title: The effects of video observation of chewing during lunch on masticatory ability, food intake, cognition, activities of daily living, depression, and quality of life in older adults with dementia: a study protocol of an adjusted randomized controlled trial.
abstract: BACKGROUND
  Masticatory functioning alters with age. However, mastication has been found to be related to, for example, cognitive functioning, food intake, and some aspects of activities of daily living. Since cognitive functioning and activities of daily living show a decline in older adults with dementia, improving masticatory functioning may be of relevance to them. A possible way to improve mastication may be showing videos of people who are chewing. Observing chewing movements may activate the mirror neuron system, which becomes also activated during the execution of that same movement. The primary hypothesis is that the observation of chewing has a beneficial effect on masticatory functioning, or, more specifically, masticatory ability of older adults with dementia. Secondary, the intervention is hypothesized to have beneficial effects on food intake, cognition, activities of daily living, depression, and quality of life.
  
  
  METHODS
  An adjusted parallel randomized controlled trial is being performed in dining rooms of residential care settings. Older adults with dementia, for whom also additional eligibility criteria apply, are randomly assigned to the experimental (videos of chewing people) or control condition (videos of nature and buildings), by drawing folded pieces of paper. Participants who are able to watch each other's videos are assigned to the same study condition. The intervention takes place during lunchtime, from Monday to Friday, for 3 months. During four moments of measurement, masticatory ability, food intake, cognitive functioning, activities of daily living, depression, and quality of life are assessed. Tests administrators blind to the group allocation administer the tests to participants.
  
  
  CONCLUSIONS
  The goal of this study is to examine the effects of video observation of chewing on masticatory ability and several secondary outcome measures. In this study, the observation of chewing is added to the execution of the same action (i.e., during eating). Beneficial effects on masticatory ability, and consequently on the other outcome measures are hypothesized. The intervention may be easily integrated into daily care, and might add to the lives of the increasing number of older adults with dementia by beneficially influencing multiple daily life functions.
  
  
  BACKGROUND
  NTR5124. Registration date: 30 March 2015.
authors: Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. j.g.douma@vu.nl.
authors: Johanna G
authors: JG
authors: Douma
authors: Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. k.m.volkers@vu.nl.
authors: Karin M
authors: KM
authors: Volkers
authors: Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. p.j.vuijk@vu.nl.
authors: Pieter Jelle
authors: PJ
authors: Vuijk
authors: Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. eja.scherder@vu.nl.|University of Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. eja.scherder@vu.nl.
authors: Erik J A
authors: EJ
authors: Scherder
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D003704:Dementia / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D004435:Eating / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D062409:Lunch / Q000502:physiology / Q000523:psychology*; D008297:Male; D008409:Mastication / Q000502:physiology; D010775:Photic Stimulation / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D014741:Video Recording / Q000379:methods