Recruitment of Older Adults With Dementia for Research: An Integrative Review.
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SUBMITTER: Davis R
PROVIDER: S-EPMC10950034 | biostudies-literature | 2022 Sep-Oct
REPOSITORIES: biostudies-literature
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Recruitment of Older Adults With Dementia for Research: An Integrative Review.
Davis Rebecca R Bekker Paige P
Research in gerontological nursing 20220901 5
Recruitment of persons with dementia into research studies is essential to provide evidence for effective care and treatment. However, recruitment is known to be difficult for this population. The current integrative review was undertaken to synthesize evidence surrounding best practices for recruiting older adults with dementia into research. Fourteen studies were identified that examined recruitment strategies for persons with cognitive impairment over a 10-year time period. Most studies were ...[more]
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Project description:BackgroundSocial media tools have provided health researchers with the opportunity to engage with communities and groups in a nonconventional manner to recruit participants for health research. Using social media to advertise research opportunities and recruit participants facilitates accessibility to participants from broad geographical areas and diverse populations. However, little guidance is provided by ethics review boards for researchers to effectively use this recruitment method in their research.ObjectiveThis study sought to explore the literature on the use of social media for participant recruitment for research studies and identify the best practices for recruiting participants using this method.MethodsAn integrative review approach was used to synthesize the literature. A total of 5 health sciences databases, namely, EMBASE (Ovid), MEDLINE (Ovid and EBSCOhost), PsycINFO (Ovid), Scopus (Elsevier), and CINAHL Plus with Full Text (EBSCOhost), were searched using predefined keywords and inclusion and exclusion criteria. The initial search was conducted in October 2020 and was updated in February 2022. Descriptive and content analyses were applied to synthesize the results, and the findings are presented in a narrative and tabular format.ResultsA total of 96 records were included in this review, 83 (86%) from the initial search and 13 (14%) from the updated search. The publication year ranged between 2011 and 2022, with most publications (63/96, 66%) being from the United States. Regarding recruitment strategy, 45% (43/96) of the studies exclusively used social media, whereas 51% (49/96) used social media in conjunction with other strategies. The remaining 4% (4/96) provided guidelines and recommendations for social media recruitment. Notably, 38% (36/96) of these studies involved hard-to-reach populations. The findings also revealed that the use of social media is a cost-effective and efficient strategy for recruiting research participants. Despite the expanded use across different populations, there is limited participation of older adults in social media recruitment.ConclusionsThis review provides important insights into the current use of social media for health research participant recruitment. Ethics boards and research support services in academic institutions are encouraged to explicitly provide researchers with guidelines on the use of social media for health research participant recruitment. A preliminary guideline prepared based on the findings of this review is proposed to spark further development in this area.
| S-EPMC9389385 | biostudies-literature
Project description:BackgroundAddressing eating difficulties among older individuals with dementia living in nursing homes requires evidence-based interventions. However, to date, there is limited evidence of effective interventions designed to maintain and/or increase independent eating. In a field in which evidence is still lacking, a critical analysis of the state of research describing its main features can help identify methodological gaps that future studies should address. Hence, the aim of this study was to map the state of the research designed to maintain and/or promote independent eating in older individuals with dementia living in nursing homes.MethodsA scoping review was performed by following the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Reviews and conceptual analyses performed with different methodological approaches, published in indexed journals, and written in English were included. Keywords Were searched for in the MEDLINE, the Cumulative Index of Nursing and Allied Health, and in the Scopus databases to identify papers published up to 31 May 2018.Results17 reviews were included, assessing interventions' effectiveness (n = 15) and providing conceptual frameworks for eating/mealtime difficulties (n = 2). Conceptual frameworks supporting interventions' effectiveness have rarely been described in available studies. Moreover, interventions tested have been categorized according to non-homogeneous frameworks. Their effectiveness has been measured against (1) eating performance, (2) clinical outcomes, and (3) adverse event occurrence.ConclusionAn increased use of conceptual frameworks in studies, as well as greater clarity in intervention categorization and outcomes, is necessary to enhance the reviews' value in providing useful cumulative knowledge in this field. Interventions delivered should embody different components that integrate individual, social, cultural, and environmental factors, while when evaluating an intervention's effectiveness, eating performance, clinical outcomes and adverse events should be considered. Together with more robust studies, involving clinicians could prove to be useful, as their knowledge of practice developed from direct experience can help develop innovative research questions.
| S-EPMC7171919 | biostudies-literature
Project description:BackgroundPhysical exercise is known to improve the level of activities of daily living and physical function in people with dementia; however, symptoms of dementia often pose challenges when implementing physical therapy. This study aimed to elucidate how physiotherapists (PTs) engage with older adults with dementia to encourage exercise and participation in physical activity.MethodsIn this qualitative study, four PTs working with older adults with dementia in long-term care facilities in Japan were recruited and interviewed. We used a modified grounded theory approach to assess how PTs engaged with older adults with dementia during physiotherapy sessions.ResultsBased on PT responses, five categories of engagement were identified: "make structured preparations for clients to begin physical activity," "link exercise therapy to a client's daily life," "discover changes in daily life," "ascertain cognitive function," and "accommodate client differences." Concepts were derived under each category. The category "make structured preparations for clients to begin physical activity" served as a preceding stage for PTs to engage with older adults with dementia. PTs linked exercise therapy to each client's daily life activities to encourage voluntary participation in daily physical activity. PTs ensured the performance of routine patterns of movement and modified these movement patterns per clients' differing paces.ConclusionPTs provided exercise and movement training based on various degrees of client involvement and made structured preparations for clients to begin physical activity that were linked to exercise therapy. Our findings may prompt PTs to encourage older people with dementia to participate in physical therapy and benefit from exercise.
| S-EPMC10373995 | biostudies-literature
Project description:ObjectiveAging can introduce significant changes in health, cognition, function, social status, and emotional status among older adults affected by cancer. Little is known about how existing nurse-led interventions address the needs of older adults. The objective was to identify existing nurse-led interventions among older adults to optimize recovery and survivorship needs.MethodsA integrative systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 Guidelines. Electronic databases (APA PsycINFO, CINAHL, MEDLINE, Scopus, and Google Scholar databases) were searched using key search terms. Articles were assessed for inclusion according to a pre-determined eligibility criterion. Data extraction and quality appraisal were conducted. Findings were integrated into a narrative synthesis.ResultsTwenty-one studies were included, and a total of 4253 participants were represented. There were a range of study designs: quantitative (n = 10), randomised controlled trials (n = 6), mixed methods studies (n = 3), qualitative (n = 1), and a non-randomized controlled study (n = 1). Most participants had prostate cancer, with some representation in colorectal, lung, head and neck, renal, esophageal, and mixed cancer patient populations.ConclusionsThis review shows a lack of evidence on the inclusion of geriatric assessments for older people with cancer within existing nurse-led interventions. Further research is needed to test nurse-led interventions with the inclusion of geriatric assessments and their contribution to the multidisciplinary team across the cancer care continuum for various cancer patient populations.
| S-EPMC10597832 | biostudies-literature
Project description:Sleep disruption in older adults living with Alzheimer's disease and related dementias (ADRD) is debilitating and contributes to increased institutionalization, reduced cognitive function, and accelerated disease progression. Furthermore, sleep disruption is linked to poor health outcomes in caregivers, such as decreased quality of life and increased caregiver burden. Given the potentially harmful side effects of pharmacologic treatment, nonpharmacologic approaches, such as music, may provide a safer alternative to reducing sleep disruption in this vulnerable population. A growing body of literature suggests that calming tailored music may improve sleep quality in older adults with memory loss, but its efficacy has not been demonstrated in older adults with ADRD in the community, where most older adults with ADRD live. If shown to be feasible and acceptable, tailored music interventions can then be tested for efficacy in reducing sleep disruption. This protocol details a wait-list randomized controlled trial (NCT04157244), the purpose of which is to test the feasibility, acceptability, and examine the preliminary efficacy of a tailored music listening intervention in older adults with ADRD who report sleep disruption. Music selections will be tailored to the music genre preferences of older adults with ADRD and account for known sleep-inducing properties. The feasibility of processes that is key to the success of the subsequent study will be examined. Preliminary efficacy of the intervention will be assessed using objective (actigraphy) and subjective (proxy-reported) sleep quality measures. In addition, qualitative data will be solicited, examining the acceptability and satisfaction with the intervention by individuals with ADRD.
| S-EPMC7945958 | biostudies-literature
Project description:Purpose: People with dementia fall more often than cognitively healthy older adults, but their risk factors are not well understood. A review is needed to determine a fall risk profile for this population. The objective was to critically evaluate the literature and identify the factors associated with fall risk in older adults with dementia. Methods: Articles published between January 1988 and October 2014 in EMBASE, PubMed, PsycINFO, and CINAHL were searched. Inclusion criteria were participants aged 55 years or older with dementia or cognitive impairment, prospective cohort design, detailed fall definition, falls as the primary outcome, and multi-variable regression analysis. Two authors independently reviewed and extracted data on study characteristics, quality assessment, and outcomes. Adjusted risk estimates were extracted from the articles. Results: A total of 17 studies met the inclusion criteria. Risk factors were categorized into demographic, balance, gait, vision, functional status, medications, psychosocial, severity of dementia, and other. Risk factors varied with living setting and were not consistent across all studies within a setting. Conclusion: Falls in older adults with dementia are associated with multiple intrinsic and extrinsic risk factors, some shared with older adults in general and others unique to the disease. Risk factors vary between community- and institution-dwelling samples of adults with dementia or cognitive impairment.
| S-EPMC5435396 | biostudies-literature
Project description:This scoping review aims to describe the range of research studies using arts-based data collection methods with immigrant and racialized older adults. A secondary aim is to identify challenges and strengths of using these approaches with this population. This review uses Arksey and O'Malley's five-stage scoping review framework with a final number of 16 references included for the study. Enhanced social connectedness, increased transparency and quality of findings, and self-empowerment were key strengths of using arts-based approaches for data collection. Challenges identified included resource limitations, cultural and language barriers, and barriers to meaningful engagement. Only a small number of studies have utilized arts-based methods with immigrant and racialized older adults. Arts-based approaches require unique methodological adaptations with this population but have the potential to increase engagement in research activities, authenticity of research findings and empowerment of older adults.
| S-EPMC11379536 | biostudies-literature
Project description:Background/objectivesDementia-friendly initiatives are becoming common in society, politics, and research, including health care. Regarding efforts to improve care for patients with dementia in hospitals, the term dementia-friendly hospital is being used increasingly. However, a theoretical understanding of this term and the underlying concept are missing. This integrative review aims to identify current descriptions of dementia-friendly hospitals and to analyze their characteristics.MethodsAn integrative review was conducted. The databases MEDLINE, CINAHL, PsycInfo, Cochrane Library, and additional resources were searched. Two reviewers independently screened publications for inclusion. We extracted data from the included publications and analyzed the descriptions of dementia-friendly hospitals using inductive content analysis in an iterative process.ResultsWe identified 4191 records and included 34 publications on 17 descriptions of dementia-friendly hospitals. These were found in the context of practice projects (n = 8), recommendations (n = 6) and research (n = 3). Our analysis resulted in six characteristics of dementia-friendly hospitals. Characteristics related to the patients and their care are continuity, person-centeredness, consideration of phenomena within dementia and environment. Additional characteristics are valuing relatives and knowledge and expertise within the hospital.ConclusionDementia-friendly hospitals are currently characterized more by healthcare practices and professional dementia experts than by the results of empirical studies. Additionally, the perspective of people with dementia is underrepresented in current descriptions. Accordingly, further research is needed that involves people with dementia in order to develop a theoretical understanding and suitable concepts of dementia-friendly hospitals, since their perspective is essential.
| S-EPMC9158310 | biostudies-literature
Project description:BACKGROUND:Ecological momentary assessment is a method of investigating individuals' real-time experiences, behaviors, and moods in their natural environment over time. Despite its general usability and clinical value for evaluating daily depressive mood, there are several methodological challenges when applying ecological momentary assessment to older adults. OBJECTIVE:The aims of this integrative literature review were to examine possible uses of the ecological momentary assessment methodology with older adults and to suggest strategies to increase the feasibility of its application in geriatric depression research and practice. METHODS:We searched 4 electronic databases (MEDLINE, CINAHL, PsycINFO, and EMBASE) and gray literature; we also hand searched the retrieved articles' references. We limited all database searches to articles published in peer-reviewed journals from 2009 to 2019. Search terms were "ecological momentary assessment," "smartphone assessment," "real time assessment," "electronic daily diary," "mHealth momentary assessment," "mobile-based app," and "experience sampling method," combined with the relevant terms of depression. We included any studies that enrolled older adults even as a subgroup and that reported depressive mood at least once a day for more than 2 days. RESULTS:Of the 38 studies that met the inclusion criteria, only 1 study enrolled adults aged 65 years or older as the entire sample; the remainder of the reviewed studies used mixed samples of both younger and older adults. Most of the analyzed studies (18/38, 47%) were quantitative, exploratory (descriptive, correlational, and predictive), and cohort in design. Ecological momentary assessment was used to describe the fluctuating pattern of participants' depressive moods primarily and to examine the correlation between mood patterns and other health outcomes as a concurrent symptom. We found 3 key methodological issues: (1) heterogeneity in study design and protocol, (2) issues with definitions of dropout and adherence, and (3) variation in how depressive symptoms were measured with ecological momentary assessment. Some studies (8/38, 21%) examined the age difference of participants with respect to dropout or poor compliance rate. Detailed participant burden was reported, such as technical problems, aging-related health problems, or discomfort while using the device. CONCLUSIONS:Ecological momentary assessment has been used for comprehensive assessment of multiple mental health indicators in relation to depressive mood. Our findings provide methodological considerations for further studies that may be implemented using ecological momentary assessment to assess daily depressive mood in older adults. Conducting more feasibility studies focusing on older adults with standardized data collection protocols and mixed-methods research is required to reflect users' experiences. Further telepsychiatric evaluation and diagnosis based on ecological momentary assessment data should involve standardized and sophisticated strategies to maximize the potential of ecological momentary assessment for older adults with depression in the community setting.
| S-EPMC7298638 | biostudies-literature
Project description:ImportanceSedentary behavior is associated with cardiometabolic disease and mortality, but its association with dementia is unclear.ObjectiveTo investigate whether accelerometer-assessed sedentary behavior is associated with incident dementia.Design, setting, and participantsA retrospective study of prospectively collected data from the UK Biobank including 49 841 adults aged 60 years or older without a diagnosis of dementia at the time of wearing the wrist accelerometer and living in England, Scotland, or Wales. Follow-up began at the time of wearing the accelerometer (February 2013 to December 2015) and continued until September 2021 in England, July 2021 in Scotland, and February 2018 in Wales.ExposuresMean daily sedentary behavior time (included in the primary analysis) and mean daily sedentary bout length, maximum daily sedentary bout length, and mean number of daily sedentary bouts (included in the secondary analyses) were derived from a machine learning-based analysis of 1 week of wrist-worn accelerometer data.Main outcome and measuresIncident all-cause dementia diagnosis from inpatient hospital records and death registry data. Cox proportional hazard models with linear and cubic spline terms were used to assess associations.ResultsA total of 49 841 older adults (mean age, 67.19 [SD, 4.29] years; 54.7% were female) were followed up for a mean of 6.72 years (SD, 0.95 years). During this time, 414 individuals were diagnosed with incident all-cause dementia. In the fully adjusted models, there was a significant nonlinear association between time spent in sedentary behavior and incident dementia. Relative to a median of 9.27 hours/d for sedentary behavior, the hazard ratios (HRs) for dementia were 1.08 (95% CI, 1.04-1.12, P < .001) for 10 hours/d, 1.63 (95% CI, 1.35-1.97, P < .001) for 12 hours/d, and 3.21 (95% CI, 2.05-5.04, P < .001) for 15 hours/d. The adjusted incidence rate of dementia per 1000 person-years was 7.49 (95% CI, 7.48-7.49) for 9.27 hours/d of sedentary behavior, 8.06 (95% CI, 7.76-8.36) for 10 hours/d, 12.00 (95% CI, 10.00-14.36) for 12 hours/d, and 22.74 (95% CI, 14.92-34.11) for 15 hours/d. Mean daily sedentary bout length (HR, 1.53 [95% CI, 1.03-2.27], P = .04 and 0.65 [95% CI, 0.04-1.57] more dementia cases per 1000 person-years for a 1-hour increase from the mean of 0.48 hours) and maximum daily sedentary bout length (HR, 1.15 [95% CI, 1.02-1.31], P = .02 and 0.19 [95% CI, 0.02-0.38] more dementia cases per 1000 person-years for a 1-hour increase from the mean of 1.95 hours) were significantly associated with higher risk of incident dementia. The number of sedentary bouts per day was not associated with higher risk of incident dementia (HR, 1.00 [95% CI, 0.99-1.01], P = .89). In the sensitivity analyses, after adjustment for time spent in sedentary behavior, the mean daily sedentary bout length and the maximum daily sedentary bout length were no longer significantly associated with incident dementia.Conclusions and relevanceAmong older adults, more time spent in sedentary behaviors was significantly associated with higher incidence of all-cause dementia. Future research is needed to determine whether the association between sedentary behavior and risk of dementia is causal.
| S-EPMC10498332 | biostudies-literature