Are hallucinations and extrapyramidal signs associated with a steeper cognitive decline in degenerative dementia patients?

The aim of this study was to verify if visual hallucinations and extrapyramidal signs are associated with a high speed of cognitive decline in degenerative dementia patients with amnesic onset. The analysis of 1082 consecutive patients showed that hallucinations, but not extrapyramidal signs, were associated with a faster cognitive decline. However, patients with hallucinations were also more severe at the time of examination with the Milan Overall Dementia Assessment (MODA). One interpretation is that hallucinations are the marker of a distinct process of nervous degeneration that specifically causes a steeper cognitive decline from onset. Another interpretation is that the speed of cognitive decline is set along a continuum, and the incidence of hallucinations is simply proportional to the level of cognitive decline. The statistical analysis of our data was consistent with the latter interpretation, in that we were able to quantify the probability of presenting visual hallucinations on the basis of the overall severity of cognitive decline

Legenda Sanctae Clarae Virginis : tratta dal Ms. 338 dalla Bibl. Comunale di Assisi

Prece ao título: Societá Internazionale di studi Francescani in AssisiPortada con escudo xilográfic

Expositio regulae fratrum minorum

Port. con esc. xi

Elderly healthcare house: engaging patients and staff in healing garden design

Objectives. Patient-specific gardens can provide general benefits related to the restorative effects of nature and respond to the specific needs of a particular patient population. These needs are to be considered in the design of outdoor space for healthcare. Our goal was to design a patient-specific garden for elderly people who live in healthcare house or use day center services (RSA Famagosta, Milano). Methods. A participatory design process was used through the organization of focus groups. A focus group is a form of qualitative research in which a group of people are asked about a topic. Focus groups allowed us to study patients, visitors and professionals in a more natural setting than a one-to-one interview. Results. With this approach, users work closely together to create a program that has been implemented by landscape architects to design a patient-specific garden, that includes elements such as different walking surfaces, slopes, steps, parallel bars, differing planter edge heights and plant labels, and other facilities that can be used in rehabilitative activities. Discussion. The participatory process involving designers, clinical staff, patients and family members has been appreciated because the users felt involved in the decision process. After the garden is built, healthcare professionals, designers and researchers will collaborate to discern the therapeutic benefits of this garden

Can theory of mind of healthy older adults living in a nursing home be improved? A randomized controlled trial

Background: Research in nursing homes mainly focused on interventions for residents affected by cognitive decline. Few studies have considered healthy older adults living in nursing homes, and this research targeted cognitive functioning. Aims: To evaluate whether socio-cognitive abilities can be improved by means of a theory of mind (ToM) training conducted by nursing home’s operators. Methods: Results: Results revealed that older adults benefitted from the ToM intervention in both practiced and non-practiced tasks, while the control group showed no change from pre- to post-test evaluation. Analyses on errors scores indicated that the ToM intervention led to a reduction of both excessive mentalizing and absence of mental states inference. Discussion: The conversation-based ToM intervention proved to be effective in improving socio-cognitive skills in cognitively healthy nursing home residents. Notably, older adults were able to transfer the skills acquired during the training to new material. Conclusions: Promoting healthy resident’s ToM ability could positively impact on their social cognition, consequently increasing their quality of life. Our findings showed that the intervention can be feasibly managed by health care assistants within the residential context