Horticultural Activities Among the People with Dementia and Their Family Caregivers
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
AgeNot listed
SponsorThe Hong Kong Polytechnic University
About this trial
The goal of this study is to explore the effects of technology-enhanced horticultural activities on people with dementia (PWD) and their family caregivers. The main questions it aims to answer are:
* Do these activities improve cognitive function and behavioral symptoms in PWD? * Do they reduce stress and depressive symptoms in caregivers and improve their quality of life?
The study will have two phases:
* Phase I: Conduct a pilot study with PWD in a geriatric day hospital to evaluate feasibility and initial effects. * Phase II: Conduct a larger trial with PWD and caregivers in community settings to further assess impact.
Participants will engage in indoor horticultural activities using a smart grower, participate in training sessions, and complete assessments before and after the intervention.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
aged 65 or above;
diagnosed with any type of dementia at the early to moderate stage;
community-dwelling (i.e., non-institutionalized); and
able to understand Cantonese and follow simple instructions.
Disqualifiers
being diagnosed with a mental disorder such as bipolar disorder, schizophrenia, or depression;
taking anticonvulsants or any kind of psychotropic drugs; and
identified with self-reported suicidal thoughts or drug abuse in the past 6 months.
Trial design
Design model
Single group
Treatments tested in this trial
Technology-enhanced horticultural activities
BehavioralThe indoor technology-enhanced horticultural activities will be delivered to people with dementia and their family caregivers through a smart grower. The smart grower is a hydroponic indoor grower that creates a controllable environment with auto optimization for growing healthy plants, fresh vegetables, herbs, and fruits. A mobile app will be connected to the grower for controlling the growing environment (e.g., lighting, watering), tracking the progress of the plants, and guiding the older people with dementia and their family caregivers in conducting the horticultural activities. The program will consist of eight face-to-face (F-T-F) horticultural activity training sessions for groups of 6-8 participants. The indoor program contains various horticultural, cognitive, and multisensory stimulation activities, such as asking PWD and family caregivers to record the sense of touch and odor when caring for the plants and to observe the various changes in the plants using the smart grower.
Treatment groups
130 Participants
are divided into 1 treatment groupGroup A: Technology-enhanced horticultural activitiesExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
PWD Outcome: Cognitive Functioning
The MoCA-5-min will assess participants' cognitive function (Wong et al., 2015). It covers four domains: attention, executive function/language, orientation, and memory. The MoCA-5-min is highly correlated with the MoCA (r = 0.87) and has excellent test-retest reliability (ICC = 0.89). Trained nursing students will conduct the MoCA-5-min assessments.
Time frame
8 Weeks2
PWD Outcome: Engagement
The Engagement of a Person with Dementia Scale (EPWDS) assesses behavioral and emotional engagement in individuals with dementia during psychosocial activities (Jones et al., 2018). Based on the Observational Method of Engagement (Cohen-Mansfield et al., 2009), it evaluates five areas: affective, visual, verbal, behavioral, and social engagement. Each area includes two items-one for positive engagement and one for disengagement-resulting in 10 items total. Negatively phrased items are reverse scored, with total scores ranging from 10 to 50, where higher scores indicate greater positive engagement. The EPWDS has excellent reliability, with an internal consistency of 0.94 and a test-retest reliability of r = 0.95 (Jones et al., 2018). In this study, two trained nursing students will administer the EPWDS through direct observations and field notes. Inter-rater reliability will be calculated to ensure consistent assessments. Observations will last for 10 minutes and occur at T0 and T1.
Time frame
8 Weeks3
PWD Outcome: Challenging Behaviors
The Challenging Behaviors Subscale of the Dementia Coding System (DeCS) will measure challenging behaviors in BPSD during the intervention (Hillebrand et al., 2023). The DeCS uses a systematic time-sampling approach, observing individuals with dementia at specific intervals. The subscale includes 18 behaviors (e.g., apathetic, tense posture, runs away) recorded on a dichotomous scale, where 0 indicates not observed and 1 indicates observed. A higher score indicates more challenging behaviors. The subscale's internal consistency is 0.71, and the test-retest reliability is ICC = 0.92 (Hillebrand et al., 2023). Two trained nursing students will conduct observations and take field notes using the DeCS. Inter-rater reliability will be calculated to ensure consistency. Observations will be conducted over five four-minute intervals at T0 and T1.
Time frame
8 Weeks4
PWD Outcome: Challenging Behaviors
Challenging behaviors of the PWD will be measured by the Chinese version of the Neuropsychiatric Inventory-Questionnaire (NPI-Q) (Wong et al., 2014), administered by caregivers. It evaluates the frequency, severity, and caregiver distress of 12 neuropsychiatric symptoms using a 5-point rating scale. The NPI-Q has acceptable psychometric properties, including a high internal consistency (α = 0.76) and test-retest reliability (0.99).
Time frame
8 WeeksSecondary outcomes
1
Feasibility Outcome: Recruitment Rate
The ratio of participants enrolled to the total number approached.
Time frame
8 Weeks2
Feasibility Outcome: Attendance Rate
The average number of sessions attended by participants relative to the total sessions offered.
Time frame
8 Weeks3
Feasibility Outcome: Completion Rate
The proportion of participants who complete at least 80% of required assessments and interventions compared to those initially enrolled.
Time frame
8 Weeks4
Feasibility Outcome: Retention Rate
The percentage of participants who remain in the study from T0 through T1.
Time frame
8 WeeksLocations
Sponsors and contacts
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Source ClinicalTrials.gov
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