In-person and internet-based cognitive intervention programs
A nonpharmacological treatment program was established, incorporating elements of cognitive, music, and art therapies. This consisted of a 1 hour session (30 min each for 32 sessions), split evenly between cognitive training, and either music therapy or art therapy. Cognitive training was provided twice a week, while music and art therapies were conducted once a week. Cognitive training was provided twice a week, and music and art therapy were provided once a week. An internet-based multimodal intervention was delivered over Zoom.Cognitive training comprised 16 sessions of 30 min each conducted over 8 weeks (twice a week). Out of these 16 sessions, eight were conducted via the internet and the other eight in person. Each session consisted of four stages: introductory activity, brain health lifestyle education, main activity, and finishing the activity. The primary activities included five domains: memory, attention, visuospatial function, frontal-executive function, and language and related functions.Music therapy included eight 30 min sessions over 8 weeks (once a week), with half of these sessions conducted over Zoom and the rest in person. Each session was structured into three stages: introductory activity (5 min), main activity (20 min), and finishing activity (5 min). In the therapeutic song singing activity, the participants had time to listen to or sing all the prepared songs together, share feelings, and discuss the meaning of the lyrics. Afterward, each section was divided into groups and solos, and each group member sang in solo and proceeded in a solo-tutti structure performed in the chorus. In addition, therapeutic singing included the writing of song lyrics by group members. In the instrumental activity, participants were expected to improvise their rhythm. After presenting a variety of rhythmic instruments, participants selected their favorite instrument, added their interpretation of the music, and improvised the rhythm presented to them on the therapist’s piano. As participants grew comfortable with their instruments, they began to recognize their roles in the solo-chorus structure, preparing themselves for expression when performing with the rest of the group. The activity involved participants trying to play melody instruments like colored handbells by reading color scores.Art therapy consisted of eight 30 min sessions over 8 weeks (once a week), evenly split between the internet-based and in-person sessions. The content of the internet based art therapy sessions were interconnected with the in-person sessions, involving the four specific sessions: “self-introduction,” (to make name tags), “Henri Matisse” (after appreciating a painting by Henri Matisse, to put the prepared color pieces together, and to make a single picture), “my hometown” (color the letters mandala and complete it), and “memory box” (to make a panorama that expresses the journey of life). The in-person art therapy sessions included the following activities: “self-introduction,” (to make name tags), “Henri Matisse” (after appreciating a painting by Henri Matisse, to carve them, and color each piece by individuals, and to take a picture and share the work by the therapist online), “my home town” (quizzes on my hometown online), and “memory box” [to make trees symbolize old age (present stage) by decorating it with pictures of one’s face and wishes, and share it online].