This study was conducted to introduce daily activity based non-face-to-face dementia program and to investigate the effect of a non-face-to-face dementia prevention program on cognitive function and depression of community-dwelling elderly. This program was designed based on APA Dementia Clinical Practice Guidelines, and it consists of daily tasks using cognitive activity diary and brain health playbook. The program gave community-dwelling elderly a chance to participate daily tasks and was effective on cognitive function and depression. Especially, two out of five participants with MCI improved to normal cognitive levels after the program. Therefore, continuous dementia prevention program is essential to the community-dwelling elderly.
Comprehensive dementia prevention therapy program is effective to the elderly. In the study of Lee et al. (2022), 10 sessions of dementia prevention program were effective on 26 elderly (15 in the experimental group and 11 in the control group) in day and night care facilities.22 CIST and SGD-K was assessed same as this study. In the study of Avila et al. (2004), the effect of the 12 weeks cognitive training program was identified in the five elderly with mild dementia[14]. The program was comprehensive including memory training, motor movement, language activity, and daily life training. Using diary was major activities in daily life training. Positive effects were identified in cognition, depression, anxiety, and quality of life. These results support the effectiveness of the comprehensive dementia prevention program and daily participation of this study.
Participation in the daily task was effective in cognitive function and depression. In the Kim’s study (2015), 8 week daily task participation program improved daily life, cognitive ability, satisfaction and orientation in 43 people with early dementia[16]. Especially, repetitive daily tasks using paper and pencil, calendars, personal memory notebooks, and mobile phones were effective in improving orientation. Among daily task activities, diary writing activity led to significant improvement in memory, concentration, language ability, temporal and spatial perception, and executive function[15]. And, it reduced depressive symptoms in chronic rehabilitation patients and their caregivers[9]. In this study, we found the significant effects in preventing memory decline of normal elderly without dementia.
Social participation decreased depression[11]. In the study of Lee et al.(2022) and Avila et al.(2004), dementia prevention program and cognitive program decreased depression[14, 22]. In this study, daily task participation decreased symptoms of depression in the normal elderly. During Covid-19 pandemic, social participation is major problems among the elderly. Therefore, non-face-to-face program could be good substitutes.
Non-face-to-face rehabilitation programs are effective to various functions in the elderly. In the study of Jelcic et al. (2014), language ability, episodic, verbal, and working memory were significantly improved after 3 months of a remote cognitive rehabilitation program in 27 individuals with mild memory impairment[23]. Antonietti et al. (2016) stated that a comprehensive remote rehabilitation approach, called ABILITY improved motor and cognitive skills for early dementia[7]. In the study of Mosca et al. (2020), 31 elderly with MCI and vascular cognitive impairment participated in a computer-based non-face-to-face rehabilitation program called GOAL Tele-R, which consisted of cognitive, physical, and social activities for 8 weeks[24]. They were effective in preventing the deterioration of cognition, memory, and daily living functions. Therefore, the effect of a comprehensive non-face-to-face dementia prevention program in this study was supported.
A strength of this study was that large sample size were recruited. And, the effectiveness of non-face-to-face dementia prevention program of the normal elderly was examined in community-based rehabilitation. Lastly, the program of this study was based from APA dementia prevention guidelines and consists of comprehensive sub-programs. Therefore, clinicians in community-based rehabilitation could provide evidence-based non-face-to-face dementia prevention occupational therapy programs.
Limitation of this study was that generalization was difficult because participants were collected in one public health center. Also, this study was not a randomized control study. And the program consisted of many sub-programs. Therefore, it was difficult to determine which factors were most effective. Therefore, study about identifying the effect of the application of a non-face-to-face cognitive rehabilitation program for patients with dementia in the future. Identifying various areas such as daily life, performance function, quality of life, and stress is necessary in future studies. Furthermore, development of a specialized program for non-face-to-face rehabilitation would be necessary.