Efficacy of Short-Term Inpatient Rehabilitation for Dementia Patients and Caregivers: Prospective Cohort Study

Schiffczyk, Claudia; Romero, Bárbara; Jonas, Christina; Lahmeyer, Constanze; Müller, Friedemann; Riepe, Matthias W.

doi:10.1159/000348357

Cited by 16 publications

(19 citation statements)

References 91 publications

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“…Rehabilitation or exercise intervention was reported to reduce the prevalence of BPSD. [ 29 , 51 , 52 ] However, it is not clear whether only rehabilitation exercise intervention was planned or other non-pharmacological or pharmacological intervention was carried out. Third, this study is based on the rehabilitation database.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation strategy for hip fracture, focused on behavioral psychological symptoms of dementia for older people with cognitive impairment: A nationwide Japan rehabilitation database

et al. 2018

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The aim is to investigate the relationship between a positive outcome on rehabilitation after hip fracture and behavioral psychological symptoms of dementia (BPSD) transition during rehabilitation. This study is a retrospective cohort study based on the Japan Rehabilitation Database. We recruited 756 subjects 65 years of age or older from 31 hospitals in the database. All subjects were in the hospital as patients undergoing rehabilitation for hip fracture. Functional independence measure (FIM), walking ability, Mini-Mental State Examination (MMSE), and BPSD were measured both at the beginning and at the end of rehabilitation. MMSE for 23 or under was defined as the cognitive-impaired group. MMSE for 24 or over was used as the cognitively intact group. Cognitive impaired participants were divided into four groups: participants presented no BPSD both at the beginning of rehabilitation and at the end of rehabilitation (Group (-/-)), participants presented BPSD at the beginning of rehabilitation but resolved at the end of rehabilitation (Group (+/-)), participants had no BPSD at the beginning of rehabilitation but appeared at the end of rehabilitation (Group (-/+)) and participants had sign of BPSD both at the beginning of rehabilitation and at the end of rehabilitation (Group (+/+)). The endpoints were waking ability, FIM gain. As results, one hundred thirty-seven cognitive-impaired older people patients out of 471 (29.1%) suffered from BPSD at the beginning of rehabilitation. FIM gains in cognitively intact group, Group (-/-), Group (+/-), Group (-/+) and Group (+/+) were 24.8 ± 18.7, 17.5 ± 16.9, 27.3 ± 19.7, 17.8 ± 12.2 and 12.2 ± 17.2, respectively. The Group (+/-) was significantly connected to a positive outcome for rehabilitation. The present study suggested that the management of BPSD can lead to better functional recovery during rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Rehabilitation strategy for hip fracture, focused on behavioral psychological symptoms of dementia for older people with cognitive impairment: A nationwide Japan rehabilitation database

et al. 2018

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“…(31,35,36,37,38) The majority of studies (n = 17) employed a control group. (27,34,39,40,41,42,43,44,45) Postintervention follow-up assessments intervals ranged from one week to twelve months.…”

Section: Methodsmentioning

confidence: 99%

“…More than half of the studies (n = 15) used the MMSE to determine level of cognitive impairment with participants; scores ranged from 17 to 28. (27,28,29,30,32,33,35,36,37,39,39,40,43,45,46) Other cognitive measures that were used included the Dementia Rating Scale (DRS), (31) Clinical Dementia Rating Scale (CDR), (18,42,44,47,48) the Rating of Anxiety in Dementia (RAID), Trails A and B, (34) and Addenbrooke's cognitive examination (ACE-III). (49) Participant attrition rates ranged from 5% to 50%.…”

Section: Methodsmentioning

confidence: 99%

“…Two multi-model interventions also included components of CBT. (47,43) In addition to CBT, these interventions included group therapy programs that combined exercise, cognitive therapy, and support programs, (47) as well as rehabilitative treatment. (43) Cognition significantly improved in postintervention in both studies.…”

Section: Cognitive Behavioural Therapy-based Interventionsmentioning

confidence: 99%

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Psychotherapeutic Interventions for Dementia: a Systematic Review

et al. 2021

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Background and Objectives While a range of psychotherapeutic interventions is available to support individuals with dementia, comprehensive reviews of interventions are limited, particularly with regard to outcomes related to adjustment and acceptance. The current review assesses studies that evaluated the impact of various forms of psychotherapeutic interventions on acceptance and adjustment to changing life circumstances for older adults with cognitive impairment. Research Design and Methods A systematic search of PubMed, PsycINFO, and CINAHL databases was conducted, restricted to articles published in English within the last 16 years (from 2003 to 2019). Twenty-four articles were identified that examined the effects of psychotherapeutic interventions on outcomes related to acceptance and adjustment which included internalizing symptoms, quality of life, self-esteem, and well-being. Fifteen studies examined interventions targeted towards individuals with cognitive impairment, while nine studies also targeted their caregivers. Results Interventions that impacted outcomes related to acceptance and adjustment (e.g., adaptation, depressive symptoms, helplessness, self-esteem, and quality of life) varied in their theoretical approach, which incorporated elements of cognitive behavioural therapy (CBT), problem-solving therapy, psychotherapy, reminiscence therapy, interpersonal therapy, mindfulness-based therapy, and meaning-based, compassion-focused therapy. Among all interventions, reductions in depression were the most commonly reported treatment outcome particularly among interventions that incorporated problem-focused and meaning-based therapies. Mixed findings were reported with regard to outcomes related to helplessness, quality of life, self-esteem, and life satisfaction indices for individuals with cognitive impairment. Discussion and Implications There is some support for the effectiveness of psychotherapeutic interventions on improving acceptance and adjustment in older adults with cognitive impairment, particularly with regard to reducing depressive symptoms.

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“…Only three studies were able to be included in the meta-analysis due to missing or incomplete data. [28][29][30] Outcomes reported in two or more studies were anxiety, 29,30 depression, [28][29][30] caregiver burden [28][29][30] and QOL. 28,30 Pooled data reported no significant changes from baseline to 3 (Figure 2A-D).…”

Section: Interventions and Outcomes Measuredmentioning

confidence: 99%

Interventions supporting caregiver readiness when caring for patients with dementia following discharge home: A mixed‐methods systematic review

et al. 2020

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Objective: To explore programs and information provided to caregivers of inpatients with dementia to assist with readiness to provide care following discharge. Methods: A mixed-methods systematic review with meta-analysis was conducted. Search terms included dementia, inpatient, caregiver, anxiety, discharge and counselling. Results: The search yielded 1938 studies (six databases), 13 met the inclusion criteria. Meta-analysis showed no statistically significant changes in anxiety, depression, burden or quality of life 3 months postintervention. Three emergent qualitative themes for staff consideration were: understanding personal characteristics of both patient and caregiver; presenting an inclusive organisational culture; and providing appropriate information at all stages of admission. A Model of Caregiver Readiness was created from the qualitative results. Conclusion: The programs did not significantly decrease the outcomes measured. However, caregivers identified that inclusion at all stages during hospital admission was a vital factor to reduce stress and increase caregiver readiness.

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Efficacy of Short-Term Inpatient Rehabilitation for Dementia Patients and Caregivers: Prospective Cohort Study

Cited by 16 publications

References 91 publications

Rehabilitation strategy for hip fracture, focused on behavioral psychological symptoms of dementia for older people with cognitive impairment: A nationwide Japan rehabilitation database

Rehabilitation strategy for hip fracture, focused on behavioral psychological symptoms of dementia for older people with cognitive impairment: A nationwide Japan rehabilitation database

Psychotherapeutic Interventions for Dementia: a Systematic Review

Interventions supporting caregiver readiness when caring for patients with dementia following discharge home: A mixed‐methods systematic review

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