Visual art therapy as a treatment option for cognitive decline among older adults. A systematic review and meta‐analysis

To investigate the effects of visual art therapy (VAT) on cognitive and psychological outcomes and explore the crucial design characteristics of VAT that might be associated with greater cognitive benefits among older adults.Systematic review and meta-analysis.Peer reviewed articles were searched from Medline, EMBASE, Global Health, Cochrane Library, Ovid Nursing database, PsycINFO, British Nursing Index, and CINAHL Complete from inception of the databases to September 2019.This review and meta-analysis was conducted and reported according to preferred reporting items for systematic reviews and meta-analyses guidelines. The Cochrane risk of bias tool was used to examine the risk of bias of the studies. Narrative synthesis and quantitative meta-analysis were performed.Twelve articles published between 2004-2019 involving 831 participants were identified. VAT significantly improved global cognitive function compared with different control groups (Hedges' g = 0.348 [95% CI = 0.026-0.671], p = .034, I2 = 66.570%). VAT also demonstrated psychological benefits in reducing depressive symptoms and anxiety. By systematic comparison of the intervention designs, it seems that those with greater cognitive benefit involved a higher level of creativity and optimized the use of essential components including art education, reminiscence, art processing, cognitive evaluation, art crafts/modelling, and socialization.Visual art therapy could be effective in improving cognitive functions and the associated psychological symptoms. Therefore, it can be adopted as an effective non-pharmacological intervention for preventing cognitive decline and dementia.This review answers the key question about the pooled effect of VAT as nonpharmacological therapy on preventing or managing dementia. In addition, it informs on the design characteristics of an effective VAT for implementing among older adults. This research will have an impact on the gerontological care and support the evidence about non-pharmacological approaches to prevent and manage dementia.目的: 研究视觉艺术疗法(VAT)对认知和心理结果的影响,并探讨视觉艺术疗法的关键设计特征,且此等特征可能与促使老年人获取更大的认知益处有关。 设计: 系统评估与荟萃分析。 数据来源: 通过Medline、EMBASE、全球健康、Cochrane图书馆、Ovid护理学数据库、PsycINFO、英国护理学文献索引数据库和护理学全文数据库(CINAHL Complete)对从数据库建立之初到2019年9月期间所发表的同行评审文章进行检索。 评估方法: 本次评估和荟萃分析工作依据系统评估和荟萃分析指南的优先报告条目开展并进行报告。采用Cochrane偏倚风险工具对研究的偏倚风险进行检验。同时还进行了叙事综合汇总和定量荟萃分析。 结果: 共选出于2004年至2019年间发表的12篇文章,其中涉及831名参与者。通过与不同的对照组相比较,视觉艺术疗法显著改善了整体认知功能(Hedges的g=0.348【95% CI = 0.026-0.671】,p= .034, I2 = 66.570%)。同时,视觉艺术疗法在缓解抑郁症状和焦虑方面还表现出心理益处。通过系统地比较干预设计,那些获得更大认知益处的人似乎具有更高的创造力水平,并充分利用了艺术教育、回忆、艺术加工、认知评估、创艺手工/建模和社会化等基本要素。 结论: 视觉艺术疗法可有效改善认知功能及相关心理症状。因此,它可以作为一种预防认知功能减退和痴呆症的有效非药物干预措施。 影响: 本项评估回答了视觉艺术疗法作为预防或治疗痴呆症的非药物疗法的集中效应的关键问题。此外,它还介绍了在老年人中实施有效视觉艺术疗法的设计特点。该项研究将对老年护理工作产生影响,并对使用非药物方法预防和治疗痴呆症的证据提供支持。.