Elena Guseva, PhD(c)
(514) 483-2121 (2364)
elena.guseva@mail.mcgill.ca
Éléna est maintenant en quatrième année d'études supérieures dans le programme de Médecine Familiale à l'Université McGill. Elle a obtenu son baccalaureat en beaux-arts en Éducation Artistique et en Psychologie, ainsi que sa maitrise en Thérapies des Arts Créatifs de l'Université Concordia en 2017. Éléna est membre de l'Association Américaine d'Art Thérapie. Son parcours interdisciplinaire découle de son intérêt continu pour le travail thérapeutique avec les populations atteintes de la démence.
Sous la supervision de la Dre Machelle Wilchesky, Éléna vise à établir la thérapie par l'art comme une option non pharmacologique efficace et sécuritaire pour la gestion des symptômes neuropsychiatriques chez les patients atteints de la démence. Le déclin cognitif accompagné de pathologie visuelle, spécifiquement dans le cas de la démence de type Alzheimer, restreint la portée et l'efficacité des interventions thérapeutiques qui peuvent être utilisées pour les personnes aux stades avancés de la maladie. Le projet d'Éléna implique le développement et l'évaluation d'interventions de thérapie par l'art adaptées à la démence, améliorées visuellement, en collectant des données neuropsychologiques à l'aide de dispositifs portables. Ce projet surmontera une limitation bien documentée des études précédentes : la difficulté associée à la quantification des effets de l'intervention compte tenu des défis de communication inhérents aux participants atteints de démence avancée.
“Physiological responses in persons living with dementia to visually supported art therapy directed on neuropsychiatric symptoms reduction: assessing efficacy of intervention using wearable sensor technology.”, Elena Guseva, PhD Student
Background: Art therapy (AT) can be beneficial in reducing neuropsychiatric symptoms (NPS) in people with mild Alzheimer’s disease (AD). As the disease progresses, however AD-related visual deficits, however, reduces the feasibility of using AT in the absence of visual adaptations. Furthermore, scientific evaluations of AT intervention effectiveness have questionable validity given that outcomes have historically relied exclusively on subjective (observational) and not objective outcome measures. Physiological signals provided by wearable sensor technology (WST) can potentially quantify AT intervention effects among individuals who are unable to communicate verbally and support existing observational assessment techniques to assess NPS in this population.
Objectives: My overarching aims are to: 1) Examine AT as a non-pharmacological option for NPS reduction in PLwD; 2) Present evidence on the use of WST for identification and monitoring of NPS in the dementia population. The objectives of my PhD dissertation publications are to:
- Present personal reflections on the use of AT in dementia care and obstacles that the field currently experiences in dementia-related research and evidence-based practice (published: https://www.tandfonline.com/doi/abs/10.1080/07421656.2019.1564613 );
- Conduct a systematic review to assess efficacy and effectiveness of AT for NPS reduction in PLwD by dementia severity;
- Conduct a systematic review to assess validity, feasibility, and acceptability of WST for detection and monitoring of NPS in PLwD (by dementia severity); and
- Present a protocol for a pilot randomized cross-over trial that uses WST to assess and compare efficacy of AT interventions with and without visual support for agitation/aggression and apathy reduction in persons with moderate and advanced Alzheimer’s disease (AD).
Methods: According to the objectives, two systematic reviews will be conducted using data from the following databases: 1) ALOIS, CENTRAL (Cochrane Library), Medline, EMDASE, CINAHL, PsycINFO (Objective 1); 2) Health sciences databases: Ovid MEDLINE, EMBASE Classic+ EMBASE, PsycINFO, CINAHL, Scopus. Engineering databases: Compendex and IEEE Xplore (Objective 2). Evidence from the two literature reviews will be integrated into the randomized cross-over pilot protocol.
Anticipated Results: I expect to demonstrate that AT has potential as an effective and appropriate psychosocial intervention for NPS reduction in persons living the moderate to advanced Alzheimer’s disease when external supports, such as adaptations to visuoperceptial changes, are made. I also expect to demonstrate that the use of WST has potential to assist in the identification and monitoring of NPS for PLwD. This would overcome the challenges associated with the assessment of the effects of psychosocial interventions (such as AT) aimed at reducing NPS in this population.
Implications of the Research: I expect that my interdisciplinary research will integrate art therapy, neuroscience and psychogeriatrics. This will be the first AT study to examine scientific evidence that can be used to inform and support AT interventions aimed at NPS reduction in dementia.