Background Mental health conditions are prevalent among Canadians and are a leading cause of disability. Each year, 1 in 5 Canadians experiences a mental health issue. A total of 5% of people aged ≥65 years perceive their mental health as fair or poor, and 6.3% of them have mood disorders. Regarding older adults with cognitive impairments such as dementia, up to 40%-50% of them experience depression at some point. We believe that older adults can benefit significantly from information and telecommunication technologies as a strategy for improving mental health conditions such as depression and anxiety, while simultaneously improving their quality of life. 3Scape Systems Inc is an Alberta-based private company that has produced a series of specialized 3D videos designed to simulate real-life events and engage individuals living with mental health disorders and cognitive impairments such as dementia. Objective This study aims to explore the trial design and effects of 3Scape videos on older adults’ symptoms of depression and anxiety and the efficacy of this technology in improving the quality of life of patients attending the Short-Term Assessment, Rehabilitation, and Treatment Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital and to provide data to estimate the parameters required to design a definitive randomized controlled trial. Methods The trial will use a randomized controlled design comprising 15 intervention participants and 15 control group participants. The participants will be adults aged ≥65 years who are cognitively intact or have minimal cognitive impairment (ie, Montreal Cognitive Assessment score ≥18), and are clients of the Short-Term Assessment, Rehabilitation, and Treatment Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital. This study’s primary outcome variables are related to clients’ depressive and anxiety symptoms and their quality of life. The control group will receive the standard of care (ie, the Short-Term Assessment, Rehabilitation, and Treatment Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital). The intervention group will receive the same standard of care as the control group and will use 3Scape Systems videos for therapeutic activities. Results Our study is currently on hold because of the COVID-19 pandemic. The recruitment process is expected to resume by November 2021, and the primary impact analysis is expected to be conducted by February 2022. Conclusions This study will provide valuable information such as the measurement of comparative intervention effects, perception of older adults and mental health therapists about the 3Scape Systems, the associated costs of treatment, and product costs. This will contribute to the evidence planning process, which will be crucial for the future adoption of 3Scape Systems. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 93685907; https://www.isrctn.com/ISRCTN93685907. International Registered Report Identifier (IRRID) PRR1-10.2196/25017
BACKGROUND Mental health is a prevalent condition amongst Canadians. Mental health conditions are the leading cause of disability, as each year 1 in 5 Canadians experiences a mental health issue. Five percent of people aged 65 years and older perceive their mental health as fair or poor, and 6.3% of them have mood disorders. Regarding older adults with cognitive impairments such as dementias, up to 40 to 50 per cent of them experience depression at some point. We believe that older adults can benefit significantly from information and telecommunication technologies (ICTs) as a strategy for improving mental health conditions such as depression and anxiety, while at the same time improving their quality of life. 3Scape Systems Inc. is an Albertan-based private company that has produced a series of specialized 3D videos that have been designed to simulate real-life events and engage individuals living with mental health disorders and cognitive impairments such as dementia. OBJECTIVE The purpose of this study is to explore the trial design and effects of 3Scape videos on older adults’ symptoms of depression, anxiety, and quality of life, as well as the efficacy of this technology in reducing the caregiver burden on the START Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital (GRH), and to provide data in order to estimate the parameters required to design a definitive Randomized Controlled Trial (RCT). METHODS The trial will use a randomized controlled design comprising 15 intervention participants and 15 control group participants. The participants will be adults aged 65 years and older who are cognitively intact or who have a minimal cognitive impairment, i.e. Montreal Cognitive Assessment (MOCA) ≥18), and clients from the START Psychiatry Day Hospital program at GRH. This study’s primary outcome variables are related to the clients’ depressive and anxiety symptoms, and their quality of life. The control group will receive the standard of care (i.e. the START Psychiatry Day Hospital program at GRH). The intervention group will receive the same standard of care as the control group at each facility and will use the 3Scape Systems videos for the therapeutic activities. RESULTS Our study is currently on hold due to the Covid-19 global pandemic. The recruitment process is expected to resume by November 2020 and the primary impact analysis is expected to be conducted by February 2021. CONCLUSIONS This study will provide valuable information such as the measurement of comparative intervention effects, perception of older adults and hand therapists about the 3Scape Systems, the associated costs of treatment, and product costings. This will contribute to the evidence planning process, which will be crucial for the future adoption of the 3Scape Systems. CLINICALTRIAL International Registered Report Identifier (IRRID): ISRCTN: 93685907 (available at https://doi.org/10.1186/ISRCTN93685907)
BackgroundPatients with depression and/or anxiety are commonly seen in inpatient geriatric settings. Both disorders are associated with an increased risk of cognitive impairments, notably in executive functioning. Transcranial direct current stimulation (tDCS), a type of non-invasive brain stimulation, involves the administration of a low-dose electrical current to induce neuromodulation, which ultimately may act on downstream cognitive processing.ObjectiveThe purpose of this study was to determine the effects of tDCS on executive functioning in geriatric inpatients with symptoms of depression and/or anxiety.DesignPilot Randomized Controlled Trial.SettingSpecialized geriatric wards in a tertiary rehabilitation hospital.MethodsThirty older-aged adults were recruited, of which twenty completed ten-to-fifteen sessions of 1.5 mA anodal or sham tDCS over the left dorsolateral prefrontal cortex. Cognitive assessments were administered at baseline and following the tDCS protocol; analyses examined the effects of tDCS on cognitive performance between groups (anodal or sham tDCS).ResultstDCS was found to increase inhibitory processing and cognitive flexibility in the anodal tDCS group, with significant changes on the Stroop test and Trail Making Test-Part B. No significant changes were observed on measures of attention or working memory.DiscussionThese results provide preliminary evidence that tDCS-induced neuromodulation may selectively improve cognitive processing in older adults with symptoms of depression and/or anxiety.Clinical Trials Registrationwww.clinicaltrials.gov, NCT04558177
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