Dementia Care

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66 Australian Journal of Dementia Care October/November 2016 Vol 5 No 5
Bringing words back to mind
Stepping stone for future dance studies
Investigating
dementia and
self-harm A recent study has examined a word training
program to assist people with semantic
dementia (SD). People with SD struggle with
significant impairments in naming and
comprehension, however their attention, daily
memory and visuo-spatial skills remain
relatively intact. Researchers are therefore
attempting to use these preserved skills to help
people with SD to rebuild their vocabulary.
In this study by Sydney researchers, four
participants with mild to severe impairments in
semantic skills participated in a word training
program.
The program used a list of words the
participant was trained in, as well as an
‘untrained’ list of words which served as an
experimental control. Digital photographs of
household objects were taken at each
participant’s home and included: food,
household appliances, kitchen utensils, outdoor
tools, and clothing. For each trained word the
participant provided a personally meaningful
description, using autobiographical memory,
personal tastes or other associations. An audio
recording of the object name and this description
was made by the researcher. These stimuli were
then incorporated into a computer program to
create an audio-visual slideshow. Participants
were encouraged to practice once a day, initially
for 30 to 60 minutes, using the slideshow and
accompanying sentence worksheets.
All four participants showed significant
improvements in their ability to name ‘trained’
items, with no changes in the untrained items.
These improvements were present within three
weeks of practice and strong effect sizes of the
treatment were observed in people with severe
deficits.
Maintenance of learning was observed on
some follow-up assessments, although it is likely
that continued practice is required to sustain the
vocabulary skills.
The researchers concluded that these findings
are promising in terms of the use of simple
home-practice interventions, even for people
with severe language difficulties.
Savage SA, Ballard KJ, Piguet O, Hodges JR (2016)
Bringing words back to mind: improving word
production in semantic dementia. Cortex 49(7) 1823-
1832.
Researchers from across
Australia have collaborated to
evaluate the feasibility of a
dance program for people with
moderate to severe dementia
living in aged care homes.
The researchers were
particularly interested in the
practicalities of recruiting and
retaining participants, the use
of assessment tools,
intervention safety, attendance,
and participant engagement. It
was hoped that further
understanding of these aspects
of the research will help guide
larger future studies to
examine the effectiveness of
dance interventions.
The research was conducted
in a Sydney residential aged
care facility where experienced
dance teachers conducted
dance groups (the active
intervention) or music
appreciation and socialisation
groups (the experimental
control). Participants were
randomly allocated to each
group. These groups were run
for 45 minutes, three times per
week for 16 weeks.
The dance intervention
sessions started with seated
dance, sometimes using props
such as scarves or musical
instruments. This was followed
by standing circle and
partnered dances.
Research psychologists and
physiotherapists blind to group
assignment assessed
participants’ responses to the
groups using the Severe
Impairment Battery (SIB;
measures attention, orientation,
language, memory, visuospatial
ability and construction), Short
Physical Performance Battery
(SPPB; measures standing
balance, walking speed and sit-
to-stand speed), and Clinical
Global Impression of Change
(CGIC; assessment of the
clinician’s view of global
functioning before and after
and intervention).
Dance teachers recorded
residents’ level of participation
(1 = participated actively
throughout; 2 = about half
watching, half participating; 3
= mostly watching throughout;
4 = uninterested, disruptive or
left the session early), falls and
other adverse events.
The researchers reported that
the recruitment process ran
smoothly and the rate of drop-
out from the program was 17%
over 32 weeks. Engagement
during each session was high
and no serious falls or
behavioural incidents occurred.
Unfortunately, average
attendance was quite poor in
the dance groups (67%)
compared with the music
groups (89%). The timing of the
sessions may have impacted on
participation as the control
group was held immediately
after breakfast, with
participants escorted to the
activity room. The dance group
was held late morning and
participants had to be escorted
from their rooms where some
were asleep. It’s recommended
this be considered in future
studies of dance interventions
to minimise bias.
Low LF, Carroll S, Merom D, Baker
J, Kochan N, Moran F, Brodaty H
(2016) We think you can dance! A
pilot randomised controlled trial of
dance for nursing home residents
with moderate to severe dementia.
Complementary Therapies in
Medicine 29 42-44. Available online
at www.complementary
Apopulation-based study by
Sydney researchers has
examined the characteristics of
older people with and without
dementia who are hospitalised
following deliberate self-harm.
This clinical area was largely
unexplored and this study
aimed to better understand the
rates of admission and
readmission for deliberate self-
harm, as well as comorbid
mental health disorders.
Using NSW hospital
admissions data from 2003-
2012, the researchers identified
a total of 427 hospitalisations of
people with dementia and
11,684 admissions of people
without dementia for self-
harm. The hospitalisation rate
for self-harm for individuals
with dementia aged 60+ years
was double the rate for people
without dementia.
For older people with and
without dementia, those who
self-harmed were more likely
to have a co-existing mental
health or alcohol use disorder
compared with those who had
admissions for non-self-harm
injuries.
People with dementia were
found to have higher 12-month
mortality rates, 28-day
readmission and a longer
length of hospital stay than
individuals without dementia.
The researchers concluded
that dementia is associated
with an increased risk of
hospitalisation for self-harm in
older people as well as worse
clinical outcomes. The high rate
of co-existing mental health
conditions suggests that
interventions aimed at
reducing the behavioural and
psychological symptoms of
dementia might reduce self-
harm in this population.
Mitchell R, Draper B, Harvey L,
Brodaty H, Close J (2016) The survival
and characteristics of older people
with and without dementia who are
hospitalised following intentional self-
harm. International Journal of Geriatric
Psychiatry. Online at www.ncbi.nlm.
nih.gov/pubmed/27357377.