Musiquence – Design, Implementation and Validation of a Customizable Music and Reminiscence Cognitive Stimulation Platform for People with Dementia

Dementia is a neurodegenerative disease that affects millions of individuals worldwide and is challenging to diagnose as symptoms may only perceivable decades later. The disease leads to a gradual loss of memory, learning, orientation, language, and comprehension skills, which compromises activities of daily living. Health-related costs caused by dementia will continue to increase over the next few years; between the years 2005 and 2009, an increase of 34% (from $315 to$422 billion worldwide) was observed in treating dementia-related issues. Pharmaceutical approaches have been developed to treat dementia symptoms; unfortunately, the risk of side effects is high. For this reason, nonpharmaceutical methods such as music and reminiscence therapies have gained acceptance as patients with dementia positively respond to such approaches even at later stages of the disease. Nevertheless, further research is needed to understand how music and reminiscence therapy should be used and to quantify their impact on individuals with dementia. The development of serious games has gained attention as an alternative approach to stimulate patients. However, the clinical impact that serious games have on individuals with dementia is still unclear. In this dissertation, we contribute with new knowledge regarding the usage of music and reminiscence approaches in people with dementia through a theoretical model. Based on Baddeley’s working memory model, our model aims to explain how the therapeutic properties of music and reminiscence can have a beneficial effect. To test our model, we developed a novel interactive platform called Musiquence, in which healthcare professionals can create music and reminiscence based cognitive activities to stimulate people with dementia. In this dissertation, we present the results from several studies about the usage and effects that music and reminiscence have on such a population. We performed two studies using Musiquence to study the feasibility of a novel learning method based on musical feedback to aid people with dementia during task performance in virtual reality settings. Results show that participants relied more on music-based feedback during the task performance of virtual reality activities than in other forms of feedback. Also, data suggest that the music-based feedback system can improve task performance, compensating for some dementia-related deficits. We also used Musiquence in a longitudinal one-month-long pilot study to assess its efficacy when used for a cognitive stimulation intervention in dementia patients. The results of the study are promising. The 3 participants showed improvements in terms of general cognition, quality of life, mood, and verbal fluency

Customizing a cognitive stimulation program for individuals with dementia through a participatory design approach

Background: Different intervention strategies, such as reminiscence and music-based therapies, effectively mitigate the cognitive decline of individuals with dementia (IwD). An important challenge when implementing these approaches lies in the need for content customization. We de signed Musiquence platform, a framework that allows the customization of music and reminiscence content in cognitive stimulation activities. (2) Methods: Here, we present a participatory design methodology for designing a seven-week customized cognitive stimulation program (CCSP) for IwD using Musiquence. We ran focus groups with 19 formal caregivers, who provided information regarding themes and music to be used in activities for IwD, and gathered preferences from 20 IwD. (3) Results: The CCSP consists of seven cycles of tasks combining the activities available in Musiquence, the seven preferential themes of IwD, and the seven songs most frequently referenced by formal caregivers. (4) Conclusions: Finally, we provide a set of guidelines to implement a participatory design approach for content development together with IwD.info:eu-repo/semantics/publishedVersio

Feasibility, Acceptability, and Preliminary Impact of Full-Body Interaction on Computerized Cognitive Training Based on Instrumental Activities of Daily Living: A Pilot Randomized Controlled Trial with Chronic Psychiatric Inpatients

Objective: To conduct a pilot randomized control trial to assess the feasibility and acceptability of full-body interaction cognitive training (FBI-CT) inspired by instrumental activities of daily living in chronic psychiatric inpatients and to explore its preliminary impact on cognitive and noncognitive outcomes. Materials and Methods: Twenty psychiatric inpatients met the inclusion criteria and were randomly allocated to the FBI-CT group (n = 10) or the tablet-based CT group (T-CT) (n = 10). Neuropsychological assessments were performed at baseline, postintervention, and 3-month follow-up. Results: Both groups presented high completion rates at postintervention and follow-up. Participants reported high satisfaction following the interventions, with the FBI-CT group exhibiting slightly higher satisfaction. A within-group analysis showed significant improvements in the FBI-CT group for processing speed and sustained attention for short periods (P = 0.012), verbal memory (P = 0.008), semantic fluency (P = 0.027), depressive symptoms (P = 0.008), and quality of life (P = 0.008) at postintervention. At 3-month follow-up, this group maintained verbal memory improvements (P = 0.047) and depressive symptoms amelioration (P = 0.026). The T-CT group revealed significant improvements in sustained attention for long periods (P = 0.020), verbal memory (P = 0.014), and executive functions (P = 0.047) postintervention. A between-group analysis demon strated that the FBI-CT group exhibited greater improvements in depressive symptoms (P = 0.042). Conclusions: Overall, we found support for the feasibility and acceptability of both training approaches. Our findings show promise regarding the preliminary impact of the FBI-CT intervention, but due to study limitations such as the small sample size, we cannot conclude that FBI-CT is a more effective approach than T-CT for enhancing cognitive and noncognitive outcomes of chronic psychiatric inpatients. Clinical trials (number: NCT05100849).info:eu-repo/semantics/publishedVersio