Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study

Abstract

The use of existing public spaces by people living with dementia, such as museums and art galleries, are becoming popular due to their ability to facilitate programs which promote social engagement and inclusion. However, few studies have investigated physiological outcomes of art gallery-based programs. Using a quasi-experimental design, the present study aimed to investigate the levels of salivary biomarkers of cortisol and interleukin-6, quality of life (QoL), depressive symptoms, cognition, and wellbeing, after attending the National Gallery of Australia (NGA) Art and Dementia program. Twenty-eight people living with dementia, each supported by a carer or family member, were recruited for a six-week program and were followed up at twelve weeks. In total, 25 participants (17 female; mean age 84.6 ± 7.27 years) completed the study, and 22 provided viable saliva samples. The waking to evening salivary cortisol ratio was higher post-intervention (p = 0.033), and returned to baseline levels at follow-up (p = 1.00), indicating a more dynamic salivary cortisol rhythm in response to the six-week program. Interleukin-6 levels remained unchanged (p = 0.664). No improvements in QoL (DEMQOL-Carer) were observed between baseline and post-intervention (p = 0.076). However, self-reported depressive symptoms decreased postintervention compared with baseline (p = 0.015), and memory (immediate recall) (p = 0.009) and verbal fluency (p = 0.027) improved between the same timepoints. The NGA Art and Dementia program appears to have quantifiable benefits, including improved hypothalamic-pituitary-adrenal axis function, justifying a need for longer controlled trial inclusive of physiological outcomes.

Using Salivary Cortisol as an Objective Measure of Physiological Stress in People With Dementia and Chronic Pain: A Pilot Feasibility Study

“…The use of different collection methods, sampling frequencies, and analytical approaches to assess salivary cortisol levels have been reported. Different collection practices tend to reflect the desired outcome measure, with some studies collecting saliva once per day (Kwan et al, 2017) while others multiple times per day (D'Cunha et al, 2019;Venturelli et al, 2016). Outcome measures included baseline cortisol levels assessed in the morning (Kwan et al, 2017), cortisol variation with circadian rhythm (Venturelli et al, 2016), or cortisol ratio (comparing waking to evening collections) (D'Cunha et al, 2019).…”

Activities outside of the care setting for people with dementia: a systematic review

“…Therefore, a total of nine studies were included. The 9 studies reported on data from a total of 177 participants living in RACF from high-income countries, Australia, 14 17–21 the USA 12 13 15 16 and Sweden 22 ( table 1 ). Study sample sizes ranged from 15 6 to 70.…”

“… 13 Two studies were randomised controlled trials, 12 13 16 one study was a controlled trial 17 and the remaining six studies used quasi-experimental designs. 14 15 18–22 The participants ranged in age from 77.0 years 19 to 88.4 years. 18 21 …”

“…Eleven articles reporting on nine different studies fit the inclusion criteria. [12][13][14][15][16][17][18][19][20][21][22] The PRISMSA flow chart is presented in figure 1. A meta-analysis was not performed due to the diversity of the included interventions and the reported outcome measures.…”

“…12 13 Grip strength is a widely used marker of whole body muscular strength, which is associated with vitality, physical function and cognitive performance. 31 32 Swimming improved grip strength, 17 18 but no benefits were observed for grip strength following 6 weeks of arts-based discussion groups, 14 suggesting that physical activity is required to see improvements. Swimming for older people has many benefits, including an increase in metabolism which can help with sleep and appetite, in addition to being a nonweight bearing form of physical activity which enables a full range of motion and joint mobility.…”