Arts and Aging Building the Science

7/27/2019 Arts and Aging Building the Science

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THEArTs

And AGInGBuilding the Science


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taBle o contentS

liSt o acronymS.................................................................................................................................................................

ExEcutivE Summary ......................................................................................................1

Commo defciecie i the reeach....................................................................................................................................... 2

Oppotuitie o Movig Fowa .............................................................................................................................................2

Background ................................................................................................................... 3

rESEarch and thE artSBridging thE gul ...................................................... 5

Paticipatoy At o Ole Ault ..............................................................................................................................................5

Muic, Heaig, a Memoy ........................................................................................................................................................6

Muical Taiig a Bai Fuctio .........................................................................................................................................8

Aeig Cogitive declie a demetia with the At................................................................................................ 8

Muic Theapy o demetia ........................................................................................................................................................11

Cot-Beeft Aalyi ......................................................................................................................................................................12

Cot a Beeft o Eviece-Bae Pogam .................................................................................................................. 14

Applyig Cot-Beeft Aalyi ..................................................................................................................................................16

aESthEticS and dESign in group living arrangEmEntS ...............................18Theoetical Backgou o reeach i Viual At .............................................................................................................. 19

deig o EveyoeIcluig Ole Ault .......................................................................................................................21

rESEarch gapS and opportunitiES ..................................................................... 22

reeach deig that Captue Log-Tem Eect o At o the Agig Poce .......................................................22

Iteicipliay Team, Itegate At Itevetio, a Eate Appoache ..................................................23

Theoie, Mechaim, Level o Aalyi, a replicable, rigoou deig .......................................................... 24

Fuig Oppotuitie o Futue Wok .................................................................................................................................25

Goig Fowa: Pomote Co-Talk a Take rik ..........................................................................................................25

aPPendiX 1: WorkShoP ParticiPantS ........................................................................................................................26

aPPendiX 2: commiSSioned PaPerS ............................................................................................................................ 27

aPPendiX 3: WorkShoP agenda ..................................................................................................................................28


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The ArTs And Aging: Building The science

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The ArTs And Aging: Building The science 1

r

ecet a ogoig eeach ugget

excitig poibilitie o the theapeutic

ue o at to impove the health a

well-beig o ole ault. A thipopulatio gow i umbe a a a popotio

o all Ameica, it will expeiece amatic

iceae i the umbe o people with agig-elate

health coitio, icluig cogitive eclie a

emetia. Give the at potetial to teat, pevet,

o amelioate thoe coitio, aitioal eeach

i eee to claiy the elatiohip betwee the at

a the health a well-beig o ole ault.

A pat o a Feeal Iteagecy Tak Foce

o the At a Huma developmet (www.nea.

gov/news/news11/Task-Force-Announcement.

html), the natioal Eowmet o the At (nEA)

a thee uit withi the natioal Ititute o

Health (nIH)the natioal Ititute o Agig

(nIA), the Ofce o Behavioal a social sciece

reeach (OBssr), a the natioal Cete

o Complemetay a Alteative Meicie

(nCCAM)joie i equetig the natioal

Acaemy o sciece (nAs) to covee a public

wokhop aou thi eeach ee. The nAs

wokhop ubequetly aime to ietiy eeach

gap a oppotuitie to ote geate ivetmet

i pomiig at-elate eeach that ca ee

itevetio to impove quality o lie o ole

ault.

so a, paticipatio i at itevetio ha

bee like with impovig cogitive uctio a

memoy, geeal el-eteem a well-beig, a well

a eucig te a othe commo ymptom o

emetia, uch a aggeio, agitatio, a apathy.

some itevetio pomote ocial iteactio,which ha multiple pychoocial beeft.

Muic i the mot commo paticipatoy at

tuie, but theate, ace, a ceative witig alo

hol pomie a eective health itevetio o

ole people. Lielog muic taiig i aociate

with may eect amog ole people, icluig

impove memoy a heaig. Howeve, people

who bega igig o othe muic activitie whe

ole alo eive beeft i may aea, a i ole

people who took actig clae o paticipate i

ceative witig pogam o the ft time.

deig a viual at play a impotat

ole i the well-beig a quality o lie o ole

people. The eig o eietial builig o

ole people ca aect the amout a quality

o ocial iteactio, phyical activity, cogitive

timulatio, a emotioal well-beig o eiet.

The lacapig, tafc ow, builig mateial,

a eig o activity hub all cotibute to the

ucce o ailue o a eietial acility a a thivig

commuity.

I aitio, the iceaig ue o uiveal

eig ca help ole people paticipate moe ully

i omal activitie. Uiveal eig embace

the itegatio o place, thig, iomatio, a

commuicatio to expa acceibility to the wiet

pectum o ue i the wiet age o ituatio.

eXecutive Summary


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i

Mach 2011, the natioal Eowmet o the

At (nEA) a the U.s. depatmet o Health

a Huma sevice (HHs) hote a ft-o-

it-ki evet to howcae a icu eceteeach o the at a huma evelopmet, with

the ultimate goal o fig way to egage the at

to impove people live. The oe-ay oum

examie the elatiohip betwee the at a

poitive health a eucatioal outcome at

vaiou egmet o the liepa a ecouage

the omatio o a log-tem eeal patehip to

pomote eeach a eviece-haig atiowie.

It alo poite to the ee o a ytematic liteatue

eview a gap aalyi to ietiy pioity aea o

uthe eeach.1

Builig o thee pomiig iitial eot,

membe o a eeal takoce icluig the

nEA a thee uit o the natioal Ititute o

Health (nIH)the natioal Ititute o Agig

(nIA), the Ofce o Behavioal a social sciece

reeach (OBssr), a the natioal Cete

o Complemetay a Alteative Meicie

(nCCAM)equete that the natioal Acaemie

(though it Committee o natioal statitic)

covee a public wokhop to exploe way to

tegthe eeach o the elatiohip o the at

1The Arts and Human Development: Framing aNational Research Agenda for the Arts, Lifelong Learningand Individual Well-Being(2011), available atwww.arts.gov/research/TaskForce/Arts-and-Human-

Development.html.

a agig. The wokhop wa hel septembe 14,

2012, i Wahigto, dC. The eciio to ocu o

ole Ameicaa to ietiy eeach gap

a oppotuitiei bae o a gowig iteeti ovel itevetio appoache o impovig the

health a quality o lie o thi gowig populatio.

I hi opeig emak, davi reube, a

geiaticia, eeache, a eucato bae at

the Uiveity o Calioia, Lo Agele (UCLA),

a chai o the wokhop, ecibe ou o hi

patietall atit o peomewho emai

highly egage a pouctive well ito thei

80 a 90. Wee thee patiet jut exceptioal

iiviual, reube ake, o i thei lietime

ivolvemet i the at help them avoi the cogitive

eclie a othe apect o agig that o ote

eoe ou health a quality o lie? To awe

thee quetio, a ely le heavily o aecote,

moe eviece i eee. specifcally, i thee a

boy o cietifc eviece that emotate the

ole o ceativity i the at i maitaiig health?

Ca geate ivolvemet i the at by ole people

euce the ue o meicie that ca have eiou

ie eect?

Paticipat om multiple icipliay

viewpoit, icluig auitoy a cogitive

euociece, geiatic, ocial wok, pychology,

epiemiology, theate at, muic, achitectue, cot-

eectivee a ecoomic, a health evice

eeach, attee the septembe 2012 public

wokhop to exploe topic elate to thee type o

Background


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4 The ArTs And Aging: Building The science

quetio. (see Appeix 1 o lit o paticipat.)

They ought to bette ueta i paticula:

The elatiohip o at pogam a

itevetio to pychological well-beig,

cogitive, eoy, a moto kill uctio

i ole ault, a the uelyig eual

pocee;

Beeft a weakee o at theapie

compae with othe behavioal a/o ug

itevetio o ole ault with ecliig

cogitive, eoy, o moto uctio;

Cot-eectivee aalyi o uch pogam

compae with othe healthcae itevetio

o thi populatio; a

The elatiohip o aethetic a eig actoto health a quality-o-lie-elate outcome o

ole ault i log-tem cae a aite livig

acilitie.

Five pape wee commiioe o peetatio at

the wokhop to ote cocete icuio about

eeach gap a oppotuitie o exploig

the elatiohip o at paticipatio to phyical

health a pychological well-beig i ole ault

(Appeix 2). Thee pape ae beig pepaeo publicatio a ae ot ummaize hee. A a

collectio, the pape a peetatio eiche

the wokhop icuio about the challege o

builig eeach capacity. They oe guiace o

the eig o utue tuie a eeach.

repeetative o eeal uig agecie that

co-pooe the wokhop coiee it impotat

o avacig thei vital iteet i ehacig health

o ole Ameica o multiple level, icluig

evelopig eective health itevetio, ceatig

ew tategie to ehace ocial ivolvemet a

uppot amog ole ault, a iceaig the

awaee a pomotig the aoptio o eective

health itevetio. Maie A. Bea, eputy

iecto o the nIA, emphaize the type o eeach

o paticula iteet to the nIA, icluig:

Icopoatig at activitie i itevetio to

emeiate o elay age-elate cogitive eclie

o eoimoto impaimet;

Examiig the potetial o pecifc at activitie

a itevetio to ehace quality o lie i

ole ault i ieet eietial ettig a

with ieet health tatue;

Examiig the potetial o at itevetio

to uppot healthy commuitie a ecouage

ocial egagemet aco geeatio; a

Uetaig the potetial impact o the at

o othe health outcome.

rocco Laema, the-chaima o the nEA,

ecibe the nEA eot to peuae eealagecie to pomote the impotace o the at i

othe ecto a it cotiue eot to geeate

geate uppot o a ackowlegemet o the

at. suil Iyega, iecto o the nEA Ofce o

reeach & Aalyi, uge the ogaize, peake,

a paticipat to coie thee oveachig iue:

Ae thee theoetical moel that explai how

paticipatio i the at aect the health a

well-beig o ole Ameica?

How ca we bet meaue the eect o at

paticipatio o ele health, give the complex

web o vaiable at wok? I paticula, ae thee

iovative tuy eig that coul be ue i

lieu o raomize Cotolle Tial (rCT)?

How ca we buil eeach capacity i thi aea?

Ca we utue a cae o eeache who ca

take thi eeach to the ext level a who ca

attact the uppot o potetial ue?

The emaie o thi epot highlight omiat

theme expee at the wokhop a ietife

efciecie i cuet eeach a oppotuitie o

movig owa. The wokhop agea i iclue

a Appeix 3.


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i

volvemet with the at ca aect people o

may phyical, cogitive, a emotioal level,

ceatig eect that ae ifcult to captue uig

taa eeach eig. Cultual ieecebetwee atit a eeache alo ca make it ha

to pouce what the cietifc eeach commuity

woul ecibe a cietifcally igoou eeach.

noice, noice, a Kame (2012) have epote

that thei each o the liteatue eveal a paucity

o eeach o the eect o at paticipatio a

phyical, cogitive, a pychological well-beig,

poibly becaue atit te to have a miet that

eit quatifcatio a eeache ae geeally

ucomotable with vagaie.2 A Toy noice

metioe, atit ae moe likely to ay, Let o

omethig a ee what happe.

Wie ue o eective theapeutic at pogam

coul ehace the health a well-beig o ole

Ameica. The cietifc commuity expect

cietifc eviece ot oly to emotate that

itevetio ae eective but alo to povie baic

iomatio about the equecy a iteity

equie (oe), the uatio o a eect, a

whethe the at itevetio wok at leat a well

a othe health itevetio.

2 noice T., noice H., a Kame A. 2012. PaticipatoyAt o Ole Ault: Beeft a Challege. Papepepae o the Wokhop o reeach Gap aOppotuitie o Exploig the relatiohip o the At toHealth a Well-Beig i Ole Ault, natioal Acaemyo sciece, Wahigto, dC, septembe 14, p.3.

The aemet o exitig eeach by the

wokhop peete ietife a umbe o commo

efciecie i at itevetio eeach, icluig:

Pooly efe, oaom, a mall ample.

Iaequate cotol goup.

Pooly efe o iaequately ocumete

at itevetio, epecially with ega to the

equecy a iteity o the activity (the oe),

makig fig ifcult to eplicate.

Icoitet health outcome aco tuie a

lack o commo tool o meauemet.

Weak tatitical methoology, epecially

give attitio o miig ata, a ovetatecocluio.

participatory artSor oldEr adultS

Wokhop paticipat Toy a Helga noice

exploe the elatiohip betwee paticipatoy at

a the cogitive/phyical health a pychological

well-beig o ole ault. They peete ome

compellig tuie howig how ole paticipatbeefte om a vaiety o at (ace, muic,

pottey, viual at, a expeive witig).

Toy noice, a poeioal acto a eucato,

emotate how actig clae he couct with

ole paticipat compel cogitive, emotioal, a

phyical actio. Actig alo egee tog ocial

reSearch and the artSBridging the gul


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uppot, a valuable aet o ole people.

To quatiy how actig aect ole people, the

noice aomly aige 122 eligible volutee

om etiemet home to a actig, igig,

o waitig-lit cotol goup. Ate a ou-week

iteive coue, the acto impove igifcatlyo eve o eight cogitive meaue, moe tha the

ige o cotol goup. Both the acto a ige

impove o el-epot o peoal gowth, a

meaue by a taa quality o lie meaue. The

cotol goup i ot how the ame impovemet.3

A theate taiig pogam ow i poge

ha ae euoimagig [MrI] to captue

poible chage i bai uctio elate to active

paticipatio i theate. Kame ecibe how

euoimagig ha bee ue to augmet cogitivea pychoocial meaue a to eveal chage

i bai uctio i ivee itevetio, icluig

execie a well a volutee activity.

Kame epote that he i wokig o a nIA-

uppote tuy cotatig balloom acig with

walkig, toig, tegtheig, a tetchig o

multiple pychoocial, behavioal, a euoimagig

meaue peviouly ue i walkig tuie. dace

i tuly multimoal, which ca complicate evaluatig

it eect uig taa eeach eig.

repoig to quetio om the auiece, Toy

noice emphaize the beeft o the multimoal

apect o actig: It ivolve the mi, boy, a

emotio. Ulike playig a itumet, actig oe

ot equie peviou taiig, o eve iitial iteet.

Paticipat i 15 yea o hi actig clae impove

o the outcome tete eve though they wee

aomly aige to the actig veu igig cla.

3 stuy paticipat wee ceee uig the Peie shotPotable Metal statu Quetioaie to eue theyha itact itellectual uctioig. The eight cogitivemeaue wee: Wo Lit Memoy, Wo Lit delayerecall, Categoy Fluecy, digit spa Fowa, digitspa Backwa, Eat Boto Memoy Tet, Eat BotoMemoy Tet elaye, Mea-E Poblem solvig. Iaitio, oe Quality o Lie scale wa amiitee: selrepote Peoal Gowth.

muSic, hEaring, and mEmory

nia Kau peete eeach o muic taiig

a agig. Oe o the mot commo complait o

a ole ault, Kau ote, i uetaig peech

whe thee i backgou oie. Aothe commo

poblem i the eclie o auitoy wokig memoy

with age. The eviece i eouig that, aco

the lie pa, muical taiig a paticipatio

ca be a emey o both poblem, a emotate

by taaize tet o heaig i oie a o

wokig memoy.

How oe muic taiig help? With ega

to heaig, Kau ote that muicia ae goo

at extactig elevat iomatio om a complex

oucape a that thi ability talate to a

geate acility with heaig peech i oie i ole

age, eve a heaig eclie.

Muic peomace equie memoy. To lea,

ea, a peom muic, muicia mut memoize

ou a viual patte; memoize auitoy-moto

equece; tue a itumet; a impovieall

activitie that execie memoy.

To bette ueta how muic taiig

aect cogitive activity, Kau a he colleague

examie bai activity i ole people with a

without muic taiig. They wee iteete i thelowig o eual activity that occu with agig.

Thi lowig i aociate with eceae ihibitio,

boae eual tuig, loge eual ecovey, a

a iceae i eual backgou oie. Kau a

colleague applie a biological appoach calle

auitoy baitem epoe to complex ou

(cABr), which ue a ew calp electoe to

captue the electical activity o euo i the bai

ue pecifc ituatio. The eual epoe to

ou come lagely om the mibai, the ite ocovegece o iomatio comig om the ea

a ivolvig emotioal aea: executive uctio,

attetio, a memoy. The mibai play a citical

ole i auitoy leaig. Kau a he colleague

examie eeback to the auitoy ytem om bai

egio epoible o executive uctio.


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The cABr techique i a eective a

poweul way to tuy bai activity elate to

commuicatio/ou, a well a how the bai

i chage by expeieceo example, muical

taiig. Kau eviio cABr aaptatio om

laboatoy ue to a much wie ue i the feli etiemet home, o example, uig a heaba

a iPa. The cABr eeach emotate the

eect o agig o timig, hamoic magitue,

ychoy (phaelockig), coitecy, a

eual oie.

Kau cite the commo ifculty o

itiguihig bill om pill, amog ole people.

The iitial lettea api, complex oui the

ouce o the ifculty i uetaig. The cABr

eult howe that epoe euo eact moelowly amog ole ubject, which mea that it

take lightly loge o ole people to ueta

the ou they have jut hea. The fig i

coitet with thoe om aimal tuie. The

evou ytem oe ot low o all ou, but

oe o ha, complex ou. Kau a he

colleague alo ou le coitecy i the eual

epoe to the epetitio o the ame ou i a

ole tha i a youge bai.

The evou ytem i goo at accuately

epoig to the ou equecie that make up

muic a peech, but thi capacity imiihe a

people age. I aitio, the peceptio o backgou

oie iceae with agig. Thee two acto may

copie to make heaig moe ifcult a we age.

Kau eeach with cABr how that

muicia weathe thee agig eect bette tha

omuicia. she ou that muicia bai

ae quicke to epo to ou a that ole

muicia ca itiguih ou moe coitetly

a ueta peech i backgou oie bette

tha ole omuicia.4 He fig ugget that a

lietime o makig muic pomote impove heaig

i oie, auitoy memoy, a biological poceig

4 I thi tuy, active muicia pactice 20 miute aay, thee time a week.

o ou. Paticipatio alo ehace commuicatio

kill, cogitive uctio, a phyical health.

rs gps Qss

Kau ote that, while thi eeach ugget

umeou beeft om paticipatio i muic, the

equecy o iteity o paticipatio equie to

gai thee beeft emai ucetai. Thee ae

may potetial eeach quetio: do the beefcial

eect iipate i people abao thei muic o

igifcatly euce thei pactice time? I o, how

log oe thi poce take? Ca they egai the

beeft i thei ole age i they etu to muic?

do people who take up muic o the ft time at

ole age alo eap beeft?

Kau ee clue to the awe to theequetio i two aveue o eeach: hot-tem

muic taiig amog chile a otwae-bae

taiig with ole ault. He eeach how that

chile eceivig muic taiig impove thei

eaig a vebal IQ moe tha thoe eceivig

at taiig, o with eithe type o taiig. Kau

aete that thi cooboate othe eeach

howig a paticulaly tog cogitive beeft

o muic, uggetig that muic might opeate

ieetly tha othe paticipatoy at.reeach with ole ault ha emotate

that otwae-bae taiig ca mimic the cogitive

beeft o muic taiig. A cuet tuy o a

auitoy- a memoy-bae bai fte pogam

put out by Poit sciece ou that heaig i oie

impove ate a iteive taiig pogam.5 Kau

alo ou gai i the auitoy wokig memoy o

tuy paticipat, compae with a cotol goup.

she ee thee fig a coitet with eviece

that the ole evou ytem i malleable a

capable o poitive chage.

I epoe to quetio om the auiece,

Kau tee the act that he eeach ivolve

people who ae actively playig a itumet.

5 The paticipat taie o the otwae 40 miute aay, fve ay a week o two moth.


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Mot o he ata petai to itumetalit a

the itumet ue oe make a ieece. The

evou ytem epo to the ou o the pecifc

itumet playe. cABr eult howe that

bai epoe wee geate o people playig

the baoo tha thoe playig piao, o example.A iteetigly, the evou ytem o taie

muicia epo to thee apect o ou

whethe they ae awake o aleep.

Kau ha a cuet tuy compaig vocalit

a umme, which peet challege whe

cotuctig a cotol goup becaue ige caot

pactice a may hou a people who play othe

itumet. Yet, igig ivolve the etie boy,

o it i moe itee i ome way. How much

people pacticewhethe they play aloe o ieembleall make a ieece a waat

aitioal eeach.

muSical trainingand Brain unction

Gottie schlaug, who i both a euocietit

a ogait, alo peete iomatio about the

elatiohip betwee muical taiig a bai

uctio. He wa aw to the topic becaue o a

peoal iteet i the euociece o peect pitch.schlaug compae the bai activity o people

who ae active muicia with paive litee.

Muicia, he ai, ae auitoy-moto athlete.

Thei bai have a igifcatly lage copu

colloum tha omuicia, paticulaly the iteio

two-thi o that egio. He ou vaiatio

accoig to the iteity o muical taiig a

by the type o itumet, peumably eectig

the ieet moto a auitoy kill equie. He

a colleague tuie the 3d cofguatio o thepecetal gyuite o the pimay moto cotex

amog tig playe a keyboa playe. stig

playe ha a moe elaboate ight moto cotex

cotollig the let ha, while the keyboa playe

ha a moe elaboate moto cotex o both ie o

the bai.

He peete vieo eviece o the theapeutic

ue o muic with people ecoveig om a bai

ijuy. A toke victim who coul ot ay I am

thity i compeheible peech coul ig the

ame wo with peect claity. schlaug ecibe

how epeate taiig coul eable ome patiet toegai the ability to peak the wo.

Muic alo ehace movemet i people

with Pakio ieae (Pd). schlaug howe

a vieo epictig how the gait a exibility

o a Pd patiet amatically impove whe

muic wa playe. similaly, noice, noice, a

Kame (2012) epote that Pd patiet howe

amatic impovemet i exibility a movemet

ate paticipatig i balloom acig clae.

reeache o ot ueta why a impaiebai ca eact o togly to muic. The eviece

how that muic ca have emakable theapeutic

eect i ome itace.

addrESSing cognitivE dEclinEand dEmEntia With thE artS

The umbe o Ameica with Alzheime ieae

(Ad) will moe tha ouble betwee 2010 a 2050,

om 5.1 millio to 13.2 millio. The iect cot o

thei cae will oa om $172 billio to $1.1 tillioove that peio.6 Thee ae o phamaceutical

cuetly available that halt the ieae, jut fve

FdA-appove ug that tempoaily impove

ymptom. But fig way to elay the ebilitatig

eect o Ad woul igifcatly euce the cot o

cae.7 Thi make the theapeutic ue o at o ole

6 see Figue 4 a page 48 i Alzheime Aociatio,2012 Alzheime dieae Fact a Figue.Alzheimersand Dementia: The Journal of the Alzheimers Association.Mach 2012; 8:131-168 a Alzheime Aociatio, 2010

Alzheime dieae Fact a Figue, both available atwww.alz.org.7 The 2012 Alzheime dieae Fact a Figue ote:Becaue o the iceae cot a lo o iepeeceaociate with placemet i a uig home, tategieto pevet o elay uig home placemet ae eiable.It ha bee etimate that elayig log-tem cae by oemoth o each peo i the Uite state age 65 o olecoul ave $60 billio each yea.


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emetia patiet a impotat iue o eeach

om a public health pepective.

Ae Batig a Kate e Meeio aee

the boy o cietifc eviece elate to at a

othe type o itevetio o cogitive eclie,

euopychiatic ymptomuch a agitatioo ight waeiga quality o lie i people

with emetia.

Batig a e Meeio examie ytematic

eview o eeach o thee type o itevetio:

phamacological, ophamacological (excluig

the at), a at pogam. Thee wee ealy

2,900 tuie publihe o thee topic ice 2000,

but ew at itevetio tuie wee iclue i

ytematic eview, ote becaue they i ot meet

eviewe baic citeia o a aomize eiga aequate cotol. A tate by othe wokhop

peete, at itevetio ae ifcult to

tuy i a rCT, which i coiee the gol

taa o cliical tial eige to tet a

itevetio efcacy o eectivee. At

itevetio ivolve multiple elemet that ca

iuece behavio, icluig ocial iteactio,

peoal iteet, a the quality o ituctio o

elivey mechaim.

de Meeio alo poite out that tet

geeally ue i rCT ivolvig cogitio a

behavio wee evelope o phamacological

tuie a tagete o the legth o time eceay

o a ug to take eect. such tet o ot captue the

immeiate impact o a at itevetio o moo

o apathy. Futhe, ome commo tet, uch a the

neuophychiatic Ivetoy, meaue behavio

uch a eluio a halluciatio, which ae

ulikely to be aecte by a at itevetio. Thi

make it ifcult to compae eult betwee at

itevetio a phamacological itevetio.

Give the poblem fttig at itevetio

tuie ito the taa rCT eig, Batig a

e Meeio expae thei aemet to iclue

itegative eview o tuie, which coie

moe qualitative apect o eeach. Becaue

phamacological itevetio wee well covee i

the ytematic eview, the autho exclue them

om the itegative eview.

Batig a e Meeio aemet o

phamacological itevetio ou that the

ug doepezil howe mot pomie o lowig

cogitive eclie, epecially whe combie withcogitive timulatio. But thi a the othe ug

tuie have igifcat ie eect, which ca

outweigh thei theapeutic beeft o patiet with

Ad. They ote that jut fve ug ae appove by

the Foo a dug Amiitatio (FdA) o ue

i Ad patiet. All how limite eectivee a

egative ie eect.

nophamacological itevetio eviewe

iclue behavio maagemet a moifcatio,

cogitive timulatio (though icuio oactivitie), chagig the phyical eviomete.g.,

emovig mio o iguiig oowayemotio-

oiete cae, a imulate peecee.g., though

vieo o amily membe.8

The at itevetio iclue i the ytematic

o itegative eview pimaily ivolve muic,

which might age om paive liteig to muic

(to calm patiet) o active um cicle paticipatio.

The tuie i ot ae cogitive eclie

but eveal epote impove euopychiatic

ymptom, uch a euce aggeive o agitate

behavio. seveal muic itevetio impove

patiet epote quality o lie, a i ome tuie

o itevetio ivolvig ama a paticipatoy

at-makig.

I geeal, the eview ou pomiig eult

om ophamacological itevetio, but the

tuie wee aulte o thei weak tuy eig.

The ample tee to be quite mall (117 patiet

o ewe) a the meaue outcome wee ot

compaable aco tuie.

The tuie tete o ieet type o

outcome, but the eult oveall howe ome

8 Othe itevetio iclue eality oietatio,emiicece, eoy timulatio, valiatio theapy, aTAP (Tailoe Activity Pogam).


18/40


beeft to cogitio. seveal itevetio i aect

euopychiatic ymptomeucig agitatio o

ight waeig, o examplebut ecoe little o

o iceible eect o quality o lie.

Becaue at-bae itevetio ae

multimoal, multilevel, a may pouce ubtlechage, they ae ifcult to evaluate a rCT.

May meauemet tool cuetly beig

ue caot captue the tue o ull impact o

multimoal itevetio. Batig a e Meeio

ecommee ietiyig a evelopig alteative

appoache to at itevetio eeach. rathe tha

ocuig o a peee itevetio, uch a muic,

ace, o theate, they uggete that eeache

ue a itegative appoach that combie thee

activitie a buil i impoviatio, expaig themultimoal apect o paticipatoy at.

They uthe ecommee eachig o the

mechaim that lea to cogitive o othe chage

to ueta how a itevetio might aect

cogitio a behavio: What ee ae egage

a how? I the itevetio paticipatoy? doe

it acilitate cogitive uctio o ocial iteactio?

They uecoe the ee o moe etail about

a itevetio to ietiy thoe mechaim a

to elect appopiate meauemet tool. such

iomatio will claiy who ca povie the pogam

(caegive o taie poeioal) a eich

coveatio betwee theapit a atit. Alo,

eeache ee to evelop itevetio tailoe

o a iiviual ituatio.

Fiig appopiate tool o evaluatig at

itevetio i cucial. de Meeio ai the

ft tep woul be to etemie which behavio

o uctio (e.g., apathy, iitability, ocial

coectee, appetite) woul be poitively aecte

by at-bae itevetio a ove what time

peio (e.g., oe hou, oe ay, oe week, etc., ate

the itevetio). she ai that tet that ca captue

immeiate a log-tem epoe make the mot

ee o evaluatig a at-bae itevetio.

The Obeve Emotio ratig scale i oe optio.9

Although a extemely bie cale, it povie a

way to eco the appeaace o pleaue, age,

axiety, ae, o geeal alete i fve-

miute iteval. Othe poible tet iclue

moitoig chage i oo coumptio, the ApathyEvaluatio scale, a a moe etaile veio o the

neuopychiatic Ivetoy.

Batig a e Meeio uggete that

eeache a atit woul o well, moeove,

to ocu o the impact o itevetio beyo

the iiviual. Atitic pouct ca ceate ocial

capital o peo with emetia by oteig cloe

coectio amog patiet, cae pate, ie,

a amily.

I epoe to auiece quetio, Batigecibe the wie impact o the Timeslip

pogam, which ivolve impoviatioal toytellig

with emetia patiet. The Timeslip pogam

ecouage people with emetia to expe

themelve though goup-geeate toie,

a ailig memoie i ot ete thei ceative

toytellig. Ate te week i the pogam,

paticipat i log-tem cae acilitie with the

Timeslip pogam wee moe egage a alet.

The pogam ca be amiitee by taie

uig home ta; oe o the upiig beeft

ha bee impove elatiohip amog the ta

a eiet. sta i Timeslip acilitie epote

moe equet ta-eiet iteactio a a

moe poitive view o thei patiet tha ta i the

cotol acilitie with o pogam.10

9 Lawto, M., Va Haitma, K., Klappe, J. 1999. ObeveEmotio ratig scale, available at www.abramsoncenter.org/pri/documents/observedemotion.pdf.10

Fitch, T., et al. 2009. Impact o Timeslip, a CeativeExpeio Itevetio Pogam o nuig Homereiet with demetia a Thei Caegive. TheGeronologist 49(1): 117-127; Philip, L., s.A rei-At,a Y. Pak. 2010. Eect o a Ceative ExpeioItevetio o Emotio, Commuicatio, a Qualityo Lie i Peo with demetia,Nursing Research59(6): 417-425. summaize i The Arts and Human

Development: Framing a National Research Agenda for theArts, Lifelong Learning and Individual Well-Being(2011),available at www.arts.gov/research/TaskForce/Arts-and-

Human-Development.html.


19/40


she uge eeache to imagie itevetio

that ca egage people outie cogegate cae

ettig. Mot itevetio ivolve people livig i

goup ettig, yet they ae a mall mioity o the

ole populatio. With the comig wave o ole

people, a utue challege will be impovig the liveo people eiig i thei ow home, ote iolate

om amily a ie.

Batig calle o exploig cot-eectivee

a ie eect o at-bae itevetio;

uppotig collaboatio betwee eeache

a at-bae pactitioe; a couctig

emotatio with eaoe eeache to bette

ueta mechaim a to yiel eciptio

though eh eye.

muSic thErapy or dEmEntia

Julee Joho, a muicia a well a a poeo,

peete eviece o the theapeutic ue o muic

pecifcally to help emetia patiet. Ealy tuie

ocue o uig muic to help maage the behavio

o people with evee emetia, uch a eucig

agitatio o aggeio, a well a iceaig alete.

numeou tuie alo have ocumete that Ad

patiet etai muic kill a muic memoy (a

peeve memoy o muic) log ate thei othecommuicatio a cogitive kill imiih.

Joho eviewe 24 tuie that ue

muic to maage emetia ymptom. The muic

itevetio wee vaie a iclue liteig to

live o ecoe muic, paticipatig i igig o

playig itumet, muic theapy, a combiig

muic with movemet. The paticipat geeally

wee i evee tage o Ad o othe emetia a

live i aite livig ettig. The ample wee

typically mall, aou 25 ubject; may wee otaomize to teatmet. The tuie late ix

to eight week, with the itevetio, o expoue,

agig om 30 to 60 miute, two to thee time

pe week.

Joho epote that may o the tuie ou

that muic itevetio euce ome egative

behavio aociate with emetia, icluig

aggeio, agitatio, axiety, epeio, a

waeig. A ew ou impovemet i cogitive

kill (pecifcally memoy a laguage). But othe

tuie ou o chage i behavio o ou a

chage i behavio but ot i cogitive kill.Thee tuie epote iteetig a

pomiig eult but i ot povie tog

cietifc eviece o efcacy o itevetio

becaue o eig hotcomig. noe iclue a

CBA o the itevetio. she quote the cocluio

o the Cochae goup eview o te tuie a a

ummay o the ituatio: Thee i o ubtatial

eviece to uppot o icouage the ue o muic

theapy i the cae o ole people with emetia.

Futhe, the methoological quality o thee mall,hot-tem tuie wa geeally poo, a wa the

peetatio o eult.11

Joho looke at thee aitioal tuie

a eache a imila cocluio. I geeal, the

citicim wee imila to thoe ietife by othe

eeache a ummaize above: iaequate

ample a metho, limite a iappopiate

outcome meaue, weak tatitical metho, a

icocluive eult.

I cotat, the tuie o phamacological aget

Joho eviewe wee well-eige, iteatioal

rCT coomig to high eeach taa.

nevethele, the eult wee iappoitig, howig

that eithe doepezil o Mematie wee eective

o teatig agitatio i Ad a that they ha egative

ie eect. Futhemoe, thee ug i ot euce

bue o caegive, which i a igifcat pat o the

cot o Ad.

Joho alo eviewe the fig om tuie

o othe ophamacological itevetio with

11 Vik, A., Buima, M., scholte, r. 2011. Thee Ino subtatial Eviece to suppot o dicouagethe Ue o Muic Theapy i the Cae o Ole Peoplewith demetia. Cochae demetia a CogitiveImpovemet Goup. Publihe olie a acceeat summaries.cochrane.org/CD003477/there-is-no-substantial-evidence-to-support-nor-discourage-the-use-of-music-therapy-in-the-care-of-older-people-with-dementia.


20/40


emetia patiet.12 Thee tuie looke at uch

itevetio a behavio maagemet, amily-bae

copig theapy, eviometal maagemet, ha

maage, a phyical activity. Howeve, the tuie

tee to ue om the ame methoological

poblem a the muic itevetio pogam.

ms is app Ps

depite thee limitatio, Joho eview o muic

itevetio howe they may pove eective i

ome cicumtace. At a miimum, eveal tuie

uggete that muic helpe impove behavioal

ymptom. Muic ha the potetial to impove the

quality o lie o both the peo with emetia

a caegive. Muic alo ha the potetial to be

cot-eective, impoe miimal ik, a i eailyacceible, icluig o cultually ivee ole

ault a thoe with emetia.

Joho peete eveal uggetio o

impovig the quality o eeach tuie o muic

itevetio:

Ecouage co-talk betwee muic a

emetia eeache (iteicipliay team,

icluig tatiticia a methoologit).

Coie uig iteatioal cliical tial citeia

o coult the Alzheime dieae Coopeative

stuy (AdCs), a acaemic eeach cootium

that tuie itevetio o Ad.

12 Fo example: Coope, C., et al. 2012. sytematicreview o the Eectivee o no-PhamacologicalItevetio to Impove Quality o Lie o People withdemetia.International Psychogeriatrics 24(6): 856-70 (Ju); Gauthie, s., et al. 2010. Eect o doepezilo Activitie o daily Livig: Itegate Aalyi oPatiet data om stuie i Mil, Moeate a sevee

Alzheime dieae.International Psychogeriatrics 22

(6): 973-983; Hulme, C., et al. 2010. no-PhamacologicalAppoache o demetia that Iomal Cae Might Tyo Acce: A sytematic review.International Journal ofGeriatric Psychiatry 25 (7): 756-763; Livigto, G., et al.2005. sytematic review o Pychological Appoacheto the Maagemet o neuopychiatic symptomo demetia.American Journal of Psychiatry 162 (11):1996-2021; Olaza, J., et al. 2010. nophamacologicalTheapie i Alzheime dieae: A sytematic review oEfcacy.Dementia and Geriatric Cognitive Disorders 30:161-178.

Iclue moe ethically a cultually ivee

ole ault.

develop bette theoetical moel to iom

eeach agea.

Coie ovel way to captue the eect o

muic o ole ault.

Iceae baic eeach about poceig/

expeiece o muic o ole ault.

Coie itevetio eect o both Ad a

o-Ad emetia.

Coie muic itevetio i ealy-tage

emetia a poibly aco the liepa.

Mot people will ot evelop emetia but may

expeiece agig-elate cogitive eclie. They

coul alo beeft om muic itevetio.

(The impotace o muic though the liepa i

ackowlege with govemet uppot i Fila,

o example.)

coSt-BEnEit analySiS

Emmet Keele aee the ifcult but eceay

execie o couctig CBA o at itevetio.

I thi couty, which ha the wol mot

expeive healthcae, it i alway impotat to

ak how much a itevetio will cot a jutiy

why moey houl be pet o it athe tha ome

othe itevetio.

At itevetio have may itagible

beeft, which may accue to caegive o amily

membe a well a the patiet. Thi acto make

it hae to couct CBA, which equie umeic

iput ito a table o coeca o iect a iiect

cot a well a the etimate meical cot oet by

the itevetio.

Keele peete a pime o the vaiou

metho o weighig cot veu beeft o ay

health itevetio. reeache geeally opt o

a ull CBA, the taa o aeig the impact

o egulatio o a iuty. Cot-oly aalye

ae ueul i buie but ae ot appopiate o


21/40


at itevetio becaue health itevetio,

whethe at pogam o bloo peue ceeig,

ae meat to impove health, ot jut to ave moey.

Aothe type o aalyicot-eectivee (CE)

aalyiocue o oe eect o outcome a may

be appopiate oly o ome at itevetio. Theyae ot eige to captue multiple eect o the

patiet a poibly o othe.

Although ome beeft ae vey ifcult to

quatiy, eeache ee to place a olla value

o all eect to obtai the et value o the pogam.

They mut go though the ame execie with

othe optio, uch a the tatu quo o aothe

itevetio.

He ote that eeache ee to pick

meaueable objective, povie eviece that apogam wok, a how how it compae with the

cot a beeft o othe itevetio. The tep

iclue ae:

speciy exactly what i beig cote.

Chooe which beeft a impact to cout.

Peict cot a impact a moetize them.

dicout utue olla to peet value.

Calculate the et beeft a chooe the

pogam with maximum et beeft.

Couct a eitivity aalyi o key aumptio

a coie the impact i aumptio ae

chage.

The cot compie the cot o each activity i the

pogam, icluig et-up (taiig a plaig, o

example) a ogoig cot. Typically, eeach cot

ae exclue.

The owteam cot ae ote le cetai,

eve though they may be ubtatial. I meical

aalye they ae moele uig ieae hitoy

moel: suppoe the at pogam potpoe ety

ito log-tem cae. Thi coul elay majo cae

cot, Keele ai, but quatiyig that eect equie

a umbe o aumptio.

The actual cot o upplie, et, o woke

ae aothe iput. Labo cot ae calculate by

etimatig the time equie o each activity at

aveage wage. The value o volutee time poe

a ieet quetio becaue thee i a oppotuity

cot: What ele coul oe be oig i etie? I a

imila vei, houl amily caegive time be eteea $0 o a appopiate wage ate? People may like

the eelig o helpig thei paet o poue, but

withi limit. At ome poit, they may be willig to

pay to egai ome o thei time.

The paticipat alo coul be oig omethig

ele with thei time, a the pogam coul alo

icu a oppotuity cot o them. Howeve, i the

pogam i u, the the paticipat time woul be

coute a a beeft a ot a cot.

Q ajs l ys (Qalys):cb dss hBfs

Health pogam aim to impove lie expectacy a

uctioig, but the quality o lie i alo impotat.

Feelig healthy o ft, comotable a pai ee

eve happy, ueul, a ocially coecteall help

efe the quality o thoe exta yea o lie.

Keele poite out that a lot o health pogam

ae ot jut aime at exteig lieiee, peopleuego milly ageou opeatio to impove

uctioig o gai ymptomatic eliethu a CBA

ee to coie impovemet i health a i the

quality o lie. QALY age om 1 (excellet health)

to zeo (eath), with vaiou tate o impeect

health i betwee. Thee value ae etemie by

health-elate quality o lie (HrQL) weight

applie to each yea o lie, i.e., QALY = yea x

HrQL acto o thoe yea. Oe ummay meaue

aggegate QALY.13

13 The ajutmet atio o quality o lie give pecifciabilitie i etemie uig uvey epoe aboutthe umbe o iability-yea a peo woul be willigto oego o evey yea o iability-ee lie. Fo a toke

victim, the value i 0.7, meaig that people have ai theywoul, o aveage, give up 14 o the ext 20 yea o lie ithey coul avoi livig with toke iabilitie.


22/40


W is d v h?

Accoig to ecoomic theoy, the value o

omethig i what people ae willig to pay o it

(Willige to Pay [WTP]). Health i a impotat

outcome that i ot puchae iectly, o ha o

clea pice. reeache ca etimate WTP value o

health i two way: 1) implicit choice, e.g., haza

pemium wage o ageou job; a 2) uvey

that ak people what they woul pay o pecifc

goo. The liteatue o both thee metho how

that people ae willig to pay betwee $1,000 a

$10,000 to euce thei ik o yig by 1/1000o

example by payig ubtatially moe o a top

ugeo to peom a iky opeatio. The value o a

aitioal QALY age om $50,000 to $250,000.

a r-W cBa exp:c gp

Keele explaie the baic piciple o CBA with

ega to at itevetio, ecibe i a pape

by Gee Cohe a colleague. I the tuy, about

160 ambulatoy ole ault wee aige to a

choale goup o thei uual activity.14 Paticipat

i the poeioally u weekly eio epote

bette oveall health (to 0.1 taa eviatio), two

ewe octo viit, a ewe ove-the-coute

meicatio a all tha the cotol goup. I thi

example, Keele aume that 0.1 taa eviatio

i health i equivalet to a 0.01 iceae i the cale

o health quality o lie ajutmet that goe om 0

to 1 o excellet health. He i ot aig a value to

othe activitie.

Net Costs

Keele aume $50,000 o the cot to maage

the poeioal choale goup. He etimatea meical avig o $250 o each o the 80

14 Cohe, G.d., Peltei, s., Chaplie, J., Kelly, J.,Fith, K.M., a simme, s. 2006. The Impact oPoeioally Coucte Cultual Pogam o thePhyical Health, Metal Health, a social Fuctioig oOle Ault. The Gerontologist 46, o. 6: 726-734.

paticipat i the choale goup i avoie octo

viit, o $20,000 total (80 x $250). so the et cot i

$30,000 ($50,000-$20,000).

Net Beneft

Aumig WTP o each aitioal QALY i $50,000,Keele etimate that the iceae health i woth

$500 o each paticipat (0.01 x $50,000). He

aume the u o igig i woth $10 each week

to each paticipat; 30 week o u the a up to

$300 o u. The aveage total iiviual beeft i

thu $800, o the total et beeft o the pogam

paticipat woul be $64,000 (80 x $800).

The pogam ha a et poitive eect ($64,000

> $30,000), but by Keele ough calculatio the

pogam i ot eceaily cot-avig a thee i tilla et cot o $30,000.

coStS and BEnEitS oEvidEncE-BaSEd programS

Melia Catoa-Bikley a Tom Pohaka

peete the iue ivolve i etemiig cot

a cot-eectivee whe talatig eeach

i at pogam ito eviece-bae pogam i

a commuity. They examie exitig moel o

aeig a implemetig phyical activity (PA)pogam to impove the health a well-beig o

ole ault, becaue, they ai, eeach o the

impact o the at to health a well-beig i ole

ault i imila to eeach o lietyle a health

pactice uch a execie. PA a at itevetio

hae imila iue a baie i etemiig cot,

cot-eectivee, a the public health impact o

pogam.

They outlie the baic quetio to ae

beoe lauchig a itevetio pogam:

1. What ae the pecifc at itevetio a

populatio to be tuie?

2. What ae the health beeft o paticipatig a

the coequece o ot paticipatig?

3. What ae the potetial baie to paticipatio?


23/40


4. How ca we evelop ucceul itevetio

a the policie to pomote them i ole

populatio, while ietiyig the citeia o

which to evaluate thei ucce?

Pohaka maitaie that the awe to all o theequetio ee ito the cot a cot-eectivee

o a pogam. I paticula, it i impotat to captue

meaue o pevalece, iciece, ateceet,

cot outcome, acto aectig the iitiatio a

maiteace o a pogam, a fally, bigig a

pogam up to cale.

Catoa-Bikley eview o at pogam

ivolvig ace, choale, theate, piao, a ceative

witig ou a umbe o poitive eect o

geeal health. specifcally, thee iclue lowemeicatio ue; ewe all a bette balace;

impove cogitio; eceae hotility, axiety,

a epeio; a iceae ee o matey a

o well-beig.15 Although eeache wee goo at

ecibig the itevetio, they wee le iliget

about ocumetig the oage, uch a time a

iteity, a the tuie eee moe ogaizatioal

tuctue. Catoa-Bikley coclue that awe

to the baic eeach quetio ae iufciet to

povie a tue CBA. Both eeache agee that the

efcacy o thee pogam ee to be etablihe

beoe the cot ca be evaluate a the eeach

talate to commuity-bae pogam.

Pohaka ote that while cot mut be

coiee, it might be utile to ty to opeatioally

efe cot at thi time. Likewie, it i ifcult to

etimate the total beeft om a tuy. Aothe way

o evaluatig cot i by lookig at the tue value o

what we have a the public health impact o what

we have oe. He ecibe how at pogam

opeate withi a boae ecological amewok.

Cuet eeach i oiete to the iiviual i

a cotolle o emi-cotolle ituatio. Yet the

15 Catoa-Bikley, M., noelke, L., Pohaka, T., asataiao, W. 2010. Impact o At Paticipatio oHealth Outcome o Ole Ault.Journal of Aging,

Humanities and the Arts 4: 352-367.

itepeoal, ititutioal, a commuity elemet

have a uctio a povie a ettig i which thee

occu. Thee ecological acto cotibute to the

tue cot. Uetaig the iteelatiohip o

actothat elemet have a uctio a well a a

locatiohelp u etimate cot. He alo ote thateeache o ot ee to iolate pecifc apect i a

pogam ha multiacete apect.

He eumeate elemet that efe eviece-

bae welle pogam a health pomotio

pogam. Thee pogam:

All iclue a theapeutic elemet (teatmet)

a a well-evelope tategy o implemetig

the teatmet (pogam elivey).

May iclue healthy ole ault a well a thoe

with moeate to igifcat health coitio.

documet the impact o meaigul

health outcome a elate emogaphic,

pychoocial, a eviometal coelatio

that iuece the behavio.

Iclue compeheive, multiacete

itevetio appopiate o ole ault.

documet eviece o a ytematic eview a

a eviece-bae pogam.

The talatio o cietifcally tete eeach

fig to commuity-bae health pomotio

pogam i ote low, agmete, a ubject to

peculatio by the pactitioe commuity. Pogam

have the geatet chace o ucce i thei metho

a goal ae well efe a ocumete, iclue

a CBA, a ae aaptable o a vaiety o eal-wol

ituatio.

Pohaka uggete uig the rE-AIM

amewok to etemie the oveall public healthimpact o pogam:Reach,Eectivee,Aoptio,

Implemetatio (coitecy a felity), a

Maiteace.16

16 A explaatio o a eouce o thoe watig toapply the rE-AIM amewok ca be ou at: www.re-aim.org.


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He alo eumeate ecommeatio o

eucig cot, etemiig cot-eectivee,

a ehacig oveall impact, icluig ocuig

o eetial elemet, coieig the cotextual

acto, a plaig o iemiatio. He uge

eeache ot to wait o eult om goltaa eviece-bae pogam. He coiee

a impotat objective o thi wokhop houl be

to iemiate the fig aleay kow. Fially,

quotig eeache Lay Gee (2008), he ai, I

we wat moe eviece-bae pactice, we ee

moe pactice-bae eviece.

Pohaka expect a polieatio o ew

eviece-bae pogam a the fel avace.

Howeve, he wae that thee ee to be a

coepoig eot to impove the quality, pomotethe exibility, a ehace the public health impact

o thee pogam.

applying coSt-BEnEit analySiS

William specto illutate eal-wol iue

aociate with CBA with a theoetical example:

a chambe muic camp o ole paticipat. It i

impotat to etemie who will beeft a who

i likely to pay o the pogam. Thi i ot alway

taightowa becaue ome beeft ae moepublic tha pivate. He ote that the CBA i meat

to etemie the value to ociety i olla tem,

with beeft expee i health eect a cot

expee i olla. The cot a beeft o ot

alway accue to the ame people.

defig the cotext o the itevetio i alo

impotat: Who i uig the pogampublic o

pivate etitie, o the paticipat themelve? Will

it be poible to evaluate health eect i tem o

euce meical cot o ewe ick ay?

df i

A metioe i othe peetatio, eeache

ee to ocumet the iteity o the itevetio.

reeig to a hypothetical example he calle the

Goup At Pogam (GAP), a muic peomace

goup, specto icue how eeache ee

to kow iteity o pactice, ot jut umbe

o hou, becaue the geatet cogitive beeft

come whe paticipat take o ifcult tak. Ae

membe ight-eaig muic o pacticig o a

goup peomace? How ifcult i the muic? Allcompoet ee to be ocumete o they ca be

eplicate to the extet poible. specto ote that

muicia bai ie by how much they pactice.

Mot poeioal pactice a aveage o about two

hou a ay, while a active amateu might aveage

30 miute a ay at mot, he peculate.

Othe apect o the pogam ca have

impotat eect, uch a whethe a poeioal

o amateu coach u the pactice, o whethe

pactice ae u by paticipat themelve, a icommo with chambe muic goup.

It alo i impotat to ak what othe apect o

the itevetio ae challegig the paticipat. I

the hypothetical GAP muic camp, ole paticipat

may have to wok hae tha youg ault to keep

tack o muic a pactice cheule. The camp may

povie phyical challege o ome people who

have mobility limitatio o who ae jut tatig o

eleaig a itumet. Each activityeheaal,

goup pactice, a the phyical equiemet o

playig ieet itumetmake ieet

ema o the bai.

i Bfs css

Beeft o thi itevetio might iclue impove

health a quality o lie, geate job pouctivity,

lowe healthcae cot, ehace ocial iteactio,

impove cogitive a moto kill, a potetially,

aatomical bai chage. Beeft may ie

epeig o the tak, the ole o the team, a who

i o the team. Fo example, balloom acig may

be a geate cogitive challege o a ma becaue he

lea the pai. sight eaig muic might equie le

eot tha peectig ew challegig muic.

The cot o itevetio mut iclue all

apect o the pogam, icluig time o eheaal

a peomace, maketig, pace etal, a


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tavel. reeache ee to coie the epeciatio

o itumet a a potetial cot. specto uggete

builig i the cot o a acilitato a ceatig

eucatioal mateial o a tool kit o ta a

coume. The cot alo houl be compae to

thoe o othe pogam.specto coclue that, a with execie

pogam, people will oly eap the beeft i they

ae puhe to exet themelve, whethe phyically

o metally. I act, i uch a pogam, the wot

playe may get the mot health beeft becaue

the pogam may be moe challegig elative to

thei iitial kill. Howeve, the equiemet ee

to be eaoable o the kill level o paticipat

to avoi exceive utatio a to miimize

pogam attitio.


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S

aa Cewe moeate a eio

o the elatiohip o aethetic a

eig acto to health a quality-o-

lie-elate outcome o ole ault ilog-tem cae a aite livig acilitie. she

ote that whe ole people move om thei

home to a aite livig acility, they ae givig

up ome iepeece, etablihig elatiohip

with a ew uppot etwok, a ajutig to a

uamilia eviomet, all o which ca cotibute

to cogitive a emotioal te. A health a

ocial cae povie ty to miimize the te a

eue the ew eviomet i timulatig, they

ee to ueta how the peo a hi o he

eviomet ae like. Cewe alo metioe

that, a the ole populatio become moe ivee,

cultual ieece i the phyical uouig may

ee to be coiee.

I hi peetatio, Victo regie emphaize

the impotace o makig aite livig home

welcomig to amily membe o all age. I hi tuy

o 300 aite livig home i the Uite state

a othe Euope, regie ietife impotat

eig elemet that ecouage iteactio a

activity, while poviig pivacy a a eietial

eel.17 The eig houl allow o a pimay pathway

with lik to activity oom, iig aea, a

17 regie, V. 2002.Design for Assisted Living: Guidelinesfor Housing the Physically and Mentally Frail. (new Yok:Joh Wiley & so.)

eatig aea o viito a well a iiviual oom.

Wiow, hal-wall, o balcoie ca allow eiet

to peview oom beoe they ete them, o they

ca ecie whethe they wat to joi the goup oactivity a avoi ueceay axiety about chace

ecoute.

regie avo builig activity oom that

might appeal to a limite goup, uch a a ecoig

o at tuio, a well a all-pupoe oom that ca

accommoate a age o moe popula activitie. He

ote that the eig o ta ofce i alo impotat

to the oveall eel o a builig. some cae acilitie

ue oatig ek o ofce with dutch oo to keep

the ta moe viually acceible to eiet.

demetia patiet might beeft om aitioal

pecifc eig eatue. A ymmetical oo pla, o

example, ca be ioietig to ole eiet, a

aymmetical layout, with itictive lamak,

like a tatue o wall ecoatio, ca help oiet

eiet. May emetia patiet uctio bette

whe poeio ae viible, a might o example

beeft om havig ope cloet, with wie baket

o toage. dutch oo a wiow that allow

eiet to ee ito othe oom alo ca be

paticulaly helpul to oiet thee eiet.

Luh lacapig a atual light i iteio

aea ae amog othe eig elemet that

cotibute to the ucce o a aite livig acility.

The co ca be tailoe to the ituatio a the

populatio goup. some eietial home have

ou that emetia patiet eact well whe thei

aeStheticS and deSign ingrouP living arrangementS


27/40


ow at i pote o hallway outie thei oom.

repoig to a quetio om the auiece about

whethe a eig elemet that i beefcial to oe

peo might be etimetal to aothe, regie

ecogize that eig ee to be aaptable o

eiet ca etai thei ee o iiviuality. Healo ackowlege the value o alteative moel

that accommoate the ee o ole ault like the

village movemet o the evice houe i nothe

Euope, which have pogam that eve ole people

livig i the uouig commuitie.

A Batig ote i a late eio, eiet

elom get the chace to eig a pace, o ceative

way ae eee to aapt the cuet eviomet

to be moe welcomig a appopiate o ole

eiet. she ha a ocumetay i poge aboutthe Peelope Poject, i which ue o pace i a

eietial home wa ecoceptualize.

thEorEtical Background orESEarch in viSual art

Kathy Hatho, a pioee i theapeutic health

cae at, ecibe how viual at ha bee ue

i healthcae o moe tha 600 yea, with ealy

ue ote ocuig o eligiou theme, uch a

heave a hell. I the 1860, Floecenightigale aee the impotace o the

hopital eviometepecially eh ai a light

i heNotes on Nursing.18 I ecet ecae, mot

hopital a uig home have ue at to ceate

a pleaat eviomet. Moe ecetly at i beig

ue theapeutically.

Hatho eviewe ome lamak tuie that

emotate the health beeft o viual at. she

peete thee theoie that uelie eeach i

viual at a health:

Popect a reuge Theoy: The ability to ee

a the ability to hie ae key to ou uvival.

Thi theoy hol that moe ma view at

18 nightigale, F. 1898. Notes on Nursing: What It Is andWhat It Is Not (new Yok: d. Appleto).

om thi pepective a i attacte to at that

ha boa vita (epeetig popect) with

viible place o eay euge, thu atiyig

iate itict o fght o ight.19

Emotioal Coguece Theoy: Ou emotioal

tate bia ou peceptio o eviometal

timuli i way that ae coguet o match ou

eelig.20

Biophilia Theoy: Millio o yea o evolutio

have let huma geetically poe to epo

poitively to atue ettig that otee well-

beig a uvival o ealy huma.21

A emial tuy o ie yea o ichage ata

ou that ecovey om ugey wa ate o

hopital patiet who taye i a oom with a view

o a atual ettig tha o patiet with a view o a

bick wall. The hopital tay wa hote (7.96 ay

compae to 8.70 ay), ewe tog aalgeic wee

eee, a uig ta wote ewe ote o the

patiet who ha oom with the atual cee. Thi

tuy, by roge Ulich, helpe lay the ouatio

o eviece-bae eig (EBd).22 Aothe ote

tuy ou that patiet who viewe eee atual

cee beoe goig ito ugey ha lowe bloo

peuea le peopeative tetha patiet

who viewe aouig pictue.

Ps, c, eisss a Pp a

Hatho ote that agig i aociate with phyical

chage that ca aect how ole people view at.

19 Appleto, J. 1975. The Experience of Landscape. (Loo:Joh Wiley)

20 Ulich, r., a Gilpi, L. 2003. Healig At: nutitioo the soul. I s. B. Fampto, L. Gilpi, & P. A. Chamel(E.),Putting Patients First: Designing and Practicing

Patient-centered Care (pp. 117146). (sa Facico, CA:Joh Wiley & so)21 Wilo, E., a Kellet, s. 1993. The Biophilia Hypothesis.(Wahigto, dC: Ila Pe)22 Ulich, r. 2004. View Though a Wiow MayIuece recovey om sugey.Science 224 (4647):420-1.


28/40


Thi etemie what viual at i appopiate to

iplay i ieet ettig. With agig, igifcatly

le light i available to the etia; epth peceptio

i impaie. Ole people ote evelop le cleoi

a cataact a they ae moe aecte by glae a

haow.demetia a othe cogitive impaimet alo

aect how people peceive at. A the ee o time

a place chage, the ability to ecogize commo

object may eteioate. The emotioal chage with

emetia mut be coiee whe electig at o

emetia patiet. Hatho elaye a example i

which a pictue o a atual lacape wa calmig

o mot people, but looke empty to Ad patiet,

who ake whee the people ha goe.

ip vs a ds e

nealy oe-hal (43 pecet) o hopital uveye

i a ecet tuy ai they iplaye viual at i the

belie that it beeft patiet a thei amilie a

cotibute to a healig eviomet.23 Extapolatig

thee fig, Hatho etimate that moe tha

20,000 acilitie o ole Ameica have viual

at, aectig moe tha 960,000 eiet. Hatho

ote that at ca timulate emotioal uctio aca be a eective way to egage ole viewe.

Mueum wolwie have pogam geae o

ole people, eve emetia patiet. The Atit o

Alzheime (ArTZ) pogam at new Yok Mueum

o Moe At (MoMA) a othe mueum, o

example, povie a oppotuity o peoal

gowth a iight a allow paticipat to acce

log-tem memoie.24 Wokig with MoMA ta,

May Mittlema a new Yok Uiveity school

o Meicie eeache ou that viual at

pogam euce epeio, impove ocializig,

23 state o the Fiel Committee. 2009.State of the FieldReport: Arts in Healthcare 2009. Wahigto, dC: societyo the At i Healthcae. Available at: thesah.org/doc/reports/ArtsInHealthcare.pdf.24 Atit o Alzheime, available at www.artistsforalzheimers.org/

a iceae el-eteem amog paticipat.25

A sweih tuy alo ou ocial a cogitive

beeft o patiet who paticipate i a at

pogam.26 A pilot tuy i fve Miwete uig

home ou that pictue a bi ou impove

the bathig expeiece o patiet, eucigagitatio a aggeio.27

Sf ess expss as as

Expeive at activitie help iiviual elax,

povie a ee o cotol, euce epeio a

axiety, ecouage playule a a ee o humo,

a well a impove cogitio a el-eteem.28

Hatho ote that makig at alo ca utue

piituality a euce boeom.At alo ca eect the emotioal a cogitive

coitio o the atit. Hatho iplaye a eie

o awig by thee atit with Ad that clealy

howe the eect o ieae pogeio ove time,

with le etail, ieet colo, a moe abtact

om, a the atit cogitive ability eclie.

The eect o at a at activitie exte

beyo the patiet. Hatho obeve the gowig

ecogitio that iplayig viual at a ceatig at

i the wokplace ca euce te o the healthcaeta a ca pomote moe compaioate, highe-

quality cae. Accoigly, ome meical chool

cuicula ae icopoatig a at compoet.

Hatho aw a ee to lea moe about

paticipatoy at pogam a about viewig at i

25 The new Yok Uiveity Evaluatio o Meet Me atMoMA i available at: www.moma.org/meetme/resources/index#evaluation(accee novembe 6, 2012). seealo: Joe, K. 2009. Keepig Thoe with AlzheimeEgage. The New York Times. At ectio (Mach 12).

26 Wiktm, B. 2002. social Iteactio Aociate withViual At dicuio: A Cotolle Itevetio stuy.Aging & Mental Health 6 (1): 82-7 (Febuay).27 Whall, A., Black, M., Goh, C., Yakou, d., Kupechmi,B., a Fote, n. 1997. The Eect o natualEviomet Upo Agitatio a Aggeio i Latestage demetia Patiet.American Journal of Alzheimers

Disease, 12(5): 216-220.28 Cohe, G. 2000. The Creative Age. (new Yok: AvoBook Ic.)


29/40


a utuctue eviomet. The buig quetio,

i he mi, i What happe whe the at oe

ight uty? We imply have o iea.

dESign or EvEryonE

including oldEr adultSValeie Fletche expae o the icuio o the

health apect o aethetic a eig, i paticula,

uiveal eig that accommoate the mobility a

cogitive ealitie o ole people.

Fletche outlie thee boa categoie o

uctioal limitatio: phyical; eoimoto; a

bai-bae, icluig cogitive uctioig a well

a metal health. she emphaize that vaiatio i

ability i omal a oiay, a that mot people

will expeiece ome limitatio uig thei live.

Thu, uiveal eig i ot jut about evig

the iable o ole people, but evig eveyoe.

Uiveal eig embace the eig o place,

thig, iomatio, a commuicatio to expa

acceibility to the wiet pectum o ue i a

wie age o ituatio.

Equitable ue i the oveachig a

taceig piciple o uiveal eig. Ue

houl be ituitive a equie miimal phyical

eot. The bet evaluatio o ucceul eigcome om people at the ege o the pectum o

ability a agethoe with the geatet limitatio

a olet age. Thee ue expet uel iight

a ipiatio a help geeate theoie, ot jut

ietiy poblem.

suppot o ceatig eablig eviomet

o people with iabilitie, whateve thei age,

ha gaie gou i ecet ecae. diability

wa eefe by the Wol Health Ogaizatio

(WHO) i 2001 a a cotextual vaiable. A uch,pecifc phyical, commuicatio, a ociopolitical

eviomet ca peet baie o iiviual

epeig o thei phyical o metal coitio.

Iiviual may be iable oly i a give cotext.

The magitue a pee o agig aou the

globe i comig ecae a a ee o ugecy

o ceatig a eviomet moe appopiate o

ole people. The pecetage o ole people livig

i commuity houig o log-tem cae iceae

haply with age. Yet, the vat majoity o ole

people will ot live i aite livig acilitie but i

pivate home withi commuitie. Thi extethe ee o uiveal eig eatue well beyo

ititutioal ettig. neithe icemetal tategie

o pecial olutio will be eough, Hatho ai, a

the ee i too geat.

Uiveal eig i a way o thikig about

huma iveity toay a about the powe o

eig. she maitaie that eig i a ocial at a

that it iuece the ee o cofece, comot,

a cotol.


30/40


i

the fal eio o the wokhop, thee paelit

wee ivite to povie iight about eeach

ee i the fel. They highlighte the tegth

a weakee o cuet eeach a oeeuggetio o ew aveue a appoache goig

owa, icluig pactical coieatio o the

implemetatio o eviece-bae pogam.

rESEarch dESignS thatcapturE long-tErm EEctS oart on thE aging procESS

Magie Lachma emphaize the ee o eeach

aco the liepa. reeach how a aociatio

betwee at a cogitive peomace, but ca atlow the eect o agig? The eeach to ate o

lietime eect o at paticipatio i ot cocluive.

relate acto, icluig eucatio, cogitive

timulatio, phyical activity, a ocial egagemet,

may be the mechaim o chage.

reeach ito the likage betwee at a

agig mut be tailoe to the goal a ituatio.

Expeimetal tuy eig uch a rCT ca vay

coitio a cotol goup (aloe veu i

goup, paticipatio veu obevatio, moeatephyical activity veu light phyical activity),

o allow paticipat to chooe thei goup o be

aige to oe. Ealie i the wokhop, it wa

ote that uch eig houl ivolve coitet

meauemet i pe- a pot- tet.

developmetal a quai-expeimetal eig

might be ue to examie the log-tem eect o at.

They ca be logituial, co-ectioal, o eveal

eig. They ca ae uch quetio a doe at

aect the agig poce? I at bette o ole thayouge ault? The ABAB eveal eig (which

ivolve a baelie, teatmet, eveal, a aothe

teatmet) ca tet whethe a at teatmet make

a ieece a, i o, whethe the eect iipate

whe teatmet i emove.

Aothe valuable eeach eig i the aily

iay a expeiece amplig. Thi occu i a

atual ettig, i which paticipat might log thei

moo whe they ae oig at. O, paticipatio i

at might be tie to uch meaue a bloo peue

o cotiol, a well a moo o peceive te. Thi

eig allow multiple outcome to be tacke,

icluig phyical health, moo, cogitio a

memoy, ocial egagemet, a logevity.

Psp Ps a

Paticipatio i the at mea leaig omethig

ew, mateig a kill, a ejoymet. It ca be a

lielog egagemet with log-latig cogitive

beeft. At ca ai the aaptatio o ole

people a they age, which ha bee ecibe a

selective Optimizatio with Compeatio (sOC):29

29 Balte, P., a Balte, M. 1990. PychologicalPepective o succeul Agig: The Moel o selectiveOptimizatio with Compeatio.SuccessfulAging:

Perspectives from the Behavioral Sciences, page 1-34.(Cambige, U.K.: Cambige Uiveity Pe).

reSearch gaPS and oPPortunitieS


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selectioocu o goal; Optimizatiomea to

achieve goal; a Compeatiomaitaiig goal

i the ace o loe.

Lachma ecibe the popect a pomie

o at o agig populatio a wie-agig. They

might ecompa theapeutic ue with emetiaa Pd, eich the geeal quality o lie, ive ew

policie, a eve ceate ew maketig tategie

o log-tem cae acilitie.

intErdiSciplinarytEamS, intEgratEd artSintErvEntionS, and EaStErnapproachES

At Kame agee with the wokhop paticipat

about the ee o iteicipliay team. He

uggete that, i aitio to cogitive cietit,

biologit, a euologit, team houl iclue

public health expet a health ecoomit.

Kame alo calle o moe elightee

achitect, a oee a examplethe Beckma

Ititute Builig at the Uiveity o Illioi,

which wo a eig awa i 1989. The builig

eig ecouage iteactio amog eeache

i ieet iciplie, which ca geeate ew

eeach iea.He alo avoe coieatio o moe aimal

moel i paallel with huma moel, a well a

ew computatioal moel. A auiece membe

quetioe whethe aimal moel coul be vali

o eeach o the at becaue at i a uiquely

huma omai. Kame ague that we ee ou

peceptual, cogitive, a moto acilitie to egage

i a appeciate at. He ote we ca lea a geat

eal about thee acilitie om aimal tuie o

bai uctio.Kame alo poite to leo that ca

be leae om Eate health pactice a

kowlege, although he ackowlege that thee

wee haly icue i the wokhop. He poite

eeache to the wok o itegative mi-boy

taiig by Chiee eeache Yi-Yua Tag a

pychologit Michael Poe.

Kame alo agee with the call o a liepa

appoach to the tuy o agig, to tack the log-tem

eect o lielog habit a activitie, icluig

execie a at paticipatio. With ew exceptio,

whe people top the phyical execie, muictaiig, o othe at activity, the beeft go away.

It woul be helpul to kow moe about how log

beeft lat.

He expee iteet i Kau eeach

appoach o matchig the appopiate at

itevetio with tagete (ote egative) agig-

elate chage. The ight itevetio might be

able to ehace auitoy a eoy uctio,

ecogitio, a pehap auitoy ecall. reeache

coul map the elatiohip betwee eiechage o outcome a at om. some outcome

meaue, uch a bai imagig, ae appopiate o

the laboatoy but ifcult to apply i a commuity

ettig. Othe meaue ae moe potable, like

iaie o witig poject, a eve ome compute-

bae meaue. A iceaig aay o meaue

i owloaable om iTue to iPa, phoe,

o compute.

Kame echoe the coce o Joho a

othe that the eeach houl itiguih type

o emetia, o example, the level o eveity a

whethe o ot it i Ad. A eeache coul

lea much about the efcacy o itevetio uig

moe ivee populatio a aimal tuie. He

metioe the wok o Heiette va Paag at nIA,

which aw o aimal tuie ivolvig bai

ioe.

reeache alo ee to coie combiig

itevetio to tet whethe uch a appoach

might be moe cot eective. A at itevetio

combie with tai chi, o example, might yiel

eve moe beeft tha eithe itevetio aloe.

Aimal tuie how, o example, that ocializig

combie with execie ometime ha aitive,

eve multiplicative eect. Echoig eveal othe

paticipat, Kame tate that total uetaig

about the uelyig mechaim i ot equie


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beoe implemetig a pogam that ha pove

eective.

thEoriES, mEchaniSmS, lEvElSo analySiS, and rEplicaBlE,

rigorouS dESignSBecca Levy coiee the eeach fig to be

pomiig a thought the peete ha ietife

ome outtaig example o both quatitative

a qualitative tuie. she eumeate ou

oppotuitie to avace eeach i the at to

impove health a well-beig i ole ault:

1: e rs B ts

Levy uggete coieig simoto moel o

ceative caee. Uig tetable hypothee, he ha

examie the pheomeo o chagig ceative

outlet to match cuet abilitie o limitatio.

Becaue o athiti, o example, Gama Moe

witche om emboiey to paitig at age 76 a

ou eomou ucce i he late-lie puuit.

Levy metioe aothe theoetical amewok:

teeotype emboimet theoy.30 Fom a youg age,

iiviual itealize el-ulfllig teeotype,

o example, that agig equal eclie, a that

ole people ae ot pouctive o ceative. Levy

a colleague ou the ik o caiovacula

evet wa highe amog ole ault who ha hel

egative teeotype o agig i youg aulthoo.31

reveig thi teeotype, uch that ole people ae

value o thei expeiece a ceativity, coul yiel

poitive health beeft.

30 Levy, B. 2009. steeotype Emboimet. CurrentDirections in Psychological Science.18(6): 332-336.31 Levy, B., Zoema, A.B., slae, M.d. a Feucci,L. 2009. Age steeotype Hel Ealie i Lie PeictCaiovacula Evet i Late Lie.Psychological Science20(3): 296-298.

2: ex Ws m asis ms e

Futue eeach coul compae paive veu active

at om a ty to meaue the egagemet level o

paticipat. The iue o choice alo ca be tete:

do health eect ie i people chooe thei at

om athe tha be aomly aige to a eeach

o cotol goup? The type o at alo ca be tete.

I paticula, i it moe eective to ue cultue-

pecifc at o to itouce ew at om?

3: dp rpb, rs dss mp ls ass

Levy echoe the call o moe igoou eeach

eig, a cite Kau tuy o uetaig

i oie a a goo example o the type o eeach

eee. I um, Levy calle o toge tatitical

metho, icluig amplig, taaize

outcome, eplicable metho, a aequate

cotol goup.

4: i ms

Levy ote that schlaug eeach o

euocogitive platicity a Kau eeach o

ole muicia bai uctio wee goo eeach

example. Aothe example i emiicece, which

may eve a a catalyt to peoal gowth o ole

ault. The autho Hey roth, o example, wote

ix autobiogaphical ovel betwee the age o 73

a 89, beakig a 45-yea wite block. roth ai

that witig allowe him to come to tem with pat

actio he egette a he ace hi ow motality.

Levy coclue by quotig robet Butle, who

ai that baby boome mut ovecome thei eial

o agig a avocate o ew way to pevet a

maage Ad. The at ca be mobilize a a key

eouce to give iiviual pupoe, which ca

impove health a logevity.


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unding opportunitiES oruturE Work

The iue o uig o at itevetio eeach

wa aee by eveal epeetative o the

teeig committee a pooig agecie.

Libeth niele (nIA), Joatha Kig (nIA),

a William Elwoo (OBssr) metioe exitig

nIH uig oppotuitie o multieoy eeach

a o poject that lik eeache a commuity

ogaizatio. reeache ca egite with the nIH

though www.grants.gov, ceate a pofle, each o

uig oppotuitie o iteet, a ubmit gat

applicatio.

suil Iyega (nEA) uggete that iteete

patie alo moito commuicatio om the

Feeal Iteagecy Tak Foce to Pomote reeach

o the At a Huma developmet (www.arts.

gov/research/TaskForce/task-force-members.html)

about utue uig oppotuity aoucemet.

The tak oce ite to acilitate eeach i thi

aea by matchig ue with eeache.

Jolee Joho metioe the Patiet-Cetee

Outcome reeach Ititute (PCOrI) a aothe

potetial uig ouce, which ca be accee at

www.pcori.org.

going orWard: promotEcroSS-talk and takE riSkS

I hi ole a chaima o the wokhop teeig

committee, davi reube ummaize the

efciecie o the exitig eeach a the baie

to avacig the fel. Techology, which wa ot

aee iectly uig the wokhop, might

povie cucial help i the implemetatio a

evaluatio o at itevetio. The wokhop alo

oly touche biey o calig-up a the felity

o pogam, which will ee to be aee, alog

with CBA, i at itevetio ae to be wiely

aopte.

He uggete that co-talk amog cietit

a eeache might eae the hotage o expet

cotibutig to the wok. He alo ai that eviewe

o gat applicatio ee to be pepae to

ackowlege ik, a to pehap u bol ew

eeach iea a well a pove appoache. He

ote that agig i a lot like lie: complicate a

mey. dot u away om the mey.


34/40


S c mbs:

David Reuben (Chai), Uiveity o Calioia, Lo

Agele (UCLA)

Sandra Edmonds Crewe, Howa Uiveity

Art Kramer, Uiveity o Illioi

Nina Kraus, nothwete Uiveity

Becca Levy, Yale school o Public Health

Helga Noice, Elmhut College

Wsp Sps rpss:

Marie A. Bernard, natioal Ititute o Agig

(nIA), natioal Ititute o Health (nIH)

Wen Chen, nIA, nIH

Constance Citro, Committee o natioal statitic,

natioal Acaemy o sciece (nAs)

Emmeline Edwards, natioal Cete o

Complemetay a Alteative Meicie

(nCCAM), nIH

William Elwood, Ofce o Behavioal a social

sciece reeach (OBssr), nIH

Sunil Iyengar, natioal Eowmet o

the At (nEA)

Nancy Kirkendall, Committee o natioalstatitic, nAs

Jonathan King, nIA, nIH

Rocco Landesman, nEA

Lisbeth Nielsen, nIA, nIH

Deborah Olster, OBssr, nIH

Molly Wagster, nIA, nIH

o Sps / as:

Anne Basting, Uiveity o Wicoi Milwaukee

Melissa Castora-Binkley, Uiveity o

south Floia

Kate de Medeiros, Miami Uiveity

Valerie Fletcher, Ititute o Huma

Cetee deig

Kathy Hathorn, Ameica At reouce

Julene Johnson, Uiveity o Calioia,

sa Facico

Emmett Keeler, rAnd a UCLA

Margie Lachman, Baei Uiveity

Tony Noice, Elmhut CollegeAlexandra Parbery-Clark, nothwete

Uiveity

Thomas Prohaska, Geoge Mao Uiveity

Victor Regnier, Uiveity o southe Calioia

Gottfried Schlaug, Beth Iael deacoe Meical

Cete a Hava Meical school

William Spector, Agecy o Healthcae reeach

a Quality

aPPendiX 1: WorkShoP ParticiPantS


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Five pape wee pepae o the wokhop o

reeach Gap a Oppotuitie o Exploig the

relatiohip o the At to Health a Well-Beig

i Ole Ault, natioal Acaemy o sciece,Wahigto, dC, septembe 14, 2012:

de Meeio K, a Batig A. Shall I Compare

Thee to a Dose o Donepezil?: An Overview o

Intervention Research in Dementia Care.

Hatho K. The Role o Visual Art in Improving

Quality-o-Lie Related Outcomes or Older

Adults.

Kau n, a Pabey-Clak A. Music and Aging:

Exercise or a Well-Tempered Mind.

noice T, noice H, a Kame A. Participatory Artsor Older Adults: Benefts and Challenges.

Pohaka Tr a Catoa-Bikley M. Cost and

Cost-Eectiveness in the Translation rom

Randomized Controlled Trials to Community

Evidence-Based Arts Programs.

aPPendiX 2: commiSSioned PaPerS


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WorkShop on rESEarchgapS and opportunitiES orExploring thE rElationShip o

thE artS to hEalth and WEll-BEing in oldEr adultS

Spb 14, 2012

500 Ft st. nW (t Kk B),room 100

Wato, d.c. 20001

Thi wokhop i peete by the natioal

Acaemy o sciece, Committee o natioal

statitic, at the equet o a cootium o the

natioal Eowmet o the At a thee uitwithi the natioal Ititute o Health: the natioal

Ititute o Agig, the Ofce oBehavioala

social sciece reeach, a the natioal Cete

o Complemetay & Alteative Meicie. The

pupoe o the wokhop i to ietiy eeach gap

a oppotuitie o exploig the elatiohip o

at paticipatio a ceativity to phyical health

a pychological well-beig i ole ault. It will

povie a citique o the fel, icluig challege

i uetakig eeach capacity-builig; a it willoe guiace o the eig o utue tuie a

eeach uig oppotunitie.

Pimay peake how i bold

8:30

is WeeCHAIr: David Reuben, UCLA

8:35W B n asConnie Citro, Committee o natioal statitic

8:45

i Wsp osMarie A. Bernard, natioal Ititute o Agig,

natioal Ititute o Health; Rocco Landesman a

Sunil Iyengar, natioal Eowmet o the At

9:00te res as ps iees ps We-Be,ce, Ses, m Ss oe as, e ue nepessesMOdErATOr:Art Kramer, Uiveity o Illioi at Ubaa

Champaig

9:05

p as oe as:Beefs ceesTony Noice a Helga noice, Elmhut College;

a At Kame, Uiveity o Illioi at Ubaa-

Champaig

9:35

ms a: Eese We-teee mNina Kraus a Alexaa Pabey-Clak,

nothwete Uiveity

aPPendiX 3: WorkShoP agendanatoa Aamy o s

natoa ra co

dvo o Bavoa a soa s a educatio

commtt o natoa statitic


37/40


10:05

dsss

10:20

Bak

10:30

ce Beefs Weesses as tees e oe Be /p iees oe asEee dees ce, Ses,/ m abMOdErATOr:Becca Levy, Yale Uiveity

10:35

S i cp t ds dpz?: a ow irs d cKate de Medeiros, Miami Uiveity a Ae

Batig, Uiveity o Wicoi-Milwaukee

10:55

ms B h dss:W W l c,l, S r SsGottfried Schlaug, Hava Uiveity

11:15

us ms m Sps d: W is S S?Julene Johnson, Uiveity o Calioia

sa Facico

11:35

dsss

12:00

l

1:00

cs-Beef ases asse w e

is as ps iees hee dee oe asMOdErATOr: David Reuben, UCLA

1:05

a P cs Bf assEmmett Keeler, rAnd a UCLA

1:35

cs cs-ess ts rz cts c e-Bs asPsThomas Prohaska, Geoge Mao Uiveity a

Melia Catoa-Bikley, Uiveity o south Floia

1:50

dsss:William Spector, Agecy o Healthcae reeach

a Quality

2:05

dsss

2:20

Bak

2:30

te res aeses dess he Q--le-reeoes oe as l-te ce assse l esMOdErATOr: Sandra Crewe, Howa Uiveity

2:35

hw ds asss l ltc eips Sss as PsVictor Regnier, Uiveity o southe Calioia,

Lo Agele

3:00

t r vs a ip Q--l ros o asKathy Hathorn, Ameica At reouce

3:25

dsss:Valerie Fletcher, Ititute o Huma

Cetee deig

3:40

dsss

3:50

Bak


38/40


4:00

rese gs oes:a SPaelit will ummaize the wokhop a oe thei

ow iight about eeach ee i the fel, aeig

pecifcally uch theme a the tate o eviece o caual

lik betwee at pogam a pecifc outcome;

appopiate eeach eig to impove the quality o uch

eviece; baic a talatioal eeach ee; a cot-

beeft aalye a othe pactical coieatio o the

implemetatio o eviece-bae pogam.

MOdErATOr: David Reuben, UCLA

4:05

Margie Lachman, Baei Uiveity

4:15

Art Kramer, Uiveity o Illioi at

Ubaa-Champaig

4:25

Becca Levy, Yale Uiveity

4:35

sss

5:30

Ajo


39/40


40/40

summay o a natioal Acaemie Wokhop,

reeach Gap a Oppotuitie o Exploig the relatiohipo the At to Health a Well-Beig i Ole Ault,

septembe 14, 2012

Arts and Aging Building the Science

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