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Background: Previous studies have shown a relationship between environments and mental health. However, limited studies have investigated the impact of environment stress (ES) on emotional reactivity. Our study aimed to fill this gap by examining how daily ES affects momentary emotional reactivity using experience sampling method (ESM). Methods: Participants were randomly recruited from a prospective cohort study in Hong Kong to participate in a 7-day ESM study. The participants received eight electronic signals daily assessing their ES, positive affect (PA) and negative affect (NA). Participants were categorized into depressed group or control group based on Revised Clinical Interview Schedule. Psychometric properties of the ESM assessment were evaluated. Multilevel linear regression analyzes were conducted to examine the association of ES with PA, NA and the group status of the participants (cases versus controls). Results: A total of 15 participants with depression and 15 healthy controls were recruited, and 1307 momentary assessments were completed with a compliance rate of 77.8%. The depressed group demonstrated a significant increase in NA in response to ES, while the control group showed a decrease in PA. In addition, the depressed group reported a lower perception of control and interaction with their environment compared to the control group. Conclusion: Using ESM, a valid, reliable, and easy-to-use self-reporting tool, our findings provided valuable insights on the potential mechanisms underlying emotional responses to stressful environments. [ABSTRACT FROM AUTHOR]

Objective: Early intervention to reduce cognitive decline and preserve functioning is a compelling public health issue. Because impaired attention occurs early in the process of cognitive impairment, focusing training strategies upon attention may be a potential intervention to prevent further cognitive decline. We sought to test the effects on cognitive performance and daily functioning of a new cognitive training program that focuses on attention. Method: This single-blind randomized controlled trial lasted 6 months and included two phases. Assessments were conducted at baseline, at 3 months, and at 6 months. The study was performed in four community older adult centers. Ninety-three participants with subjective cognitive impairment without dementia were included. Forty-seven participants were randomized to the Integrated Attention Training Program (IATP), and 46 were randomized to the control group. The two arms of the study included the IATP (intervention group) and a health-related education program (active control group). Results: No significant interactions were identified between group and time for the Clinical Dementia Rating--Sum of Boxes and other secondary outcomes, except for the Digit Forward Score (p < .05; effect size, 0.057). When the preintervention and postintervention results were compared, the IATP group showed significant improvement in grand mean effect (p < .05) and accuracy (p < .05) in the Attention Network Test, Digit Backward Score (p < .05), Category Verbal Fluency Test (p < .05), and Trail Making Test A (p < .01) immediately after the intervention. These improvements were sustained 3 months after the intervention. Conclusion: The IATP showed domain-specific effects but had no effects on global cognition or functioning. It could not show a superior benefit in cognition and functioning when compared with non-specific mental stimulation in a group format. Further studies are needed to determine the role of attention in cognitive training. [ABSTRACT FROM AUTHOR]

Lifetime prevalence of psychotic disorders varies widely across studies. Epidemiological surveys have rarely examined prevalences of specific psychotic disorders other than schizophrenia, and the majority used a single-phase design without employing clinical reappraisal interview for diagnostic verification. The current study investigated lifetime prevalence, correlates and service utilization of schizophrenia-spectrum, affective, and other non-affective psychotic disorders in a representative sample of community-dwelling Chinese adult population aged 16-75 years (N = 5719) based on a territory- wide, population-based household survey for mental disorders in Hong Kong. The survey adopted a 2-phase design comprising first-phase psychosis screening and second-phase diagnostic verification incorporating clinical information from psychiatrist-administered semi-structured interview and medical record review to ascertain DSM-IV lifetime diagnosis for psychotic disorders. Data on sociodemographics, psychosocial characteristics and service utilization were collected. Our results showed that lifetime prevalence was 2.47% for psychotic disorder overall, 1.25% for schizophrenia, 0.15% for delusional disorder, 0.38% for psychotic disorder not otherwise specified, 0.31% for bipolar disorder with psychosis, and 0.33% for depressive disorder with psychosis. Schizophrenia-spectrum disorder was associated with family history of psychosis, cigarette smoking and variables indicating socioeconomic disadvantage. Victimization experiences were significantly related to affective psychoses and other non-affective psychoses. Around 80% of participants with any psychotic disorder sought some kind of professional help for mental health problems in the past year. Using comprehensive diagnostic assessment involving interview and record data, our results indicate that approximately 2.5% of Chinese adult population had lifetime psychotic disorder which represents a major public health concern. [ABSTRACT FROM AUTHOR]

Background: Family members, who provide the majority of care for persons with dementia, are especially vulnerable to developing depression. Interventions targeting their depressive symptoms have been proposed but their efficacies vary considerably. It has been suggested that interventions carried out in the home setting and involving both caregivers and care recipients are more efficacious. This study aims to compare the efficacy of a home-based structured exercise programme involving both persons with dementia and their caregivers with nonexercise social contact control in treating depression among caregivers. Methods/design: This is a parallel-group, assessor-blind, randomised controlled trial. A total of 136 caregiver-carerecipient dyads (i.e. 272 participants in total) will be recruited and randomly allocated to either a home-based structured exercise (sitting Tai Chi) group or a social contact control group. The trial comprises a 3-month intervention phase followed by an extended observation phase of another 3 months. All participants will be assessed at baseline, 6th week, 12th week and 24th week. The primary outcome will be the reduction in depression among caregivers as measured by the Hamilton Rating Scale for Depression. The secondary outcomes will be burden, quality of life, cognitive performance and balance ability of the caregivers, as well as the neuropsychiatric symptoms, cognitive function, balance and functional abilities of the persons with dementia. We will also examine whether the brain-derived neurotrophic factor gene modulates mood changes in response to exercise. Discussion: The findings offer a potential avenue of intervention by providing a low-cost, safe and effective treatment for depression among dementia caregivers, which may in turn also benefit the care recipients. Trial registration: ClinicalTrials.gov Identifier: NCT02132039, registered on 28 April 2014. [ABSTRACT FROM AUTHOR]

Background: There has been longstanding interesting in cognitive training for older adults with cognitive impairment. In this study, we will investigate the effects of working memory training, and explore augmentation strategies that could possibly consolidate the effects in older adults with mild neurocognitive disorder. Transcranial direct current stimulation (tDCS) has been demonstrated to affect the neuronal excitability and reported to enhance memory performance. As tDCS may also modulate cognitive function through changes in neuroplastic response, it would be adopted as an augmentation strategy for working memory training in the present study.Methods/design: This is a 4-week intervention double-blind randomized controlled trial (RCT) of tDCS. Chinese older adults (aged 60 to 90 years) with mild neurocognitive disorder due to Alzheimer's disease (DSM-5 criteria) would be randomized into a 4-week intervention of either tDCS-working memory (DCS-WM), tDCS-control cognitive training (DCS-CC), and sham tDCS-working memory (WM-CD) groups. The primary outcome would be working memory test - the n-back task performance and the Chinese version of the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog). Secondary outcomes would be test performance of specific cognitive domains and mood. Intention-to-treat analysis would be carried out. Changes of efficacy indicators with time and intervention would be tested with mixed effect models.Discussion: This study adopts the theory of neuroplasticity to evaluate the potential cognitive benefits of non-invasive electrical brain stimulation, working memory training and dual stimulation in older adults at risk of cognitive decline. It would also examine the tolerability, program adherence and adverse effects of this novel intervention. Information would be helpful for further research of dementia prevention studies.Trial Registration: ChiCTR-TRC- 14005036 Date of registration: 31 July 2014. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment is an intermediary state between normal aging and clinical Alzheimer's disease. Early intervention of mild cognitive impairment may be an important strategy in the management of Alzheimer's disease. The proposal aims to evaluate if electroacupuncture would optimize cognitive function in subjects with mild cognitive impairment and understand the role of electroacupuncture in the treatment of Alzheimer's disease. Methods/design: A randomised patient- and assessor-blind sham-controlled trial is designed to assess whether electroacupuncture intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment. One hundred and fifty subjects aged 65 years of age or over with a diagnosis of mild cognitive impairment are recruited from the community and elderly centre in Hong Kong. All subjects are randomly allocated into two groups (75 subjects each group): the electroacupuncture group and sham control. Participants in the electroacupuncture group receive electroacupuncture stimulation by sterile, disposable acupuncture needles inserted to the acupoints with a depth of 1 to 3 cm. The acupuncture needles are subjected to 2 Hz electroacupuncture wihtat an intensity of 5 to 10 mA. Each participant receives electroacupuncture for 8 weeks (once a day, 3 days a week) and the treatment lasts for 30 minutes each time. For sham electroacupuncture, needles are inserted to a depth of 1 to 2 mm, and connected to the electroacupuncture device without any current passing through. Outcome measures (including primary and secondary outcome measures) are collected at baseline, at the end day of intervention, and months 4 and 6 after intervention. The primary outcome is measured by the Alzheimer Disease Assessment Scale-Cognitive subscale. Secondary outcomes are measured by the mini-mental state examination, category fluency text and the Short Form 12. Discussion: The study will provide evidence for evaluating and understanding the role of electroacupuncture in the treatment of Alzheimer's disease. Trial registration: This trial is registered with chictr.org (registration number: ChiCTR-TRC-12002414. Registration date: 11 August 2012. [ABSTRACT FROM AUTHOR]

The article reports on research which investigated the association of estrogen receptor a (ESRl) polymorphisms and cognitive decline in older adults. Researchers evaluated 284 older Chinese older adults. They found that there was an association between ESRI polymorphisms and cognitive decline or specific areas in cognitive profile in older adults.

Background: This study aims to develop and validate a Chinese translation of the 6-item De Jong Gierveld Loneliness Scale - a widely used instrument to measure loneliness — specifically determining its psychometric properties in community- dwelling Chinese elders in Hong Kong. The relationships between loneliness and several clinical variables are also assessed. Method: The English version was translated into Chinese. Content validity was established by group discussion and Delphi panel. The questionnaire was administered to 103 Hong Kong Chinese community-dwelling elders. Statistical analysis was performed to test the reliability and validity of the scale. Results: The content validity was high as shown by the results of the Delphi panel. Cronbach's a of the 6-item scale was 0.76. For the inter-rater reliability of the six items, the intra-class correlation coefficients ranged from 0.98 to 1.00. The emotional loneliness subscale significantly correlated with the social loneliness subscale (p = 0.37; p < 0.001). In using a direct question to measure loneliness, 21 participants (20%) reported that they were lonely. The overall loneliness scale score significantly correlated with the answers on the direct question of loneliness (rob = 0.71; p < 0.001). The overall loneliness score showed significant correlation with Cornell Scale for Depression in Dementia (p = 0.29; p = 0.003), current smoking status (rob = 0.24; p = 0.014), and some objective social characteristics. Conclusion: The Chinese version of the 6-item De Jong Gierveld Loneliness Scale is a reliable and valid measure of loneliness in Chinese elders. [ABSTRACT FROM AUTHOR]

Background/Aim: HLA-A is a locus of the major histocompatibility complex situated on chromosome 6p21.3. Several genome-wide linkage analyses suggested that a putative locus predisposition for Alzheimer’s disease (AD) is found on chromosome 6p21. In this study, we investigated the association between HLA-A alleles and AD in a Chinese community. Methods: Fine genotyping of 160 Chinese AD and 167 age-matched nondemented subjects was performed for the first time by sequence-based typing of the HLA-A locus. Results: We found that HLA-A2 carriers (including prevalent alleles, 0201, 0203 and 0207) were more prevalent in the AD group; the frequency of HLA-A2 was increased in AD patients versus controls, but the difference was not significant after Bonferroni correction for the number of alleles tested (p = 0.075). A gene-gene interaction was observed between ApoE and HLA-A, the presence of HLA-A24 (particularly the prevalent allele 2402) might act as another independent risk factor of developing AD for subjects not carrying the ApoE ε4 allele (relative risk = 2.98, 95% CI = 1.14–8.24). Carriers of HLA-A2 had an earlier onset of AD by 2.4 years (p = 0.030) and HLA-A2 interacted with ApoE ε4 in modulating the age at onset in AD. Conclusions: This study suggested that HLA-A may be involved in the pathogenesis of AD. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background With the rapid growth of the older population, early detection of cognitive deficits is crucial in slowing down functional deterioration of the elderly persons. Objectives To examine the validity and reliability of the Chinese (Cantonese) version of the Hierarchic Dementia Scale (CV-HDS) for Chinese older persons in Hong Kong. Methods The HDS was translated into Cantonese Chinese. The content and cultural validity were evaluated by six expert panel members. Sixty-two participants with diagnosis of dementia were recruited for evaluation. Inter-rater reliability, test–retest reliability, internal consistency and concurrent validity were examined. Results The CV-HDS demonstrated satisfactory psychometric properties. inter-rater reliability and test–retest reliability were high (α = 0.89 and α = 0.94 respectively). High value of Cronbach's alpha (α = 0.94) demonstrated good internal consistency. The concurrent validity of CV-HDS, through correlation with its scores with that of the Chinese version of Mini Mental Status Examination, was established (ranged from r = 0.58 to r = 0.78, p < 0.01). Conclusions The CV-HDS is a reliable and valid instrument for assessing severity of cognitive impairment in Cantonese speaking Chinese people with dementia. It facilitates treatment planning to optimize the effects of functional training and rehabilitation. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

To assess the correlation between clinical characteristics and the caregiving experience of caregivers of patients with schizophrenia. Two hundred and one patients with schizophrenia and their caregivers were recruited from a psychiatric clinic. The involvement evaluation questionnaire (IEQ) and the general health questionnaire (GHQ) were administered to the caregivers. The patients were assessed by the Structured Clinical Interview, the positive and negative syndrome scale (PANSS) and the global assessment of functioning scale (GAF). Correlation analysis and regression analysis was performed to identify the best predictors of caregiver stress. The most important clinical predictor of caregiver stress as assessed using IEQ was the GAF, followed by PANSS-Pos and Neg scores and admission. Positive symptoms contributed more to overall caregiver stress than negative symptoms. Both symptom severity and patient function were important factors in the caregiver experience. Treatment should aim not only to reduce symptoms but also maximize function. Service planning should include psychosocial intervention involving caregivers. [ABSTRACT FROM AUTHOR]

Background Agitated behaviours among persons with dementia are distressing to both patients and their caregivers. As pharmacological interventions may be limited by their potentially adverse effects, the use of complementary therapies for treatment of agitation has become more popular and aromatherapy is the fastest growing one. Objectives This study investigates the effectiveness of lavandula angustifolia (lavender) in treating agitated behaviours of demented people in Hong Kong. Methods It was a cross-over randomized trial. Seventy Chinese older adults with dementia were recruited; half were randomly assigned to the active group (lavender inhalation) for three weeks and then switched to control group (sunflower inhalation) for another three weeks; the other half did the opposite. Clinical response was evaluated using the Chinese versions of Cohen-Mansfield Agitation Inventory (CCMAI) and Neuropsychiatric Inventory (CNPI). Results The mean CCMAI total scores decreased from 24.68 to 17.77(t = 10.79, df = 69, p < 0.001). The CNPI scores changed from 63.17 (SD = 17.81) to 58.77 (SD = 16.74) (t = 14.59, df = 69, p < 0.001) after receiving Treatment A (Lavandula Angustifolia). There were no period and sequential effects noted. Conclusion In summary, lavender is effective as an adjunctive therapy in alleviating agitated behaviours in Chinese patients with dementia. In a patient population particularly vulnerable to side effects of psychotropic medications, aromatherapy using lavender may offer an alternative option. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BackgroundThe clinical significance of subjective memory complaints in elderly subjects has been an area of active research. In this study, we evaluated subjective complaints and self-evaluation of memory test performance in subjects with Questionable dementia (QD) and mild Alzheimer's disease (AD). MethodsNinety-two subjects (35 cognitively intact normal controls NC, 33 QD, and 24 mild AD) were assessed. Subjective memory complaints were evaluated using a memory inventory for the Chinese (MIC); objective assessment of awareness was assessed by the self-evaluation of own memory test performance. Cognitive function was assessed with the Alzheimer's Disease Assessment Scale—Cognitive subscale (ADAS-Cog), Category Verbal Fluency Test (CVFT) and Executive Interview (EXIT-25). Depressive symptoms were evaluated with the Cornell Scale for Depression in Dementia (CSDD). ResultsThe total number of subjective memory complaints (MI-tol) were significantly different between different subject groups (Kruskal Wallis test, χ2 = 13.19, p = 0.001). Significant correlations between scores of the MI-tol and CSDD (r = 0.33, p < 0.001), CMMSE (r = -0.33, p < 0.001), CDR (r = 0.36, p < 0.001) were found. In self-evaluation of memory test performance, the NC group tended to under-estimate while the AD subjects tended to over-estimate their performance. Group differences in the discrepancies of self-evaluation of memory performance were significant for both the immediate (Kruskal Wallis test, χ2 = 9.86, p = 0.007) and delayed recall (Kruskal Wallis test, χ2 = 10.55, p < 0.001) trials. ConclusionsSubjects with QD and mild AD showed higher frequency of subjective memory complaints, reflecting that the subjects still retain some ability to appreciate own memory function. However, the trend for over-estimation of performance in AD subjects suggests that the precision of estimation may be suboptimal. Moreover, depressive symptoms may affect the presentation of memory complaints and this factor should be carefully considered in future prospective studies. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background This paper describes the development and validation of the Memory Inventory for Chinese (MIC), for measuring the awareness of memory deficits in the Chinese population with Alzheimer's disease (AD). Methods A combination of qualitative and quantitative approaches was adopted. The MIC was developed with focus group discussion and pilot testing. It has a patient and a caregiver version. A consecutive series of 79 new out-patients with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorder Association (NINCDS-ADRDA) criteria of probable and possible AD and 20 non-demented elderly subjects were recruited. Results A high internal consistency was found, with Cronbach alpha of 0.89 for the patient version and 0.90 for the caregiver version of MIC. The inter-rater reliability was satisfactory. For validity assessment, the caregiver score of the MIC correlated significantly with cognitive score of the subject as assessed by the Mini-Mental State Examination (rp = -0.37; p < 0.01). The Memory Deficit Awareness Score, calculated by subtracting the patient score from the caregiver score, correlated significantly with clinician ratings of awareness of memory impairment (rs = -0.67; p < 0.01). Conclusions The MIC appears to be a culturally appropriate and valid instrument for the measurement of awareness of memory deficits in Chinese patients with AD. Potential applications of the MIC should be further explored in other subtypes of dementia and in prospective studies. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Subjective memory complaints in subjects with mild cognitive impairment may represent a genuine decline in episodic memory. This paper evaluates the neuropsychological correlates of the semantic fluency test in subjects with questionable dementia (QD). Methods: A total of 331 Chinese subjects (118 normal controls, NC, 150 with QD and 63 with mild Alzheimer’s disease, AD) were assessed with the Category Verbal Fluency Test (CVFT), the AD Assessment Scale – cognitive subscale (ADAS-Cog), and digit and verbal span tests. CVFT performance was evaluated in each Clinical Dementia Rating (CDR) group. The total number of exemplars, the subcategory and the category size generated were evaluated. Neuropsychological correlates of CVFT scores were computed. Results: Significant differences in CVFT performance were found between the different CDR groups. The subjects with QD had intermediate scores compared to the NC and AD subjects (1-way ANOVA, p < 0.001, post-hoc Bonferroni comparisons). In NC the CVFT scores were significantly associated with ADAS-Cog total, and immediate and delayed recall scores (partial correlations controlled for age and education, p < 0.005). In the QD group the CVFT scores were correlated with ADAS-Cog total, and immediate recall and object naming scores (partial correlation controlled for age and education, p < 0.005). Regression analysis revealed that age and delayed recall were significant predictors of CVFT performance in NCs. In the QD group, age, ADAS-Cog immediate recall and object naming scores predicted the CVFT performance. Conclusions: The CVFT was impaired in the subjects with QD. Apart from episodic memory, semantic memory deficits also occur early in AD. The different cognitive predictors of CVFT scores in the NC and QD groups suggest that the test is associated with specific psychological functions at different stages of cognitive impairment. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Introduction: The applicability of category verbal fluency test (VFT) as a screening test for Alzheimer's disease (AD) in the Chinese population was studied. Methods: VFTs with categories of 'animal', 'fruit' and 'vegetable' were administrated to 72 subjects with AD and 81 aged-matched, community-dwelling, non-demented elderly (NC) in Hong Kong. Results: A significant difference in VFT scores between NC and AD groups was found (t-test, p < 0.05). CMMSE scores were significantly correlated with VFT performances in both subject groups. The correlation of combined VFT scores with age and educational level was significant only in the NC group (Pearson correlation, p < 0.05). At a cut-off score of 24/25, the sensitivity and specificity of the VFT in screening of dementia were 86.8 and 93.4% for subjects with no formal education. For literate subjects, an optimal cut-off score of 31/32 was identified across different educational levels. Conclusion: Although VFT performance was influenced by demographic factors like age and education, cognitive function was the most determining factor. With easy administration and satisfactory sensitivity and specificity, VFT is a useful and quick clinical screening test for AD in Chinese elderly. [ABSTRACT FROM AUTHOR]

Objective To investigate the association between 5-HT2A receptor polymorphism and neuropsychiatric (NP) symptoms in Chinese elderly with Alzheimer's disease (AD). Methods This case-control study evaluated Chinese subjects with AD first presented to an university affiliated psychogeriatric clinic. Eighty-seven subjects with NINCDS-ADRDA diagnosis for probable and possible AD were recruited consecutively from the psychogeriatric clinics of the Prince of Wales Hospital in Hong Kong. 5-HT2A receptor polymorphisms were examined by polymerase chain reaction (PCR), enzyme digestion and gel electrophoresis. NP symptoms were assessed by the Chinese version of the Neuropsychiatric Inventory (NPI). Results The genotype frequencies were significantly different in subjects with regards to the presentation of delusions, aggression, aberrant motor behavior and apathy (Pearson Chi Squares, p < 0.05). If only homozygote states were included, there were significantly fewer subjects of CC genotype with delusion (Pearson chi square, p < 0.05). Conclusions Specific NP symptoms in AD were significantly associated with 5-HT2A receptor polymorphisms. Possible ethnic differences in the behavioral expression of 5-HT2A receptor polymorphisms are worthy of further exploration. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Behavioural and psychological symptoms (BPSD) are common during the course of dementia and present severe problems to patients and their caregivers. Objectives To assess the therapeutic efficacy and safety of haloperidol and risperidone in treating BPSD in Chinese dementia patients. Methods A 12-week double-blind randomised comparison of haloperidol and risperidone treatments was conducted in 58 patients with DSM-IV diagnosis of dementia of Alzheimer's type or vascular dementia. They were randomly assigned to receive flexible doses (0.5 to 2 mg/day) of haloperidol or risperidone. Clinical response was evaluated using the Cohen-Mansfield Agitation Inventory (CMAI), the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Simpson-Angus Scale, Functional Assessment Staging and Cantonese version of the Mini-Mental State Examination. Results The mean doses at the last week were 0.90 mg/day of haloperidol and 0.85 mg/day of risperidone. Both haloperidol and risperidone significantly reduced the severity of BPSD (scores on CMAI and BEHAVE-AD), with no significant between-group differences. Haloperidol-treated patients showed a worsening on Simpson-Angus scale while there was no significant change in this measure in risperidone-treated patients. Conclusions Low-dose haloperidol and risperidone were well tolerated and associated with reductions in the severity and frequency of behavioural symptoms in subjects with dementia. Risperidone may have a more favourable risk-benefit profile in view of its lower propensity to induce extrapyramidal symptoms. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives: To develop a classification to describe leisure activities of elderly Hong Kong Chinese based on the functions fulfilled, namely: intellectual, physical, social, and recreational. Methods: A focus group comprising care-for-the-elderly professionals was invited to identify leisure activities commonly practised by elderly Chinese in Hong Kong. An independent panel of occupational therapists in the field of geriatrics and psychiatry was invited to classify the activities into physical, intellectual, social, and recreational categories based on their professional opinion in the context of local practice. The classification was then validated against the opinions of a non-depressed elderly convenience sample with relatively preserved cognition. Results: A total of 33 types of activities were identified, of which 13 were classified as intellectual, 8 as social, 9 as recreational, and 3 as physical. The 3 types of physical activities (mind-body exercise, strenuous aerobic exercise, and stretching and toning exercise) were further divided into different subtypes. Conclusions: An easy-to-understand classification of late-life leisure activities among Chinese has been developed. [ABSTRACT FROM AUTHOR]

Objective: Early intervention to reduce cognitive decline and preserve functioning is a compelling public health issue. Because impaired attention occurs early in the process of cognitive impairment, focusing training strategies upon attention may be a potential intervention to prevent further cognitive decline. We sought to test the effects on cognitive performance and daily functioning of a new cognitive training program that focuses on attention., Method: This single-blind randomized controlled trial lasted 6 months and included two phases. Assessments were conducted at baseline, at 3 months, and at 6 months. The study was performed in four community older adult centers. Ninety-three participants with subjective cognitive impairment without dementia were included. Forty-seven participants were randomized to the Integrated Attention Training Program (IATP), and 46 were randomized to the control group. The two arms of the study included the IATP (intervention group) and a health-related education program (active control group)., Results: No significant interactions were identified between group and time for the Clinical Dementia Rating-Sum of Boxes and other secondary outcomes, except for the Digit Forward Score ( p < .05; effect size, 0.057). When the preintervention and postintervention results were compared, the IATP group showed significant improvement in grand mean effect ( p < .05) and accuracy ( p < .05) in the Attention Network Test, Digit Backward Score ( p < .05), Category Verbal Fluency Test ( p < .05), and Trail Making Test A ( p < .01) immediately after the intervention. These improvements were sustained 3 months after the intervention., Conclusion: The IATP showed domain-specific effects but had no effects on global cognition or functioning. It could not show a superior benefit in cognition and functioning when compared with non-specific mental stimulation in a group format. Further studies are needed to determine the role of attention in cognitive training.