Category Archives: Interviews with experts

Guest interviews help readers figure out how to solve care dilemmas.

Can Busy Hands Promote Better Minds?

Researchers in two different parts of the world — India and Finland — have been conducting studies to see if occupational therapy and hands-on hobbies improve quality of life for dementia patients. The group in India studied more male patients. The one in Finland studied women. Both found improved responses among patients who spent time engaged with different hands-on activities.

IMG_1656

Considering these two research projects together, it seems that it can be very beneficial to keep dementia patients busy with activities that involve both their minds and their hands. Here is a laymen’s explanation of this work.

The study in India was led by Prakash Kumar and his colleagues. They used a scale developed by the World Health Organization to complete a Quality of Life Assessment among dementia patients. Then they had a group of participants (80.5% male) engage in a structured program of activities that included:

  • Relaxation for 10 minutes which involved alternately tensing and releasing different group of muscles
  • Physical exercises for 10 minutes aimed at maintaining strength, mobility, circulation and general health
  • Personal activities for 15 minutes which included general care of nails, teeth and hair — and  household tasks such as arranging bed sheets, gardening and counting currency.
  •  Cognitive exercise for 20 minutes included reading,  solving picture puzzles, drawing, and clay color activity
  •  Recreational activity for 10 minutes such as viewing television, playing indoor games, table games, quizzes, Chinese checkers, telling stories, singing, and participating in organized social events.

The researchers wanted patients to do activities that stimulated their physical, functional, behavioral, psychological, and cognitive skills. After five weeks in the program — with two 70 minute sessions per week — patients showed significant improvement in physical performance, sleep quality, and energy for activities of daily living. The Quality of Life surveys also showed that patients had a greater appreciation of life and reduced negative feelings like anxiety and depression.

In the Finnish study, Sinikka Hannele Pöllänen and Reetta Marja Hirsimäki, conducted reminiscence sessions with older women in residential care who had severe symptoms of dementia. These same women enjoyed doing crafts as a leisure activity earlier in their lives. The researchers conducted three reminiscence sessions using different kinds of handicrafts to trigger memories and offer stimulation. Activities that combine several different senses (such as smell, touch, and taste) stimulated verbal reactions, better attention and nonverbal communication among the patients. In this group, the most interesting triggers also succeeded in stimulating the recall of forgotten, pleasing experiences related to doing crafts.

Both of these studies help to make the point that it’s important to try to keep loved ones involved in doing things that combine the work of hands and mind. This isn’t always easy — apathy may make them want to give up before they start. It’s also true that when one is busy cleaning the house, cooking, or doing other essential work, it’s hard to find time to organize an activity for someone with dementia. But if you can make the time, it may be worth the effort to get them involved in a hands-on project that stimulates them during the day, and promotes calmer evenings (and better sleep!) for all.

TBI — A New Term for the Dementia Handbook

Cause and effect are words that haunt us when caring for someone with dementia. Many times I ask myself how my health conscious mom ended up with such an awful disease. Is it genetic or did she suffer an early trauma that we don’t know about? Luckily I’m not the only person asking that question.

Between the Pond and the Woods

New research has been conducted to analyze huge volumes of medical records to see if there’s a connection between Traumatic Brain Injury (TBI) and later development of dementia. The research was carried out by Deborah E. Barnes, PhD, MPH, Allison Kaup, PhD, Katharine A. Kirby, MA, Amy L. Byers, PhD, MPH, Ramon Diaz-Arrastia, MD, PhD and Kristine Yaffe, MD of the University of California at San Francisco. The article describing their study appears in Neurology, the official journal of the American Academy of Neurology. Because they studied patient records and not brain chemistry, their work is easier to understand than many other scientific papers.

Basically, this research team reviewed medical records for 188,764 U.S. veterans who were 55 years of age or older. All patients in the study had at least one inpatient or outpatient visit during the period under review and none had a dementia diagnosis at their first visit.

By examining nearly a decade’s worth of patient records, the researchers tallied the number of veterans who had a diagnosis of Traumatic Brain Injury (TBI) to see if TBI was associated with an increased incidence of dementia.

The research findings provide lots of food for thought. After controlling for the impact of other health factors, TBI in older veterans was associated with a 60% increase in the risk of developing dementia over 9 years.  According to the study’s authors, “TBI in older veterans may predispose toward development of symptomatic dementia”.  The study also raises a host of questions about how to treat TBI in younger veterans and other members of our society who have suffered brain injuries.

For lots of us, these finding won’t resolve the “cause/effect” question. But they give us plenty to think about while living in a society where so many young athletes suffer sports concussions, adults want to ride motorcycles without a helmet, and thousands of young people go off to fight in wars. I’m not suggesting that we cease all of these activities, just that we consider the cost that may be paid by those now suffering preventable pain.