Efficacy and Feasibility of a Conceptual Art Pilot Program for Community dwelling Seniors

Transcription

1 Efficacy and Feasibility of a Conceptual Art Pilot Program for Community dwelling Seniors Colette Brown, Andrea Chirino, Cristina Cortez Partners in Research & Outreach for Health (PRO Health) Lab at California State University, Long Beach Building a Network Neurons = Axons + synapses Brain plasticity: Soft t shirt connections = adaptable neural networks (resilient, can compensate for loss) Hardened connections = rigid neural networks (cannot repair/adapt) Plasticity & Cognitive Health Targeting plasticity as the goal of many non pharmacological interventions for normal, mild MCI, & early stage AD (Herholz, Herholz, & Herholz, 2013; Wan & Schlaug, 2010). Cognitive training Music Physical activity Cognitive Reserve theory of neurological resilience (Stern, 2013; Valenzuela, 2011), can be strengthened through: Educational attainment Job complexity Intellectual leisure activities 1

2 Dementia Risk & Protective Factors Better Cognitive Functioning Executive Function Cognitive Flexibility Cognitive Reserve Physically & Cognitively Stimulating Activities Reduced Dementia Risk or Slowed Progression Art & Dementia Emotional and behavioral benefits post onset (Cowl & Gaugler, 2014) Lack of research on cognitive impacts of art with normal adults, and protective factors Labeled as therapy (Brown, 2012) Expressive emphases Expressionism Conceptualism cognitive CRITICAL THINKING PROBLEM SOLVING idea discussion 2

3 Current Study: Aims o o Develop a cognitive health intervention that uses Conceptual art and is tailored for seniors. Evaluate whether healthy older adults who participate in an art based cognitive health program will show improvements in cognitive functioning and wellbeing. Sample Curriculum EXAMPLES OF CLASS PROJECTS Building a Network (T shirt activity) Used to demonstrate compensatory brain plasticity. Yvonne Rainer (Movement Project) Used to promote body awareness and expand perceptions of mobility. Sol Lewitt (Instructions Project) Used to demonstrate and practice flexibility of communication. Marcel Duchamp (Take Home Activity) Used to practice cognitive flexibility. Eligibility Criteria Participants must: Be 60 years old Speak English or Spanish Available to participate in a 12 week long program at Centro Salud es Cultura Be considered cognitively normal (as measured through Mini Cog and self reported medical history) 3

4 Participant Demographics Sample Size n=17 Ages years old (M=72.11 years, SD=7.35) Gender 16 women (94%), 1 man (6%) Ethnicities Marital Status 38.9% Caucasian, 29% African-American, 33.3% Latina 44% married, 66% widowed or divorced Annual Income 83% Less than $25,000 Living alone 50% yes Research Design & Study Timeline Cognitive Assessment Psychosocial Assessment Resources Scale Baseline Program Implementation The Mind is a Muscle II a 12 week cognitive health program using: art based strategies & participatory methods Cognitive Assessment Psychosocial Assessment Qualitative interviews 12 Weeks and Post Intervention Overview of Measures Cognitive Assessment Trail Making Test (TMT) Trail A attention Trail B executive function Trails B A (ΔTMT) cognitive flexibility Cognitive Reserve Scale (CRS) Measures frequency of participation of brain stimulating activities across the lifespan Linked to development of Cognitive Reserve (brain s ability to compensate for decline via neuroplasticity). Cognitive Flexibility Scale (CFS) Ability to shift perceptions and responses in a given situation (e.g.) I can find workable solutions to seemingly unsolvable problems. 4

5 Overview of Measures Psychosocial Assessment Satisfaction With Life Scale (SWLS) Global life satisfaction (e.g.) So far I have gotten the important things I want in life. Personal Health Questionnaire (PHQ 8) Depressive symptoms (e.g.) How often during the past 2 weeks: Feeling bad about yourself, or that you are a failure, or have let yourself or your family down Measures: Qualitative Interviews Semi structured questions: Likes/dislikes? Personal changes experienced? Applied what you learned? Memorable experience? Suggestions to improve the program? Results: Program Feasibility 19 attendees throughout program 2 not eligible 6 stopped attending Retention: 11 out of 17 eligible participants # of Classes 1 4 classes 5 8 classes 9 12 classes Attended # Participants 4 (22%) 5 (28%) 9 (50%) Bilingual Course Facilitation (En/Es) 12 week time commitment Attendance/Schedule Challenges Health Issues Snacks 5

6 Results: Cognitive Outcomes Objective Measures Change from Baseline to 12 Weeks Attention (Trail A) No significant change Executive function (Trail B) (Z = 2.40, p =.017*) Cognitive flexibility (ΔTMT) (Z = 2.09, p =.037*) Improved (quicker) performance Improved (quicker) performance Self Report Measures Cognitive flexibility (CFS) No significant change in ability & confidence in flexibility Cognitive reserve (CRS) No significant change in frequency of cognitive activities Results: Psychosocial Outcomes Self Report Measures Change from Baseline to 12 Weeks Life satisfaction (SWLS) (Z = 2.20, Increased life satisfaction p =.028*) Depression (PHQ 8) No significant change (possible ceiling effect) Results: Qualitative Responses 6

7 Results: Qualitative Responses More Open/Engaged and cognitive flexibility: I just look at things differently than I did before made me think harder about some of the things I look at and whether they have a different meaning or they can mean more than they do already. It personally opened my mind to looking at things in better perspectives. Results: Qualitative Responses Social Experience and sense of purpose: it made me feel like, I was involved. I was important. I was a part of this. And so was everybody else to the degree that they felt comfortable it was like this sense of community coming together and making something Results: Qualitative Responses Social Experience & Intellectually Enriching as interacting mechanism for cognitive training: it s like I m mentally exercising when I m challenged by someone such as you it leads to other parts of your brain because you meet people...sometimes it takes discussions or personal discussions take the route of actually learning by accident. 7

8 Discussion/Implications Strengths: Promising findings despite small sample size Innovative model for engagement and plasticity High program enjoyment Limitations: Improving retention (time commitment) Gender differences Individual preferences for specific activities Future directions: Group Differences between those who stayed vs not Cognitive function associations with: Openness to Experience Social Engagement Thank you to our supporters Thank you! 8