Arts and Aging Building the Science
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Transcript of 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
liSt o acronymS
ad Azm aadcS Azm da coopatv sty
artZ Att o Azm
aBr atoy batm po to ompx o
cBa ot-bft aay
cE ot-tv
EBd v-ba
da u.s. Foo a d Amtato
mri toa mat oa magap gop At Poam
hhS u.s. dpatmt o hat a hma sv
hrQl at-at qaty o
iQ t qott
ltc o-tm a
mma Mm o Mo At
naS natoa Aamy o s
nccam natoa ct o compmtay a Atatv M
nEa natoa eowmt o t At
nia natoa ittt o A
nih natoa ittt o hat
oBSSr Of o Bavoa a soa s ra
pa pya atvty
pcori Patt-ct Otom ra ittt
pd Pako a
Qaly Qaty Ajt l Ya
rct aomz oto ta
Soc stv Optmzato wt compato
ucla uvty o caoa, lo A
Who Wo hat Oazato
Wtp W to Pay
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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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The ArTs And Aging: Building The science 3
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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The ArTs And Aging: Building The science 5
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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6 The ArTs And Aging: Building The science
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 ArTs And Aging: Building The science 7
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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8 The ArTs And Aging: Building The science
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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The ArTs And Aging: Building The science 9
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).
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10 The ArTs And Aging: Building The science
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.
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The ArTs And Aging: Building The science 11
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.
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12 The ArTs And Aging: Building The science
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
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The ArTs And Aging: Building The science 13
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.
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14 The ArTs And Aging: Building The science
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?
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The ArTs And Aging: Building The science 15
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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16 The ArTs And Aging: Building The science
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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The ArTs And Aging: Building The science 17
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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18 The ArTs And Aging: Building The science
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
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The ArTs And Aging: Building The science 19
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.
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20 The ArTs And Aging: Building The science
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.)
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The ArTs And Aging: Building The science 21
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.
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22 The ArTs And Aging: Building The science
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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The ArTs And Aging: Building The science 23
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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24 The ArTs And Aging: Building The science
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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The ArTs And Aging: Building The science 25
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.
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26 The ArTs And Aging: Building The science
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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The ArTs And Aging: Building The science 27
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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28 The ArTs And Aging: Building The science
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
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The ArTs And Aging: Building The science 29
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
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30 The ArTs And Aging: Building The science
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
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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