Page 109 - HA Convention 2015
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Service Priorities and Programmes Free Papers

SPP1.6 Patient Empowerment  10:45  Room 221

An Effective Cognitively Active Lifestyle Programme on Cognitive Function Improvement in Elderly with                             Monday, 18 May
Cognitive Impairment
Leung ML, Wong KY, Yim PY
Occupational Therapy Department, United Christian Hospital, Hong Kong

Introduction

Researches showed that lifestyles that combined cognitively stimulating activities, physical activities and rich social context
may provide the best odds of preserving cognitive function in the elders. It was found that cognitive stimulating activities
induce neurogenesis and hippocampal synaptic reactivity, reorganisation of neurocognitive networks and attenuate the
adverse effect of stress hormones and improve executive functioning. Qigong – the Chinese style Mind Body (MB) in cross-
sectional studies has proven protective in preserving memory in older adults. The enhancement of cerebral perfusion,
increased brain volume and enriched environment in socialisation during MB were the proposed mechanism. A Cognitively
Active Lifestyle Programme (CAL) with combination of cognitive stimulating activities and MB (Health Qigong) was developed
to empower patients to develop a cognitively healthy lifestyle, build up cognitive reserve and delay cognitive decline.

Objectives

To investigate the effectiveness of a lifestyle-based intervention programme to the cognitive function of elderly with cognitive
impairment.

Methodology

Elderly screened in Occupational Therapy Department of the United Christian Hospital showing objective evidences of
cognitive impairment and symptoms of mild cognitive impairment or early dementia (Stage three to four of the Functional
Assessment Staging Test) were recruited to CAL. The programme consisted of six weekly one-hour group programme and
daily home programme, including cognitive stimulating worksheet (which served activation of temporal lobe and frontal
cortex function and executive function) and health Qigong practice. Daily log book was used to encourage adherence to the
programme. Pre- and post-treatment assessments with Chinese version Mini-mental State Examination (CMMSE), Verbal
Fluency Test (VFT) and Digit Span Forwards (DSF) were adopted.

Results

25 participants with mean age of 75.6 year had completed the treatment. Mean baseline CMMSE score=23.1, VFT=9.56,
DSF=6.8. Paired-sample T test showed significant improvement in post-treatment CMMSE (24.76, p=.00) and VFT (29.68,
p=.00). The mean score of DSF was improved (7.16). The mean self-rated satisfaction score was 7.96 out of 10. It is
concluded that the CAL programme was effective in promoting cognitive function of elderly with symptoms of mild cognitive
impairment and early dementia and reflected in improvement in CMMSE and VFT. Literature suggested that a stable CMMSE
and VFT scores in two years predicted a 91% chance of maintaining stable cognitive state at five years. Modelling suggested
that if the average onset age could be delayed by five years, incidence would be halved by 2050. Lifestyle intervention as
intervention strategies, like CAL group, may contribute to ease the burden of healthcare system in long run. Longitudinal
follow-up to evaluate the sustaining effect and adherence to home programme is worth for further study.

                                                                                                                                  HOSPITAL AUTHORITY CONVENTION 2015

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