Although cognitive rehabilitation is not a new field of intervention, as it dates back to the treatment of brain-injured soldiers during World War I, the use of cognitive rehabilitation intervention therapies for individuals with dementia and mild cognitive impairment has yet to draw definite conclusions about its effectiveness. Based on the conceptual framework of biopsychosocial theoretical model, this study explored to what extend cognitive rehabilitation intervention was effective in improving the memory and mood functioning of elderly adults with mild cognitive impairments. An archived data set of 216 elderly adults collected at a midwestern agency in the United States during the period of May 2012 through December 2013 was used. Wilcoxon matched pair tests were used to assess elders' changes in memory and mood functioning. Results indicated that there were no significant changes in memory skills or mood functioning found after the elderly individuals participated in the cognitive rehabilitation program within the 18-month period of continuous intervention training. Several limitations could explain these results including a small sample size of 88 participants that finished the 18-month program; the quality of the assessment process; and the lack of further information on the archived data such as demographics, patients' medication regimen, or type of family support. Health care professionals, families, and caretakers may use these results to understand the importance of closely monitoring the training and checking for positive results and adjusting the intervention as needed. Results of the study also highlighted the importance of focusing on promoting a take-charge collaborative approach to awareness and life satisfaction which is a salient implication for positive social change.

Indiana University-Purdue University Indianapolis (IUPUI) / Only one third of older breast cancer survivors (BCS) meet national physical activity (PA) guidelines. Theories of self-regulation and research with older adults suggest that executive function (EF) plays an important role in PA, yet the impact of lower EF on older survivors’ PA is unknown. My project addressed this gap using secondary data from the Thinking and Living with Cancer (TLC) cohort study, which examined cognitive function among older BCS pre-treatment, followed every 12 months, and contemporaneously assessed matched controls. My first aim was to test two hypotheses regarding EF change and PA and determine if these relationships differ between BCS and controls. My hypotheses were: 1) EF decline from baseline to 12 months will predict lower PA at 24 months, and 2) lower PA at 12 months will predict EF decline from 12 to 24 months. My second aim was to explore whether the effects of EF change on PA in BCS differed based on risk factors for accelerated cognitive decline (i.e., older age, more advanced cancer stage, comorbidity, and APOE ε4 genotype). The TLC study measured EF with neuropsychological tests and PA with the International Physical Activity Questionnaire-Short Form. For aims 1 and 2, I used multiple regression with multiple imputation. Primary results showed no significant effect of EF change from baseline to 12 months on PA at 24 months (β=-0.01, p=0.88) and no significant group (BCS vs. controls) by EF interaction (β=-0.05, p=0.33). Separate models in BCS and controls showed similar findings. In the entire sample, PA at 12 months significantly predicted EF change from 12 to 24 months (β=0.17, p=0.01), but there was no significant group by PA interaction (β=-0.06, p=0.54). Separate analyses by group found a significant effect of PA for controls (β=0.07, p=0.02), but not for BCS (β=0.05, p=0.27). Regarding the second aim, there were no significant interactions between EF change and the proposed risk factors on PA. Findings were largely inconsistent with theory and prior research. Continued research in this area will inform future exercise interventions to improve physical and cognitive health for the growing population of older cancer survivors.

Bakgrund: Den största risken för att drabbas av en demenssjukdom idag är hög ålder. Inom de närmsta tio åren beräknas andelen äldre att öka och de äldre äldre, alltså personer över 80år, att öka med upp till 50%. Uppskattningsvis drabbas 90% av de som har en demenssjukdom någon gång under sjukdomsförloppet av BPSD-symtom. Dessutom är det vanligare att äldre personer har kronisk smärta än hos övriga befolkningen, och förekomsten av smärta ökar ytterligare bland personer som bor på särskilt boende. Tidigare studier visar att äldre personer tenderar att vara underbehandlade vad gäller smärta och att smärta kan förvärra BPSD hos äldre personer med kognitiv svikt. Motiv: Motivet för studien är att öka förståelsen och kunskapen för vad som kännetecknar smärta hos äldre personer med kognitiv svikt. Få tidigare studier belyser sambandet mellan smärta och BPSD- symtom, om sambandet ser annorlunda ut vid olika grader av kognitiv svikt eller om det skiljer sig åt mellan exempelvis män och kvinnor. Syfte: Syftet med den här studien är att undersöka sambandet mellan smärta och BPSD hos äldre personer med kognitiv svikt som bor på särskilt boende Metod: Studien är en kvantitativ tvärsnitsstudie som bygger på tidigare insamlad data, AC-studien som genomfördes 2013 i Västerbottens län. Resultat: Resultatet i studien visar att det finns signifikanta samband mellan smärta och BPSD hos personer äldre personer med kognitiv svikt. Resultatet visar även att oberoende av andra faktorer kan smärta associeras med sömnstörning, depressivitet, regressivt olämpligt beteende samt kvinnligt kön.  Konklusion: Sambanden mellan smärta och BPSD behöver utforskas mer, företrädesvis med en annan design än denna studie för att fullt ut kunna förklara hur sambandet ser ut. Det behövs även ökad kunskap om hur smärta bedöms, utvärderas och behandlas samt hur smärta kan komma till uttryck hos personer med demenssjukdom. / Background: The greatest risk of developing dementia today is old age. Within the next ten years people over the age of 80 is expected to increase by 50%. It is estimated that 90% of those who have dementia at some point during the course of the disease suffer from BPSD symptoms. In addition, it’s more common for older people to have chronic pain than in the rest of the population, and the incidence of pain increases further among people living in nursing homes. Previous studies show that older people tend to be undertreated in terms of pain and that pain can worsen BPSD in older people with cognitive impairment. Motive: The motive of this study is to contribute to an increased understanding in how pain is characterized in the elderly with cognitive impairment. Few previous studies shed light the relationship between pain and BSPD and if there are differences according to the degrees of cognitive impairment or gender. Aim: The aim of this study is to investigate the relationship between pain and BPSD in elderly people with cognitive impairment living in nursing homes. Methods: This is a quantitative cross-sectional study based on previously collected data, the AC study conducted in 2013 in Västerbotten County. Result: The results of the study show that there is a significant association between pain and BPSD in elderly people with cognitive impairment. The results also show that, independent of other factors, pain can be associated with sleep disorders, depression, regressively inappropriate behaviour and gender. Conclusion: Relationships between pain and BPSD needs to be explored further, preferably with a different design, in order to fully explain the relationship. There is also a need for increased knowledge about how pain is assessed, evaluated and treated and how the pain can be expressed in people with dementia.

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Persons with traumatic brain injuries (TBI) who have engaged in problematic or illegal sexual behavior present with complex assessment and intervention needs yet remain understudied within the empirical literature. In the current exploratory analysis, important differences in adaptive and clinical functioning, adverse childhood experiences, and criminal offense history are examined in 25 persons with previous brain injury, 118 persons with intellectual disability but no known TBI, and 103 persons with no history of brain injury or intellectual disability, all of whom have engaged in problematic sexual behavior and who were residing in secure forensic inpatient care. Group differences were examined using comparisons of means and chi-squares. Results highlight important differences in education and employment experiences, diagnostic presentation, exposure to childhood maltreatment, and justice system involvement and characteristics of their sexual offense victims. Associations with prior literature and future research directions are discussed.

Abstract: Introduction: Cerebral palsy (CP) in children can severely affect balance, movement and posture (Vitrikas et al., 2020). Children with CP seem to participate less in personal care and hygiene, home and school tasks. Participating in everyday life activities is fundamental for every person and seem to be important for independence (Parkes et al., 2010). Occupational therapy aims to provide engagement in activities of daily living and meaningful occupations (Soderback, 2009). Aim: The aim of this review is to identify intervention methods that facilitate activities of daily living for children with cerebral palsy. Method: For this scoping review three databases were used for data extraction: Cinahl, Pubmed and Psycinfo. All steps by the Johanna Briggs Institute (JBI) manual, were followed. Results: Seven interventions were proposed. Those were either activity focused or function focused. The methods were active vestibular intervention, goal-oriented program, group-task oriented program, constrained-Induced movement therapy, virtual reality intervention, “regular” occupational therapy program and Hand Arm Intensive Therapy (HABIT). Conclusions: Different interventions seemed appropriate for facilitation of daily activities for children with CP. In each intervention different assessment scales were used to measure outcomes and this may give an unclear view of which might be the most effective for this population.