Effects of Horticultural Therapy on Elderly at Risk of Cognitive Decline

NCT03045718 | Unknown

• 1 other identifier: 2016/00949
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this study is to determine whether horticultural therapy would improve the psychological well-being older adults who are at risk of memory (cognitive) decline. 100 elderly subjects who are at risk of cognitive decline will be randomized into the active horticultural therapy or to the waitlist control group. Sessions will be conducted weekly for 9 months, and participants will be assessed at 3 time-points: at the start of the study, at 3 months and at 9 months. It is hypothesized that participants who undergo horticultural therapy will perform better on neuropsychological tests when compared to control, and that they will have improved psychological well-being and functional outcomes.

Conditions

Horticultural Therapy; Dementia

Keywords

Horticultural Therapy; Dementia; Randomized Controlled Trial; Elderly; Prevention

Outcome Measures

Primary Outcomes (6)

• Changes in Clinical Dementia Rating (CDR) at baseline and at 9 months

  Clinical Dementia Rating (CDR ) is a 5-point scale used to characterize six domains of cognitive and functional performance applicable to Alzheimer disease and related dementias: Memory, Orientation, Judgment \& Problem Solving, Community Affairs, Home \& Hobbies, and Personal Care.

  Baseline, 9 months

• Changes in Colour Trails Tests (CTT) scores at baseline, 3 months and 9 months

  Colour Trails Tests (CTT) 1 and 2 assesses sustained attention and sequencing.

  Baseline, 3 months, 9 months

• Changes in Digit Span Task scores at baseline, 3 months and 9 months

  Digit Span Task, which consists of a Digit Span Forward (DSF) and a Digit Span Backward (DSB) task is used to assess attention and verbal working memory.

  Baseline, 3 months, 9 months

• Changes in Rey Auditory Verbal Learning Test (RAVLT) scores at baseline, 3 months and 9 months

  Rey Auditory Verbal Learning Test (RAVLT) evaluates declarative verbal learning and memory.

  Baseline, 3 months, 9 months

• Changes in Block Design scores at baseline, 3 months and 9 months

  Block Design is a subtest that is administered as part of several of the Wechsler Intelligence tests, and it primarily measures visual-spatial and organizational processing abilities, as well as non-verbal problem-solving skills

  Baseline, 3 months, 9 months

• Changes in Semantic Verbal Fluency scores at baseline, 3 months and 9 months

  Semantic Verbal Fluency assess lexical knowledge and semantic memory organization.

  Baseline, 3 months, 9 months

Secondary Outcomes (8)

• Changes in Zung Self-Rating Depression Scale (SDS) scores at baseline, 3 months and 9 months

  Baseline, 3 months, 9 months

• Changes in Zung Self-Rating Anxiety Scale (SAS) scores at baseline, 3 months and 9 months

  Baseline, 3 months, 9 months

• Changes in Ryff's Scales of Psychological Well-being scores at baseline, 3 months and 9 months

  Baseline, 3 months, 9 months

• Changes in Friendship Scale (FS) scores at baseline, 3 months and 9 months

  Baseline, 3 months, 9 months

• Changes in EuroQol Five Dimensions Questionaire (ED-5D-3L) scores at baseline, 3 months and 9 months

  Baseline, 3 months, 9 months

Study Arms (2)

Horticultural Therapy

EXPERIMENTAL

Horticultural Therapy will consists of 1 hour sessions, weekly for 9 months, to engage subjects in gardening-based activities.

Behavioral: Horticultural Therapy

Waitlist Control

OTHER

The control group will be placed on a waiting list and only be contacted for assessments. They will receive the same Horticultural Therapy intervention after the active treatment group at a later date.

Behavioral: Horticultural Therapy

Interventions

Horticultural Therapy BEHAVIORAL

The Horticultural Therapy intervention will be delivered by trained facilitators at the Therapeutic Garden at Hort Park, and consists of 1 hour sessions weekly for 9 months. The Horticultural Therapy program is designed to stimulate the senses through interaction with the tasks and the environment, promote social interaction and also to promote a sense of self-worth through completion of projects. It encompasses a range of activities including general gardening and also project-based craft activities.

Horticultural Therapy; Waitlist Control

Eligibility Criteria

• Age: 60 Years - 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \. Community-living elderly aged 60 years and above, AND 2.
• Mild Cognitive Impairment based on clinical history and neuropsychological test scores (Z score \<0 and \>-1.5), OR
• Subjective Memory Impairment based on self-report, OR (C) 2 or more risk factors for dementia such as family history, cerebrovascular disease, and cardiovascular risk factors

You may not qualify if:

• Existing diagnosis of dementia, OR
• Comorbid major mental illness (such as Major Depressive Disorder and Psychosis), OR
• Severe or unstable life-limiting medical illness, OR
• Severe physical impairment precluding participation in Horticultural Therapy

Sponsors & Collaborators

• National University Hospital, Singapore: lead
• National Parks Board, Singapore: collaborator
• Ministry of Health, Singapore: collaborator
• Ministry of National Development, Singapore: collaborator

Study Sites (1)

National University Hospital

Singapore, Singapore

Location

Related Publications (5)

• Soga M, Gaston KJ, Yamaura Y. Gardening is beneficial for health: A meta-analysis. Prev Med Rep. 2016 Nov 14;5:92-99. doi: 10.1016/j.pmedr.2016.11.007. eCollection 2017 Mar.

  PMID: 27981022 BACKGROUND

• Blake M, Mitchell G. Horticultural therapy in dementia care: a literature review. Nurs Stand. 2016 Jan 20;30(21):41-7. doi: 10.7748/ns.30.21.41.s44.

  PMID: 26786461 BACKGROUND

• Noone S, Innes A, Kelly F, Mayers A. 'The nourishing soil of the soul': The role of horticultural therapy in promoting well-being in community-dwelling people with dementia. Dementia (London). 2017 Oct;16(7):897-910. doi: 10.1177/1471301215623889. Epub 2015 Dec 23.

  PMID: 26701960 BACKGROUND

• Kamioka H, Tsutani K, Yamada M, Park H, Okuizumi H, Honda T, Okada S, Park SJ, Kitayuguchi J, Abe T, Handa S, Mutoh Y. Effectiveness of horticultural therapy: a systematic review of randomized controlled trials. Complement Ther Med. 2014 Oct;22(5):930-43. doi: 10.1016/j.ctim.2014.08.009. Epub 2014 Sep 1.

  PMID: 25440385 BACKGROUND

• Annerstedt M, Wahrborg P. Nature-assisted therapy: systematic review of controlled and observational studies. Scand J Public Health. 2011 Jun;39(4):371-88. doi: 10.1177/1403494810396400. Epub 2011 Jan 27.

  PMID: 21273226 BACKGROUND

MeSH Terms

Conditions

Dementia

Interventions

Horticultural Therapy

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Hong Yee Tan, MMed(Psy)

  Associate Consultant

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 5, 2017
• First Posted: February 7, 2017
• Study Start: January 1, 2017
• Primary Completion: August 1, 2019
• Study Completion: December 1, 2019
• Last Updated: February 7, 2017

Record last verified: 2017-02

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)