Examining the Effects of an Outdoor Nature-Based Park Visit Program on the Behaviors, Mood, Quality of Life and Cognitive Symptoms of Individuals with Dementia and the Burden, Well-Being, and Support of Caregivers
Date
2025-01-13
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Abstract
Background: As Canada's population ages, dementia prevalence is projected to rise significantly, highlighting the need for effective interventions to maintain cognitive function and enhance quality of life (QoL). Activities involving nature, particularly outdoor activities, may help slow cognitive decline and improve mood in people living with dementia (PLWD). However, the benefits of outdoor nature-based activities for PLWD in community settings and their impact on caregivers are poorly understood. Objective: This thesis examines the effects of an 8-week park visiting program on PLWD and caregivers. It investigates how this nature-based intervention is associated with changes in behaviour, mood, cognitive function, and QoL among PLWD, along with caregiver burden, well-being, and support. Design: This pilot study included community-dwelling PLWD and caregivers. Participants completed weekly 120-minute park visits guided by evidence-based recommendations. Outcome measures were collected at baseline, week 4, and week 8. The primary outcome measure was the Neuropsychiatric Inventory (NPI) to assess behavioural changes. Secondary outcomes included the Cornell Scale for Depression in Dementia (CSDD), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Dementia Quality of Life (DEMQOL), Zarit Burden Interview (ZBI) and the Carer Well-being and Support questionnaire (CWS). Results: Eight PLWD-caregiver pairs participated. The mean age of PLWD was 73.4 ± 5.8 years (mean ± standard deviation) and 62.5% males. Caregivers ranged in age from 45 to 71 years, with 87.5% being female. The NPI scores showed non-significant numerical improvement at Week 8 (mean difference (MD) -3.63, p = 0.10). Secondary outcomes revealed significant reductions in depressive symptoms on the CSDD (MD -1.50, p = 0.04) at Week 8, significant improvement in overall cognitive function on the RBANS (MD 6.25, p = 0.02) at Week 8, and a significant increase in QoL at Week 8 (DEMQOL: MD 3.25, p = 0.003; DEMQOL-proxy: MD 6.38, p = 0.04). Caregiver burden and well-being did not show significant changes Conclusion: Nature-based outdoor interventions, such as visits to local parks, may improve behaviours, mood, cognition, and QoL for PLWD, offering a promising lifestyle approach in dementia care. Future research could establish these activities as essential components of psychosocial dementia interventions.
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Keywords
Aging, Dementia, Alzheimer's, Older Adults, Neurocognitive, Outdoor, Nature, Nature-based, Psychosocial, Pre-post
Citation
Abolarin, M. (2025). Examining the effects of an outdoor nature-based park visit program on the behaviors, mood, quality of life and cognitive symptoms of individuals with dementia and the burden, well-being, and support of caregivers (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.