Browsing by Author "Li, Polly W. C."
Now showing 1 - 5 of 5
Results Per Page
Sort Options
Item Can visual art therapy be implemented with illiterate older adults with mild cognitive impairment? A pilot mixed-method randomized controlled trial(SAGE, 2020) Masika, Golden M.; Yu, Doris S.F.; Li, Polly W. C.Older adults with mild cognitive impairment (MCI) with no literacy are at increased risk of progression to dementia. Whether it is feasible to engage this population in visual art therapy (VAT) and yield effects on cognition and depression remained unclear. A pilot mixed-method single-blinded randomized controlled trial was conducted in a sample of community-dwelling older adults with MCI. The experimental group (n = 21) was assigned to 12 sessions of VAT over 6 weeks, and the control group (n = 18) was assigned to 6 weekly health education (HE) on nonbrain health topics. Participants were evaluated at baseline using Montreal Cognitive Assessment–5-minute protocol (MoCA-5-min) and Geriatric Depression Scale Short Form (GDS-SF). A focus group discussion (FGD) was also conducted to the experimental group to explore their experiences of participating in the VAT. Findings indicated that both VAT and HE groups had significant improvement in MoCA-5-min scores and depressed mood over time; however, the significant group × time interaction effect was noted only for the psychological outcome. Findings from the FGD indicated that participants had challenging experiences at the beginning of the therapy, but later, they were able to cope and found that the VAT was relevant and beneficial for their cognitive and psychosocial health. This pilot study provided initial evidence about the potential benefit of VAT in improving cognitive and psychological well-being of older adults with MCI and low literacy and provided insights on how to better engage them in this cognitive stimulating intervention. A full-scale trial is recommended for a stringent evaluation.Item Montreal cognitive assessment 5‐minute protocol is accurate in screening for mild cognitive impairment in the rural African population, neuropsychology: cognitive and functional assessment in diverse populations(Alzheimer's Association Publication, 2020) Masika, Golden Mwakibo; Wong, Adrian; Lin, Rose S.Y.; Lee, Diana T. F.; Yu, Doris S. F.; Li, Polly W. C.The prevalence of dementia in Tanzania, as in other developing countries is progressively increasing.1 Yet the screening instruments for the pre‐clinical stage of the diseases are lacking. This study examined the diagnostic accuracy of the Montreal Cognitive Assessment‐5‐minutes protocol (MoCA‐5‐min) among older adult in the rural Tanzania. After cultural adaptation following Brislins approach,2 the MoCA‐5‐min and the IDEA cognitive screening were concurrently administered to community‐dwelling older adults (n=202) in Chamwino district and 40 re‐evaluated at 6 weeks. Exploratory factor analysis (EFA) using principal component method and oblique rotation was performed to determine the underlying factor structure of the scale. The concurrent and the diagnostic accuracy of the MoCA‐5‐min were examined by comparing its score with IDEA cognitive screening and the psychiatrist’s diagnosis using DSM‐V criteria respectively. The EFA found that all the MoCA‐5‐min items highly loaded into one component, with factor loading ranging from 0.550 to 0.879. The intraclass correlation coefficient for 6 weeks test‐retest reliability was 0.85. Its strong significant correlation with the IDEA screening (Pearson's r = 0.614, p < 0.001) demonstrated a good concurrent validity. Using the psychiatrists rating as a gold standard, the area under the curve (AUC) was 0.861, (95% CI = 0.799 – 0.922) (Figure 1). With the optimal cut‐off score for MCI at 22, the sensitivity was 80% and specificity was 74%. As for dementia, at a score of 16 the sensitivity was 90% and specificity was 80%, whereas the AUC was 0.910, (95%CI = 0.852 – 0.967) (Figure 2). Upon stratifying the sample into different age groups, the optimal cut‐off scores tended to decrease with the increase in age (Table 1). The MoCA‐5‐min is reliable and provides a valid and accurate measure of cognitive decline among older population in the rural settings of Tanzania. The use of varying cut‐off scores across age groups may ensure a more precise discriminatory power of the MoCA‐5‐min.Item P2‐452: Applicability of the kiswahili version of montreal cognitive assessment among older adults with very little and no education in rural Tanzania: a validation survey(Alzheimer's Association Publication, 2019) Masika, Golden Mwakibo; Yu, Doris S. F.; Li, Polly W. C.The incidence of dementia in the low and middle‐income countries, particularly sub‐Saharan Africa is rising [1,2]. The Montreal Cognitive Assessment (MoCA) has been widely used to screen for pre‐clinical and clinical stage of this dementia. However, its use in Tanzania is very limited. The aim of this study was to investigate the applicability and psychometrics of the Kiswahili version of MoCA (K‐MoCA) among older adult in the rural Tanzania. The K‐MoCA was administered to 259 community living older adults in Chamwino district, together with the IDEA cognitive screening, IDEA‐Instrumental Activities of Daily Living, and Mental Health Inventory as referencing instruments to examine its concurrent and construct validity. The IDEA was a more validated cognitive test for the Tanzanian population [3]. A subsample (n = 86) were diagnosed by a psychiatrist as 19 having normal cognition, 42 having MCI and 25 having dementia for examining its sensitivity and specificity. The reliability, and correlation of the K‐MoCA with IDEA cognitive screen were also investigated. K‐MoCA demonstrated an acceptable reliability (Cronbach alpha= 0.78) and was significantly correlated with the IDEA cognitive screen (r = 0.651, p < 0.001). Referencing to IDEA scores and psychiatrist rating, the K‐MoCA total and the domain scores except abstraction and delayed recall, were significantly different between subjects with normal cognition, MCI and dementia; which indicated satisfactory discriminant validity (Table 1). Table 2 shows the construct validity of K‐MoCA where the cognitive scores converges with the predicted relationship with age, education and instrumental ADL ability. However, the screening ability (Figure 1 and Figure 2), using the psychiatrist's rating as the golden standard, Receiver Operating Curve analysis, indicated that the recommended cut‐off scores of 26 and 18 did not give acceptable specificities for detecting MCI (Sensitivity: 92%; specificity: 11) and dementia (Sensitivity: 92%; specificity: 55) respectively. The results may be related to the fact that some of the items were less culturally relevant to the Tanzanian population. Overall, the utility of K‐MoCA for detecting MCI and dementia in this population was low due to less cultural relevance of some items. Modification to those items are recommended to improve its utility. its utilityItem Visual art therapy as a treatment option for cognitive decline among older adults: a systematic review and meta‐analysis(John Wiley & Sons, Inc, 2020) Masika, Golden M.; Yu, Doris S. F.; Li, Polly W. C.To investigate the effects of visual art therapy (VAT) on cognitive and psychological outcomes and explore the crucial design characteristics of VAT that might be associated with greater cognitive benefits among older adults. Systematic review and meta‐analysis. Peer reviewed articles were searched from Medline, EMBASE, Global Health, Cochrane Library, Ovid Nursing database, PsycINFO, British Nursing Index, and CINAHL Complete from inception of the databases to September 2019. This review and meta‐analysis was conducted and reported according to preferred reporting items for systematic reviews and meta‐analyses guidelines. The Cochrane risk of bias tool was used to examine the risk of bias of the studies. Narrative synthesis and quantitative meta‐analysis were performed. Twelve articles published between 2004–2019 involving 831 participants were identified. VAT significantly improved global cognitive function compared with different control groups (Hedges' g = 0.348 [95% CI = 0.026–0.671], p = .034, I2 = 66.570%). VAT also demonstrated psychological benefits in reducing depressive symptoms and anxiety. By systematic comparison of the intervention designs, it seems that those with greater cognitive benefit involved a higher level of creativity and optimized the use of essential components including art education, reminiscence, art processing, cognitive evaluation, art crafts/modelling, and socialization. Visual art therapy could be effective in improving cognitive functions and the associated psychological symptoms. Therefore, it can be adopted as an effective non‐pharmacological intervention for preventing cognitive decline and dementia. This review answers the key question about the pooled effect of VAT as nonpharmacological therapy on preventing or managing dementia. In addition, it informs on the design characteristics of an effective VAT for implementing among older adults. This research will have an impact on the gerontological care and support the evidence about non‐pharmacological approaches to prevent and manage dementia.Item Visual art therapy as a treatment option for cognitive decline among older adults: a systematic review and meta‐analysis(Wiley, 2020) Masika, Golden M.; Yu, Doris S. F.; Li, Polly W. C.Aims: To investigate the effects of visual art therapy (VAT) on cognitive and psychological outcomes and explore the crucial design characteristics of VAT that might be associated with greater cognitive benefits among older adults. Design: Systematic review and meta‐analysis. Data sources: Peer reviewed articles were searched from Medline, EMBASE, Global Health, Cochrane Library, Ovid Nursing database, PsycINFO, British Nursing Index, and CINAHL Complete from inception of the databases to September 2019. Review methods: This review and meta‐analysis was conducted and reported according to preferred reporting items for systematic reviews and meta‐analyses guidelines. The Cochrane risk of bias tool was used to examine the risk of bias of the studies. Narrative synthesis and quantitative meta‐analysis were performed. Result: Twelve articles published between 2004–2019 involving 831 participants were identified. VAT significantly improved global cognitive function compared with different control groups (Hedges' g = 0.348 [95% CI = 0.026–0.671], p = .034, I2 = 66.570%). VAT also demonstrated psychological benefits in reducing depressive symptoms and anxiety. By systematic comparison of the intervention designs, it seems that those with greater cognitive benefit involved a higher level of creativity and optimized the use of essential components including art education, reminiscence, art processing, cognitive evaluation, art crafts/modelling, and socialization. Conclusion: Visual art therapy could be effective in improving cognitive functions and the associated psychological symptoms. Therefore, it can be adopted as an effective non‐pharmacological intervention for preventing cognitive decline and dementia. Impact: This review answers the key question about the pooled effect of VAT as nonpharmacological therapy on preventing or managing dementia. In addition, it informs on the design characteristics of an effective VAT for implementing among older adults. This research will have an impact on the gerontological care and support the evidence about non‐pharmacological approaches to prevent and manage dementia.