of results.ObjectiveThis study validated a newly developed questionnaire for measuring the attitudes of Greek nurses towards computerized dementia screening.Material and methodsThe questionnaire was validated in a sample of 212 undergraduate psychology students and subsequently administered to a sample of 19 nurses working in a general hospital. Reliability of the questionnaire was calculated using Cronbach’s alpha (= 0.762). Factor analysis revealed the existence of a single factor (acceptability-feasibility) that accounted for 33.73% of variance with an eigenvalue of 3.036.ResultsThe total score of all the items loading on the single factor (acceptability-feasibility) was calculated. Scores ranged between 10 and 40 with the average score for the validation group being 29.33 (SD = 4.89) and the average score for the nurses’ group being 29.50 (SD = 3.20).DiscussionThe questionnaire has acceptable reliability. Results indicate that acceptability-feasibility is high in both groups and there were no statistically significant differences between the two groups.Electronic supplementary materialThe online version of this article (10.1007/s00391-019-01633-0) contains supplementary material, which is available to authorized users.

Background With age, most cognitive functions decline. As the number of people aged 60 years and older is expected to rise rapidly within the next decades, identifying interventions that promote healthy cognitive ageing is of utmost importance. Promising research on bilingualism has led to the notion that learning a foreign language could protect against cognitive decline. Foreign language learning likely promotes executive functions, which are higher-order cognitive abilities particularly affected by age-related cognitive decline. However, evidence is still sparse and has produced contradictory results. This study aims to investigate the effects of short and intensive foreign language learning on executive functions in healthy older adults. Methods In a randomised controlled trial, we will assign 60 native German-speaking monolingual healthy older adults, aged 65–80 years, to either a foreign language learning or a waiting list control group. Language learners will attend a face-to-face, group-based Spanish course for beginners for 1.5 h a day, 5 days a week, for a total of 3 weeks. Cognitive performance in executive functions will be assessed before and after the intervention or after a waiting period of 3 weeks (waiting list control group). Participants will be tested again after 3 months to evaluate longitudinal effects of foreign language learning. The waiting list control group will receive Spanish lessons only after the final assessment and will be invited to an additional voluntary evaluation after completion of the course. Discussion To the best of our knowledge, we are conducting the first randomised controlled trial on the effects of short and intensive foreign language learning in older adulthood on executive functions. Enhanced cognitive performance after foreign language learning would indicate that learning a foreign language could enlarge cognitive reserve and thus promote healthy cognitive ageing in older adults. Trial registration German Clinical Trials Register DRKS00016552. Registered on 11 February 2019.