Purpose: The aim of the project is to contribute to the physical, social, and psychological well-being of elderly individuals with cognitive impairment within a multidisciplinary approach framework, and to increase the level of knowledge and awareness about diseases and aging by organizing exercise, art, and education workshops under the guidance of expert health and art professionals. Scope and Target Group: Cognitive impairment affects daily life activities by impacting cognitive abilities such as memory, attention, and concentration. Mild Cognitive Impairment (MCI), Dementia, and Alzheimer's Disease (AD) are common cognitive impairments in the elderly. Early prevention strategies and intervention measures during this period are crucial. It is known that non-pharmacological interventions, especially in the early stages of MCI, are a window of opportunity that is promising and cost-effective. The primary target audience of this project is elderly individuals diagnosed with MCI, Dementia, and AD. To maximize the impact, some of the planned training sessions included family members of patients. Method and Expected Results: The project carried out in collaboration with Balıkesir University and Balıkesir Altıeylül Municipality. Various exercise and art workshops organized. Workshop activities conducted for eight weeks and included an Exercise Workshop (music-based exercises, exercise with active video games, clinical Pilates training, cognitive exercise therapy approach, Nordic walking, dance therapy), Skill-Oriented Art Workshop (systemic calligraphy therapy, soap-candle making workshop, culinary arts workshop), and Disease Awareness Studies (disease awareness information and education, the process from diagnosis to acceptance, experiences of patients and relatives, use of daily life technologies, home adjustments against falls, introduction of municipal services for the elderly).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
37
In our study workshop activities conducted for eight weeks and included an Exercise Workshop (Music-Based Exercise Workshop, Exercise Training with Active Video Games (Exergaming), Clinical Pilates Training Workshop, Cognitive Exercise Therapy Approach Workshop, Nordic walking, dance therapy), Skill-Oriented Art Workshop (Systemic Calligraphy Therapy Workshop, soap-candle making workshop, culinary arts workshop), and Disease Awareness Studies (disease awareness information and education, the process from diagnosis to acceptance, experiences of patients and relatives, use of daily life technologies, home adjustments against falls, introduction of municipal services for the elderly).
Balikesir University Cagis Campus 10145 Balikesir
Balıkesir, Balikesir University Cagis Campus, Turkey (Türkiye)
Mini Mental State Test
It is emphasized in the literature that the Mini Mental State Examination (MMST) is the most frequently used test worldwide for cognitive disorders (Ciesielska et al., 2016). MMST tests orientation, memory, attention, calculation, recall, language, motor function and perception, and visuospatial abilities, and its greatest advantage is that it can be applied easily and quickly (Salis et al., 2023). MMST was used to evaluate cognitive functions in our study. A score between 27-30 on the MMST is considered normal, 24-27 as MCI, 20-23 as mild stage, 10-19 as moderate stage, and 0-9 as advanced stage dementia (Güngen et al., 2002). Individuals with a score of 27 or less on the MMST were included in our study.
Time frame: From enrollment to the end of intervention at 8 weeks
Montreal Cognitive Assessment Scale (MoCA)
MoCA is one of the most frequently used tools in clinics to assess cognitive functions and has been translated into 35 languages (Sokolowska et al., 2018). It tests many cognitive domains including short-term memory, visual-spatial skills, executive functions, attention, concentration and working memory, language and orientation. It has been reported that its sensitivity varies between 67-100% and its specificity between 50-95% when evaluated using different cutoffs (Zhuang et al., 2021). The advantage of the test is that it provides a more comprehensive assessment compared to the assessment methods used in the field and is used quite frequently in the elderly population (Breton et al., 2019). MoCA was used in the project to assess the change in cognitive functions of individuals with cognitive impairment.
Time frame: From enrollment to the end of intervention at 8 weeks
Muscle Strength Assessment
Handgrip strength is a suitable measurement method for both clinical practice and public health research. Although the measurement of handgrip strength evaluates the function of a muscle group, it can be used to obtain a general idea about the musculoskeletal system in older adults. For this reason, it has been accepted as an indicator of general body strength. In our study, hand dynamometer and pinchmeter devices were used to evaluate the muscle strength of the participants. For the measurement of handgrip strength, participants were asked to sit in a chair with back support and fixed arms and rest their forearms on the arm of the chair so that their wrists were just at the edge of the chair. Measurements were made three times with a hand dynamometer, one minute apart, from the right and left hands, and the average of the results was recorded (Vermeulen et al., 2015).
Time frame: From enrollment to the end of intervention at 8 weeks
Flexibility Assessment
Spinal mobility and flexibility are an important component of healthy physical fitness for elderly individuals (Taşpınar et al., 2023). One of the methods frequently used in the literature for flexibility assessment is the sit-and-reach test. The patient is asked to sit with their legs together and their feet on a box, then bend forward as much as possible by extending their arms, without bending their knees, and remaining motionless for 1-2 seconds. The measurement was repeated three times and the average of the farthest distances reached was recorded in cm (Mayorga-Vega et al., 2014).
Time frame: From enrollment to the end of intervention at 8 weeks
Physical Activity Level
The short form of the International Physical Activity Questionnaire (IFQQ) was used to determine the physical activity levels of the participants. The IFQQ is a 7-item scale that evaluates the duration and frequency of vigorous physical activity, moderate physical activity, walking and sedentary behavior based on MET values (Craig et al., 2003). The physical activity levels were calculated according to the scores obtained by multiplying the duration, frequency and MET values of the physical activities that the participants participated in for at least 10 minutes within 7 days. The physical activity level assessment was made at the beginning and end of the project, and was repeated three months after the workshops were completed to evaluate sustainability.
Time frame: From enrollment to the end of intervention at 8 weeks
Depression Assessment
The Elderly Depression Scale (GDS) is a tool for the diagnosis and assessment of depression in elderly individuals and was developed based on the findings that elderly individuals with depression exhibit unique symptoms such as physical symptoms, anxiety, and decreased cognitive functions (Sheline et al., 2006).
Time frame: From enrollment to the end of intervention at 8 weeks
Quality of Life Assessment
Quality of life is a concept related to the individual's perception of his/her situation in life in line with his/her expectations, goals, interests and desires within the culture and social environment he/she lives in, and is defined as the multidimensional evaluation of the individual's person-environment system according to both personal and socio-economic criteria (Stoner et al., 2019). In our study, the 19-item Quality of Life Scale for the Elderly, developed by Hyde et al. (2003), specific to the elderly population, was used.
Time frame: From enrollment to the end of intervention at 8 weeks"
Well-Being of Individuals Who Provide Care
Caregiving, which is a multidimensional experience, can cause difficulties as well as positive aspects. In our study, the "Zarit Caregiving Burden Scale" was used to assess the stress experienced by those who provide care to elderly individuals. Studies have reported that the internal consistency coefficient of the scale is between 0.87-0.94 and the test-retest reliability is 0.71. The scale, which can be filled out by the caregivers themselves or the researcher, consists of 22 items that determine the effect of caregiving on the individual's life. The Likert-type scale can also be answered as never, rarely, sometimes, often, or almost always. The minimum score that can be obtained from the scale is 0 and the maximum score is 88. A high scale score indicates that the distress experienced is high.
Time frame: From enrollment to the end of intervention at 8 weeks
Satisfaction, Knowledge and Awareness Assessment
At the end of all workshops, patient and caregiver satisfaction, exercise or disease-related knowledge and awareness levels were evaluated by the research team according to the content of the activity. Patients and their relatives were asked to rate their satisfaction level out of 10 after the activities and to answer questions about satisfaction. Below are sample questions that we want the patient to rate as strongly agree (5), agree (4), undecided (3), disagree (2), strongly disagree (1): * I had a good time and enjoyed the workshop. * The training of expert staff increased my awareness of methods for combating the disease. * Workshops increased my social participation. * I am aware that I need to gain an exercise habit in order to increase my physical activity level. * Exercise, art and music increase my quality of life and psychological well-being.
Time frame: From enrollment to the end of intervention at 8 weeks
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