Effects of creative expression therapy for older adults with mild cognitive impairment at risk of Alzheimer’s disease: a randomized controlled clinical trial

Abstract

ObjectiveElderly people with mild cognitive impairment (MCI) are at high risk for dementia. This study compared the effects of standard cognitive training with a creative expression (CrExp) program.MethodsAdult patients with MCI aged 60 years and older (N=93) were randomly assigned to either CrExp therapy (n=48) or a control group who received standard cognitive training (n=45) for 16 weeks. The Montreal Cognitive Assessment, Chinese Version of the Auditory Verbal Learning Test, Chinese Version of the Category Verbal Fluency Test, Digit Span Test, Trail Making Test, Chinese Version of Activities of Daily Living scale, and Memory Satisfaction Questionnaire were used to measure cognitive functioning and daily living abilities. Assessments were administered at baseline, postintervention, and 6 months follow-up.ResultsAt postintervention, patients receiving CrExp therapy scored significantly higher than patients receiving standard cognitive training, in general cognitive functioning, memory, executive function, functional status, and everyday living ability. The improvements in cognitive functioning were maintained at the 6 month follow-up.ConclusionCrExp therapy has greater positive effects on cognitive functions and daily living ability than standard cognitive training. This unique therapy may serve as a cost-effective adjunct to standard interventions for older adults with mild cognitive impairment.

Efficacy of lifestyle and psychosocial interventions in reducing cognitive decline in older people: Systematic review

“…All but nine studies only measured outcomes immediately post-intervention. Four studies used a repeated measures designs that included immediate post-intervention and more distal outcomes in analyses (Fogarty et al, 2016;Mackin et al, 2014;Thiel et al, 2012;Zhao et al, 2018); and two studies reported immediate post-intervention and more distal end-points separately (Eyre et al, 2017;Fiatarone Singh et al, 2014). Of the studies evaluating impact after the post-intervention period, only two demonstrated evidence of effectiveness beyond the immediate post-intervention period: a year after cessation of a 6 month exercise intervention (Fiatarone Singh et al, 2014); and two months after cessation of a creative expression intervention (Zhao et al, 2018).…”

“…Two studies found that creative art groups delivered by professional therapists improved cognition in people with MCI. Zhao et al (2018) evaluated 25 group sessions of drawing and story-telling over 16 weeks in China (n = 93). The control group received an equivalent amount of social contact, social activation and cognitive strategy training.…”

Effects of Creative Expressive Arts-based Storytelling (CrEAS) programme on older adults with mild cognitive impairment: protocol for a randomised, controlled three-arm trial

“…9 CrExp activities such as storytelling, visual arts, dance, music and dramatic arts are innovative, non-pharmacological interventions that have been applied in clinical settings involving children, patients with cancer, older people and patients with MCI and dementia. [10][11][12][13][14][15] Among the different types of CrExp, visual arts may be especially useful for people with normal or suboptimal cognition as they have been shown to improve cognitive function, psychological symptoms, physiological state, social wellbeing and connectedness in older adults with or without cognitive dysfunction, 13 16-21 although the findings in individuals exhibiting cognitive decline are controversial. A systematic review of the literature revealed that visual arts therapy has a positive effect on depression, anxiety, quality of life (QoL), coping ability and self-esteem but has no clinically significant effect on cognition.…”

“…Our earlier work in a randomised controlled trial (RCT) comparing the effects of standard cognitive training with a CrExp programme for older people with MCI found that the latter had beneficial effects on cognitive function and daily living ability. 13 A subsequent exploratory RCT examining the efficacy of CrExp therapy (with the control group receiving standard cognitive training) in older people with dementia demonstrated significant improvements in cognitive function, QoL, level of depression, communication ability and emotional status. 27 The main form of CrExp activities in these two studies was storytelling.…”

“…In other studies, the intervention period of art-based activities for older people or for those with cognitive impairment ranged from 3 to 40 weeks, with no consensus as to the optimal duration. 17 35-37 Based on the results of our previous work, 13 we determined that an intervention cycle of 24 weeks and frequency of once a week can achieve clinical benefits. We hypothesise that the 24-week CrEAS intervention will Open access result in greater improvement in cognitive function and other health-related outcomes in older adults with MCI compared with those who continue their usual activities or receive other types of recreational intervention, and that this will be accompanied by favourable changes in functional connectivity of specific brain regions.…”