Journal of Rehabilitation Sciences & Research

Enhancing Independence in Activities of Daily Living, Cognitive, and Physical Skills for Elderly with Dementia: A Randomized Controlled Trial of Meaningful Task-Oriented Intervention

Farzad Rabiei; Malahat Akbarfahimi; Mahtab Roohi-Azizi; Marjan Ghandi

Volume 11, Issue 2 , June 2024, , Pages 102-108

Abstract

Background: Dementia is recognized as a neurodegenerative disease that gradually causes serious cognitive, motor, and functional impairments in affected individuals. This study explored ... Read More Background: Dementia is recognized as a neurodegenerative disease that gradually causes serious cognitive, motor, and functional impairments in affected individuals. This study explored the impact of a meaningful task-oriented intervention on independence in activities of daily living, cognitive status, and physical abilities, including gait speed and balance, among elderly patients diagnosed with mild to moderate dementia. Methods: In this randomized controlled trial, 40 participants aged 60-70, with a Functional Assessment Staging Tool (FAST Scale) score of 1-5, were recruited. They were randomly assigned to either a control group (n=20) receiving standard care, including medication and routine consultation, or an intervention group (n=20) receiving standard care along with eight 45–60-minute sessions of task-oriented interventions. These interventions were centered around familiar daily life activities in the home environment and were conducted twice a week. The primary outcome measure was the participants' independence in activities of daily living, assessed using the Barthel Index. Secondary outcome measures included cognitive function, evaluated using Addenbrooke’s Cognitive Examination-Revised, and physical performance, assessed through the Timed Up and Go test, 10 Meter Walk Test, and Berg Balance Scale. Results: The meaningful task-oriented intervention demonstrated significant improvements in independence in activities of daily living (p<0.01) compared to the control group. Additionally, improvements were observed in cognitive function and physical performance, including balance, lower limb strength, and walking speed (p<0.05). Conclusion: The integration of meaningful task-oriented interventions centered around familiar activities within the home environment appears to offer significant benefits for elderly patients with dementia. By engaging in tasks that resonate with their daily routines, these interventions can support the maintenance of essential skills and foster a sense of independence among affected individuals.

Comparison of Brain atrophic changes in dementia patients with and without swallowing dysfunction

Mansoureh Chegeni; Shiva Ebrahimian dehaghani; Mehrzad Lotfi; Zahra Salami

Volume 9, Issue 2 , June 2022, , Pages 72-78

Abstract

Background: on the one hand, very limited studies were performed on identifying the active regions during swallowing among healthy individuals and those with dementia. On the other ... Read More Background: on the one hand, very limited studies were performed on identifying the active regions during swallowing among healthy individuals and those with dementia. On the other hand, to the best of our knowledge, no research has yet compared the injured areas in the brain of patients with dementia with and without dysphagia, such that damage to specific regions in dementia causes dysphagia may be found using this approach. The present study was performed to evaluate the atrophic changes in the internal temporal lobe (hippocampus), frontal (anterior cingulate cortex), and parietal (posterior cingulate cortex), and insula cortex in these patients.Methods: the present study is a retrospective cross-sectional study. 54 patients with dementia were investigated. The data were collected using a checklist, including information related to the dysphagia, and the brain MRI findings to determine atrophy. The extent of atrophic changes was recorded in the checklist using the median temporal lobe atrophy (MTA) score, Koedem score scale, and the global cortical atrophy (GCA) scale. To present the results, descriptive statistics, and data comparison, chi-square tests were used.Results: The mean age of the examined patients was 72.01 with a standard deviation of 10.64 years, and range of 50-95 years. Out of them, 32 (59.3%) were male, and 22 (40.7%) were female. The degree atrophy of hippocampus (p=0.12), frontal lobe (P=0.46), parietal lobe (P=0.83), and insular cortex (P=0.91) in the patients with and without dysphagia did not show significant differences. The frequency distribution of the degree of atrophy based on the site of the development of atrophy was significant in the patients with dysphagia (P=0.033).Conclusion: In general, the findings showed that individuals with dementia who had dysphagia had more hippocampal and frontal lobe (and anterior cingulate) atrophy than dementia patients who did not have this impairment.

Journal of Rehabilitation Sciences & Research

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Keywords = Dementia

Enhancing Independence in Activities of Daily Living, Cognitive, and Physical Skills for Elderly with Dementia: A Randomized Controlled Trial of Meaningful Task-Oriented Intervention

Abstract

Comparison of Brain atrophic changes in dementia patients with and without swallowing dysfunction

Abstract