Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Ng TC, Chen Y, Hsueh HMH, Ko WMD, Yuen WH, Cham KY, Li HL, Fung WSA
Affiliation :
Department of Psychiatry, Queen Mary Hospital, Hospital Authority
Introduction :
Dementia intervenes in one’s ability to perform daily activities as it contributes to the progressive decline of cognitive and motor functions, and psychological and behavioural problems (American Psychiatric Association, 2013). A meta-analysis of 96 studies estimated that there were 0.07 million people aged 65 or above in Hong Kong, with a prevalence of 7.2%, outweighing China (5.3%) and Taiwan (6.0%) (Wu et al., 2018). The progressive cognitive decline could lead to loss of independence, reduced quality of life, increased care burden, and long-term care costs (Arvanitakis et al., 2019). A meta‐analysis included 5897 individuals with dementia from 20 studies concluded that the apathy symptoms (43-59%), depression and anxiety (38-41%) were highly prevalent across dementia stages (Leung et al., 2021). Institutionalization often results as higher levels of care are required, posing substantial costs to individuals, families, and healthcare systems. This led to calls for interventions.
Objectives :
(1)To evaluate the effectiveness of exergaming on cognitive function among older adults with dementia. (2)To evaluate the effectiveness of exergaming on depressive, anxiety, and stress symptoms among older adults with dementia. (3)To assess the client’s satisfaction and adherence to the programme.
Methodology :
A quasi-experimental design would be adopted in the project. Patient who are age ≥ 65, diagnosed with dementia, and HK-MoCA ranged from ≥4 and ≤25 (MCI cut off) (Roalf et al., 2013; Toots et al., 2017) were included for exergaming intervention. Assessments of HK-MoCA and DASS would be conducted by independent nurses at pre-test and post-test. When participants finished all sessions, they needed to complete the post-test of DASS, HK-MoCA (alternate versions), and the satisfaction questionnaire. A comparison of the mean scores from the pre-test and post-test data after 18 sessions would be conducted. This would involve calculating the differences in mean scores between the two sets of data to determine the extent of change resulting from the intervention. Written consent was required to assure voluntary participation (see attachment C). The details of the programme were fully disclosed through an information sheet (see attachment D) and a leaflet (see attachment E).
Result & Outcome :
The primary outcomes were cognitive functions and psychological outcomes. Cognitive functions were measured by Hong Kong Version of Montréal Cognitive Assessment (HK-MoCA) and psychological outcomes were measured by Depression Anxiety Stress Scale (DASS-21). The secondary outcome were client’s satisfaction and adherence to the programme which were measured by the attendance record (see attachment A) and satisfaction questionnaire (see attachment B). Eight participants were analysed. The comparison of pre-test and post-test scores for the HK-MoCA showed that six out of eight participants showed improvements in the test. The mean score of HK-MoCA showed improvements from 13.25 to 16.25. The pre-test and post test scores for the DASS also showed improvement in depression, anxiety, and stress among the participants. In the depression aspect, the differences between mean scores decreased 11.75 (75.8%). In the anxiety aspect showed a decreased mean score of 6.5 (72.2%), while the mean scores of stress aspect decreased by 5.5 (47.8%). The satisfaction questionnaire revealed that all participants enjoyed playing Nintendo Switch games. They were able to handle the challenging with ease after receiving instructions from the facilitator, and expressed a willingness to continue playing Switch games for exercise purposes after their discharge (see Attachment F).
