Alba Sánchez

Multisensory stimulation for people with dementia: a review of the literature

The use of multisensory stimulation in people with dementia is becoming increasingly popular in the last decades. The aim of this review is to analyze the therapeutic effectiveness of multisensory stimulation in people with dementia. We made a search on Medline and Web of Science databases referred to all researches published from the year 1990 to 2012, which used multisensory stimulation techniques in people with dementia. The revision of the 18 articles which fulfilled the inclusion/exclusion criteria seems to prove evidence that multisensory stimulation environments produce immediate positive effects on the behavior and mood of people with dementia. Based on the above, we think it can be a useful nonpharmacological intervention on neuropsychological symptoms though, in any case, it would be necessary to start more reliable protocols from the methodological point of view in order to establish its long-term effectiveness.

Mental and psychological conditions, medical comorbidity and functional limitation: differential associations in older adults with cognitive impairment, depressive symptoms and co‐existence of both

Cognitive impairment and depressive symptoms are common among the geriatric population but the co‐occurrence of both is rarely studied. The purpose of this study was to identify and compare the factors associated with three groups of elderly people: those assessed with cognitive impairment alone (COG), depressive symptoms alone (DEP) or co‐existence of both (COG‐DEP).

Effects of Multisensory Stimulation on a Sample of Institutionalized Elderly People With Dementia Diagnosis A Controlled Longitudinal Trial

Long-term effects of multisensory stimulation were assessed using a “Snoezelen” room on older residents with dementia. Thirty patients were randomly assigned to 3 groups: multisensory stimulation environment (MSSE) group, individualized activities (activity) group, and control group. The MSSE and activity groups participated in two 30-minute weekly individualized intervention sessions over 16 weeks. Pre-, mid-, posttrial, and 8-week follow-up behavior, mood, cognitive, and functional impairment in basic activities of daily living were registered. Items included in the physically nonaggressive behavior factor improved significantly in post- versus pretrial in the MSSE group compared to the activity group, with no significant differences between MSSE and control groups. The MSSE and activity groups demonstrated behavior improvements and higher scores on the Cohen-Mansfield agitation inventory, verbal agitated behavior factor, and Neuropsychiatric Inventory–Nursing Home, with no significant differences between groups. The MSSE could have long-term positive effects on such neuropsychiatric symptoms in older people with dementia.

Depressive symptoms and other factors associated with poor self-rated health in the elderly: Gender differences

Aim:  The main objective of this study was to identify determinants of poor self‐rated health. We hypothesized that poor self‐rated health reflects not only health, but also physical, functional, psychological and social factors.

Multisensory Stimulation on Mood, Behavior, and Biomedical Parameters in People With Dementia: Is it More Effective Than Conventional One-to-One Stimulation?

The purpose of this study was to assess the effects of multisensory stimulation in a multisensory stimulation environment (MSSE) such as a Snoezelen room versus one-to-one activity sessions with regard to mood, behavior, and biomedical parameters (heart rate and blood oxygen saturation). The MSSE group and activity group (one-to-one activities) of patients with dementia participated in 2 weekly individualized intervention sessions over 16 weeks, where mood and behavior before, during, and after the sessions, and biomedical parameters immediately before and after, were recorded. Immediately after the sessions, patients spoke more spontaneously, related better to others, were more attentive to their environments, more active/alert, less bored/inactive, and more relaxed/content. Both groups exhibited decreases in heart rate and increases in oxygen saturation (Spo 2) values from before to after the sessions. The MSSE sessions in a Snoezelen room were found to be as effective as activity sessions, highlighting the importance of the one-to-one interaction with the therapist.

Comparing the effects of multisensory stimulation and individualized music sessions on elderly people with severe dementia: a randomized controlled trial

The objective of this study was to compare the effects of a multisensory stimulation environment (MSSE) and individualized music sessions on agitation, emotional and cognitive status, and dementia severity in a sample of institutionalized patients with severe dementia. Twenty-two participants with a diagnosis of severe or very severe dementia were randomly assigned to two groups: MSSE and individualized music sessions. Both groups participated in two 30-min weekly sessions over 16 weeks. Outcomes were agitation (Cohen-Mansfield Agitation Inventory, CMAI), mood (Cornell Scale for Depression in Dementia, CSDD), anxiety (Rating Anxiety in Dementia, RAID), cognitive function (Severe Mini-Mental State Examination, SMMSE), and the overall severity of dementia (Bedford Alzheimer Nursing Severity Scale, BANS-S). They were assessed at baseline (pre-trial), in the middle (mid-trial), at the end of the intervention (post-trial), and 8 weeks after the intervention (follow-up). Patients in the MSSE group showed significant improvement in their RAID and BANS-S scores compared with the individualized music group post- versus pre-trial. With regard to agitation, there was improvement during the intervention in both the MSSE and individualized music groups in the CMAI total score after 16 weeks of intervention, with no significant differences between the groups. The results suggest that MSSE could have better effects on anxiety symptoms and dementia severity in comparison with individualized music sessions in elderly patients with severe dementia.

Multisensory stimulation as an intervention strategy for elderly patients with severe dementia: a pilot randomized controlled trial

The objective of this study was to compare the effect of multisensory stimulation environment (MSSE) and one-to-one activity sessions in the symptomatology of elderly individuals with severe dementia. Thirty-two participants were randomly assigned to the following 3 groups: MSSE, activity, and control group. The MSSE and activity groups participated in two 30-minute weekly sessions over 16 weeks. Pre-, mid-, and posttrial; 8-week follow-up behavior; mood; cognitive status; and dementia severity were registered. Patients in the MSSE group demonstrated a significant improvement in the Neuropsychiatric Inventory and Bedford Alzheimer Nursing Severity Scale scores compared with the activity group. Both MSSE and activity groups showed an improvement during the intervention in the Cohen-Mansfield Agitation Inventory aggressive behavior factor and total score, with no significant differences between groups. The MSSE may have better effects on neuropsychiatric symptoms and dementia severity in comparison with one-to-one activity sessions in patients with severe dementia.

Laboratory values in a Spanish population of older adults: A comparison with reference values from younger adults

OBJECTIVE To examine the laboratory indices in a population aged 65 years or more and compare them with the reference values used for young adults. STUDY DESIGN Distribution patterns of frequently used biochemical and hematological indices were examined in a sample (N=600) of non-institutionalized adults aged over 65. OUTCOME MEASURES The obtained values were compared with the reference intervals for young adults. RESULTS On some of the indices analyzed, large proportions of the participants had values above the upper limit of the reference interval: glucose, 25.0%; urea, 26.6%; creatinine, 27.2% of males; total cholesterol, 54.6%; and low-density lipoprotein cholesterol, 35.8%. Of the participants who met the World Health Organizations diagnostic criteria for diabetes, 31.8% said they had not been previously diagnosed. Similarly, 74.9% of subjects with total cholesterol values above the reference value indicated in the European guidelines on cardiovascular disease said they had not been diagnosed with dyslipidemia, as did 75.5% of those with low-density lipoprotein cholesterol values above the European reference value. The proportion of participants who were not aware that they might be suffering from those disorders was significantly higher among those who reported not having visited their doctor within the last 6 months. CONCLUSION Further studies should examine whether the use of adapted, more appropriate reference values for elderly populations will help physicians to make early and correct diagnoses and to decide when medical intervention is required.

Predictores de mala salud autopercibida en una población de personas mayores

INTRODUCTION Self-Rated Health is part of the comprehensive concept of Quality of Life and is a valid measurement of health status. The main objective of this study was to test the predictive value of some different variables on the poor Self-Rated Health among elders. MATERIAL AND METHODS We performed a cross-sectional study on a sample consisting of 140 participants. MEASUREMENTS age, gender, level of education, environment, cognitive status, physical impairment, diseases, health perception and social support. The influence of the studied variables on the poor Self-Rated Health was performed with a logistic regression analysis and a ROC curve to establish the cut-off values for these variables with the best sensitivity and specificity to predict the poor Self-Rated Health. RESULTS A poor Self-Rated Health was significantly associated with age, comorbidity, and the perception of poor functional social support, whereas no association was found with gender, environment and educational level. CONCLUSIONS Old age, the number of diagnosed diseases, and functional social support are Self-Rated Health risk factors, while the characteristics and repercussions of the diseases should not be considered.

Influence of Social Support on Older Adults with Cognitive Impairment, Depressive Symptoms, or Both Coexisting:

The influence of social support dimensions (the extent of contact with others, the satisfaction with contacts, and the availability of help if sick or disabled) in elderly people with cognitive impairment (COG), depressive symptoms (DEP), or the co-occurrence of these symptoms (COG-DEP) was assessed in a cross-sectional analysis of a representative sample of 579 individuals aged 65 years and older. A lower extent of contact was related to COG (OR: 2.26). Fair satisfaction with contacts was related to DEP (OR: 2.88) and COG-DEP (OR: 4.22). A low level of satisfaction with contacts was an important predictor for DEP (OR: 7.99) and COG-DEP (OR: 7.88). Therefore, different dimensions of social support were independently correlated with different aspects of mental health. Quantitative aspects of social support were significantly linked to the presence of cognitive impairment. Satisfaction with social support affected depressive symptoms both alone and when they co-occurred with cognitive impairment.