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A Mobile App-Based Individualized Nonpharmacological Intervention for Behavioral and Psychological Symptoms in Dementia: Pilot Randomized Controlled Trial

2026-04-29T08:04:22Z

Title: A Mobile App-Based Individualized Nonpharmacological Intervention for Behavioral and Psychological Symptoms in Dementia: Pilot Randomized Controlled Trial Authors: Cho, Eunhee; Yang, Minhee; Hwang, Sinwoo; Kim, Eunkyo; Cho, Jungwon; Kim, Min Jung Abstract: Background: Behavioral and psychological symptoms of dementia (BPSD) are common and negatively impact both individuals with dementia and their families. Although nonpharmacological interventions are recommended as the first-line treatments, their use in community settings is limited by access and caregiver resources. Existing approaches are often not individualized and rely on institutional or clinician-led delivery. Objective: We developed a caregiver-initiated and individualized multimodal mobile app. The app delivers tailored nonpharmacological interventions-such as music therapy, exercise, and reminiscence therapy-based on each user's preferences and functional abilities. This study aimed to evaluate the effectiveness of this mobile app-based intervention in reducing BPSD in community-dwelling persons living with dementia. Methods: This study used a single-blinded randomized controlled trial design. Participants were recruited from an outpatient clinic of a tertiary hospital, a dementia care center, and 5 home care service centers. A total of 36 dyads participated, each comprising a community-dwelling person living with dementia aged 60 years or older and their primary family caregiver. The dyads were randomly allocated to either the intervention or control group. The intervention group received a caregiver-initiated, multimodal, mobile app-based individualized intervention for 4 weeks, whereas the control group continued with usual care. The primary outcomes were overall BPSD, agitated behavior, and depression. The secondary outcomes were nighttime sleep efficiency and caregiver competency in managing BPSD. Assessments were conducted at baseline, immediately after the intervention, and at a 2-week follow-up. Results: Of the 36 randomized dyads, 33 were included in the final analysis. Although the intervention group showed greater reductions in overall BPSD, agitated behavior, and depression after the intervention, no significant group-by-time interaction effects were observed in the total sample. In the subgroup analysis of participants with clinically significant baseline BPSD, a statistically significant improvement in overall BPSD was found in favor of the intervention group (beta=-12.885, 95% CI-24.530 to-1.240; P=.03). No significant effects were observed for either nighttime sleep efficiency or competence in the management of BPSD. Conclusions: A mobile app-based individualized intervention may offer a flexible, caregiver-initiated approach to managing BPSD in home-care settings. While overall effects were limited, exploratory subgroup findings provided meaningful insights, indicating potential benefits for those with higher baseline symptom severity. The results highlight the need for further research on adaptive personalization and optimized intervention delivery to enhance the clinical effectiveness of digital dementia care.

Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: Protocol for a Scoping Review of Patient Perceptions, Barriers, and Facilitators

2026-04-13T00:31:42Z

Title: Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: Protocol for a Scoping Review of Patient Perceptions, Barriers, and Facilitators Authors: Park, Sikyeong; Park, Yu Shin; Hong, Dahye; Kang, Bada; 박유신 Abstract: Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a major global health concern, affecting over 30% of adults worldwide. Closely associated with metabolic comorbidities such as obesity, type 2 diabetes, and dyslipidemia, MASLD relies heavily on health behavior modification for effective management. However, sustaining healthy behaviors remains challenging, particularly due to the disease's asymptomatic nature in its early stages and low perceived severity among patients. Thus, understanding patient perceptions and identifying barriers and facilitators are essential for developing effective, patient-centered interventions. Objective: This scoping review protocol aims to systematically map the existing literature on patients' perceptions of MASLD and to identify barriers and facilitators that influence disease management and patient engagement. Methods: This scoping review will follow the Joanna Briggs Institute scoping review methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic search will be conducted in PubMed, CINAHL, Cochrane Library, and PsycINFO by using MeSH terms and keywords such as "MASLD," "NAFLD," "perception," "awareness," "attitude," "barriers," and "facilitators." Two independent reviewers will screen studies, extract data using a standardized charting form, and resolve discrepancies through discussion or consultation with a third reviewer. Eligible studieswill include adults with MASLD/NAFLD and will focus on patient perceptions, health beliefs, behaviors, or barriers and facilitators to management. Data synthesis will be guided by the socioecological model to categorize findings across individual, interpersonal, organizational, community, and public policy levels. Results: The research protocol was finalized in January 2026. This study received no external funding. A preliminary literature search was conducted by January 30, 2026, and formal screening of titles and abstracts is scheduled to begin in February 2026. Data extraction and synthesis are expected to be completed by April 2026. The final results are anticipated to be submitted for publication in the summer of 2026. Conclusions:This scoping review will offer a comprehensive overview of patients' perceptions of MASLD, as well as the barriers and facilitators that influence its management. The results will inform the development of patient-centered strategies aimed at improving care delivery and reducing disease impact. International Registered Report Identifier (IRRID): DERR1-10.2196/81404

Dynamic Relationship Between Sleep Patterns and Behavioral and Psychological Symptoms of Dementia: Longitudinal Observational Study

2026-04-13T00:52:02Z

Title: Dynamic Relationship Between Sleep Patterns and Behavioral and Psychological Symptoms of Dementia: Longitudinal Observational Study Authors: Cho, Eunhee; Hwang, Sinwoo; Yang, Minhee; Kim, Eunkyo; Cho, Jungwon; Park, Chang; 양민희 Abstract: Background: A higher prevalence of behavioral and psychological symptoms of dementia is associated with a greater caregiver burden and increased mortality in people with dementia. Considering the possibility of a reciprocal relationship between sleep disturbances and these symptoms, time series analyses are necessary to explore the associated temporal dynamics. Objective: This study aimed to examine dynamic interdependencies between sleep disturbances and behavioral and psychological symptoms of dementia in older adults. Methods: Daily interactions between sleep patterns and behavioral and psychological symptoms of dementia were analyzed over a 14-day period using a panel vector autoregressive model. Data were collected from June 2018 to June 2020 in community and institutional settings. A total of 154 older adults with dementia wore wrist actigraphy devices continuously for 2 weeks for sleep data, and caregivers recorded behavioral and psychological symptoms of dementia in a daily symptom diary. Results: Using a panel vector autoregressive model, we analyzed data from 154 older adults living with dementia and their caregivers. The results showed unidirectional Granger causality running from the number of awakenings on the previous day to irritability (P=.03) and appetiteor eating disorders (P=.04) on the following day. Conversely, some of the previous day's behavioral and psychological symptoms of dementia temporally preceded subsequent changes in sleep patterns. Specifically, delusions had a Granger-causality effect on total sleep time (P<.001), wake after sleep onset (P=.01), and the number of awakenings (P=.006), while irritability had a Granger causality effect on the number of awakenings (P=.007). Notably, bidirectional Granger causality was observed between irritability and the number of awakenings. Conclusions: This study demonstrates that the relationship between the behavioral and psychological symptoms of dementia and sleep patterns is dynamic and forms a vicious cycle. Consequently, early intervention to alleviate symptoms is imperative, and strategies to enhance sleep quality and address sleep disturbances should be prioritized.

Association between low muscle mass and depression in South Korean adults

2026-04-30T02:42:40Z

Title: Association between low muscle mass and depression in South Korean adults Authors: Kim, Hyunkyu; Park, Yu Shin; Kim, Seung Hoon; Cho, Hyun-Sang Abstract: Background Although the association between sarcopenia and depression is well-established, studies exploring the link between low muscle mass and depression in the general population are limited. This study aimed to investigate whether participants' muscle mass proportion was associated with the prevalence of depression. Additionally, we examined whether individuals with lower muscle mass exhibited greater symptom burden, using both categorical and continuous analytic approaches. Methods Data from the 2022 Korea National Health and Nutrition Examination Survey were used for this study. Altogether, 4185 participants who completed the Patient Health Questionnaire-9 were included. Muscle mass was measured using the bioelectrical impedance analysis method, and the participants were divided into low, medium, and high groups based on the proportion of appendicular muscle mass relative to body weight. The association between low muscle mass and depression was analyzed using multiple logistic regression. Results Men in the low muscle mass group exhibited 1.99 times higher odds of depression, (odds ratio = 1.99, 95% confidence interval = 1.03-3.85) and 1.61 times higher in women (OR = 1.61, 95% CI = [1.00-2.58]) using the medium muscle mass proportion group as a reference. Furthermore, in continuous analyses, higher muscle mass proportion was inversely associated with PHQ-9 scores in both men and women, suggesting a negative relationship between muscle mass proportion and depressive symptom burden. Conclusion This study identified an association between reduced muscle mass and depression. Future prospective studies should explore whether this relationship is causal and determine whether interventions to increase muscle mass can help reduce the prevalence of depression. Such investigations could offer valuable insights into population-level strategies for mitigating depression.