The COVID-19 pandemic significantly impeded face-to-face health and social care delivery for people living with dementia and their carers. Interruption of meaningful activity engagement along with increased social isolation is known to be associated with loss of skills, increased loneliness, physical deterioration and decline in cognition and mood in people with dementia. To ensure continuity of care for people living with dementia, for whom multimodal, non-pharmacological intervention programmes were being provided, there was an urgent need to adopt a remote delivery model. Guidance on digitally delivered assessment and care specific to non-pharmacological interventions for dementia is lacking. Adoption of technology-enabled care for people with dementia requires overcoming barriers to technology use, adaptation of therapeutic guidelines, adaptation of communication methods and carer support. Despite these challenges, therapists successfully transitioned from in-person to digital delivery of therapeutic interventions with associated benefits of continued meaningful activity engagement discussed.

In China, the ageing population and the prevalence of dementia are projected to escalate significantly by 2050 resulting in a substantial increase in health and economic burden on caregivers, healthcare facilities, healthcare providers and communities. There is no published national dementia policy or strategy in China. This case report describes significant barriers contributing to diagnostic problems and inadequate care of dementia through the case of an older female in rural China, whose condition deteriorated due to neuropsychiatric and functional symptoms of undiagnosed dementia. Intersectoral collaboration between care organisations facilitated delivery of a non-pharmacological intervention programme which was associated with improvements in the patient’s functional and neuropsychiatric symptoms. The case demonstrates that recruitment and training of a wider range of health and care professionals and caregivers in a systematic approach to non-pharmacological interventions could help overcome barriers to the specialised care needs of people with dementia where resources are lacking.

Objective: To determine the effect of later-life formal education or learning on quality of life (QOL), wellbeing, mood, and cognition. Methods: A systematic literature review of interventional clinical trials and observational studies was conducted for adults aged ≥55 years who had undertaken formal education or learning programs. Outcome measures included physical activity, happiness, affective and behavioral symptoms, cognitive function, and QOL. Bias was assessed using funnel plots, Egger’s test, and leave1out analysis. Results: From 32 studies identified, we showed qualitative increases in cognitive function, life satisfaction, and self-confidence associated with learning. A meta-analysis revealed a significant pooled mean difference in MMSE scores (0.40, 95% confidence intervals = [0.12, 0.67]). Although there was a low risk of publication bias there was a high risk of sampling bias. Conclusion: Participation in formal education or learning contributed to increased wellbeing, QOL, healthy cognitive function, self-dependency, and a sense of belonging in older adults.

Introduction: In China, the over 60 population is estimated to grow from 12% in 2010 to 33% of the overall population by 2050. The escalation in the aging population is projected to result in an Alzheimer's disease prevalence of 27.7 million people in China by 2050 causing substantial health and economic burden. While there are some published studies on multicomponent, non-pharmacological interventions for people with dementia, we have found no published community-based approach to care that encompasses personalized selection of non-pharmacological interventions, active social participation, and dementia education. Patient concerns: An elderly female living at home alone in urban Beijing presented with significant short-term memory impairment, episodes of confusion, difficulty with language skills, and episodes of wandering. She had become reclusive and disengaged from her previous social networks, and no longer attended any community activities or events. The patient had no significant past medical or psychiatric history. Diagnosis: The patient was diagnosed with Alzheimer's disease by a local physician based on clinical features of impaired communication, disorientation, confusion, poor judgement, behavioral changes, and difficulty speaking. Depression was considered a differential diagnosis but is also both a risk factor and symptom of dementia. Interventions: A novel, community-based, multicomponent social care program for dementia was used to facilitate implementation of non-pharmacological interventions, gradual socialization and provide supportive carer and community education. Non-pharmacological interventions included a combination of validation therapy, music therapy, art therapy, reminiscence therapy, talking therapy, reality orientation, cognitive training, smell therapy, food therapy, sensory stimulation, garden therapy, and physiotherapy. Outcomes: Improvements in the patient's Geriatric Depression Scale and Mini Mental State Examination scores were noted in association with increased social participation in the community. Conclusion: The community-based, multicomponent dementia social care program described in this case report has enabled a socially isolated patient with Alzheimer's disease to reduce her social isolation with an associated improvement in her mood and prevention of cognitive decline. Educating the community was an essential part of re-integrating the patient into the social setting. Reducing social isolation and increasing community engagement were essential to maintaining the patient's independence in her own home.

Introduction: Promoting healthy ageing is increasingly important to maintain functional ability and wellbeing in older age. However, there is a lack of consolidated evidence-based information to support the selection of non-drug interventions to support healthy ageing outcomes for individuals. Methods: A narrative review of the evidence-based literature on non-drug interventions to support healthy ageing was performed. Evidence for intervention benefits was evaluated and mapped into the Systematic Wellness Intervention Pathway framework and aligned to relevant goals, needs and outcomes relating to physical fitness and function, emotional wellbeing, cognitive health, sleep and diet and nutrition. Comments from a modified Delphi survey of 75 expert peer reviewers were analysed to inform the development of the next Pathway iteration. Results: The narrative review identified key healthy ageing interventions, including physical activity, social interaction, interventions for emotional wellbeing, creative and cognitively stimulating activities and diet and nutrition. Peer review survey results indicated majority agreement with all domains and non-drug interventions for healthy ageing in the Pathway, and suggested interventions and outcome revisions informed Pathway iteration. Conclusion: The Pathway could be a step forward in operationalising the delivery of non-drug interventions in an accessible and scalable way, supplementing conventional health and social care, to enable older people to live well for longer.