10.06. Have there been any scoping reviews of dementia research to identify research gaps? | Hong Kong SAR

10.06. Have there been any scoping reviews of dementia research to identify research gaps? | Hong Kong SAR

22 Aug 2022

There is no published scoping review of dementia research in Hong Kong at this moment. Yet, the TIP-CARD research team has conducted a scoping review on the non-medical literature through systematically searching “Hong Kong” and “dementia/Alzheimer’s Disease/cognitive impairment” in three databases: Medline, PsycInfo and PubMed. There is no restriction on the year of publication during the search. Initially, 1656 non-duplicated articles have been identified. After reviewing by two independent researchers in the team, 285 empirical studies published between 1991 and June 2019 are included in this review. These studies are categorized into the following 8 themes:

  1. Interventions for PwD or PwCI: 68 studies
    • More than half of the intervention studies aims at improving the cognitive functioning and memory of the participants, and 10 studies have focused on Behavioural and Psychological Symptoms of Dementia (BPSD) (mainly agitation).
    • Improvement in IADL, falling, mood, social interaction, pain management, diabetic control, sleep quality, psychomotor speed has also gained some attention.
    • The influence of Chinese culture has been widely observed in the use of intervention: there are 9 Tai-Chi, 7 acupuncture, 4 mah-jong, 3 calligraphy, 2 Chinese Chan, and 1 Six Arts intervention studies. The effectiveness of music-with-movement intervention, Cognitive Stimulation Therapy, and various cognitive training interventions have also been examined.
  2. Instruments for screening/assessing patient and caregiver: 56 studies
  • There are 9 studies developing instruments for caregiver’s burden, management strategy, expressed emotion, grief, and positive aspects of caregiving.
  • 47 studies are validating instruments for older adults with cognitive impairment. Most of them are screening tools for dementia /cognitive impairment, and assessment for memory and cognitive decline. A few are examining BPSD, awareness of memory deficits, dementia psychosocial care quality, executive function and testing new means of assessment.
  1. Caregiver status and caregiving experience: 49 studies
  • There are 30 quantitative studies and 19 qualitative studies, including 14 intervention studies improving caregiver outcomes.
  • A wide range of topics are observed, including caregiver well-being, caregiver burden, education and training, coping and management strategy, attitudes towards persons with dementia and decision making, social support, abuse, positive meaning finding, self-efficacy, gratitude, anticipatory grief, expressed emotion, and life satisfaction.
  1. Health & functional performance: 48 studies
    • These 48 studies describe: 1) the clinical profile of the population with neuropsychiatric symptoms, 2) physical status such as eye movement, oral health, hearing impairment, late-life body mass index; 3) activity status like physical activities, sedentary behaviour, getting lost; 4) psychosocial status including emotional reactions, loneliness, subjective complaints, 5) capacity to make decisions on treatment, financial issues; and 6) care needs and service use.
  2. Associated factors for cognitive health: 37 studies
    • Four groups of factors for cognitive health have been examined in Hong Kong population: 1) physiological factors: frailty, widened pulse pressure, poor balance, diabetes; 2) neurocognitive and psychosocial factors: semantic fluency, neuropsychiatric symptoms, depression, distress, self-esteem, anxiety, quality of life; 3) demographic factors: education, gender, subjective social status; and 4) lifestyle: nutrition, dietary, spiritual activity, physical exercise, leisure activity.
  3. Service providers’ attitudes and capacity: 12 studies
  • There are studies examining service providers’ knowledge, attitudes towards disease and persons with dementia, as well as how they practice and manage care services.
  • The job and life satisfaction of paid carers have also been discussed.
  • Physicians, nurses, nursing assistants and other healthcare workers in both healthcare and long-term care system have been mentioned.
  • Two educational interventions on service providers have been evaluated.
  1. Prevalence of dementia: 8 studies
    • There are 5 studies reporting estimates on prevalence of dementia in Hong Kong.
    • Regarding different types or stages of dementia, 1 study reported on the prevalence of very mild and mild dementia, 1 on cognitive impairment, and 1 on dementia with Lewy Bodies.
  2. Awareness and attitudes towards dementia: 7 studies
  • There are 7 studies describing and investigating the attitudes, awareness and experience about dementia and its care of the persons with dementia as well as the general public.