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Novel Research and Care Strategies for Older Adults with Stroke...
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Novel Research and Care Strategies for Older Adults with Stroke and/or Dementia

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 2681

Editors

Dr. Irene Hartigan

E-Mail Website
Guest Editor
School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland
Interests: stroke; dementia; person-centred care; health innovation; caregiver support; ageing population; palliative care
Dr. Gary Mitchell

E-Mail Website
Co-Guest Editor
School of Nursing and Midwifery, Queen's University, Belfast BT9 7BL, UK
Interests: care of older people; care homes; chronic illness; healthcare education
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As populations across the globe continue to age, the prevalence of age-related conditions such as stroke and dementia is rising sharply, posing significant challenges to healthcare systems, caregivers, and communities. These complex conditions often co-occur, compounding the burden on individuals and requiring integrated, person-centred approaches to care. This Special Issue, “Novel Research and Care Strategies for Older Adults with Stroke and/or Dementia”, seeks to explore novel research, interventions, and models of care that address the multifaceted needs of older adults living with stroke, dementia, or both.

We invite contributions that examine novel clinical practices, interdisciplinary care models, technological innovations, and policy frameworks that enhance the quality of life, autonomy, and dignity of older people. Submissions may include original research, systematic reviews, implementation studies, and case reports that highlight best practices in prevention, diagnosis, rehabilitation, long-term care, and caregiver support.

Particular emphasis will be placed on innovations that promote equity, cultural sensitivity, and sustainability in geriatric care. We also welcome studies that explore the intersection of stroke and dementia, including shared risk factors, diagnostic challenges, and integrated care pathways.

This Special Issue aims to foster a global dialogue among researchers, clinicians, policymakers, and stakeholders to advance evidence-based, compassionate, and future-ready approaches to geriatric care. By sharing diverse perspectives and experiences, we hope to contribute to a more inclusive and responsive health and social care landscape for older adults.

Dr. Irene Hartigan
Guest Editor

Dr. Gary Mitchell
Co-Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stroke
  • dementia
  • integrated care
  • person-centred care
  • health innovation
  • caregiver support
  • ageing population

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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14 pages, 613 KB  
Article
Evaluation of the “Los Filabres” Protocol on Behavioral and Psychological Symptoms of Dementia and Psychotropic Drug Use in Nursing Home Residents
by Isaac García Carricondo, Ana Rocío García Carricondo, Raúl Romero Del Rey and Raquel Alarcón-Rodríguez
Healthcare 2026, 14(13), 1934; https://doi.org/10.3390/healthcare14131934 - 1 Jul 2026
Viewed by 254
Abstract
Background/Objectives: Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent among nursing home residents and represent a major clinical and care-related challenge. These symptoms are frequently associated with increased psychotropic drug use despite limited efficacy and important safety concerns. This study aimed [...] Read more.
Background/Objectives: Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent among nursing home residents and represent a major clinical and care-related challenge. These symptoms are frequently associated with increased psychotropic drug use despite limited efficacy and important safety concerns. This study aimed to evaluate longitudinal changes in BPSD and psychotropic drug use following implementation of the “Los Filabres” protocol, a structured person-centered non-pharmacological intervention, in nursing home residents with dementia. Methods: A single-arm longitudinal pre–post observational study was conducted in five nursing homes in Andalusia, Spain, including 204 residents with dementia or cognitive impairment. After staff training, the intervention was implemented over 12 months. Outcomes were assessed at baseline (T0), 6 months (T1) and 12 months (T2) using the Neuropsychiatric Inventory (NPI), including symptom frequency, severity, clinical relevance, and caregiver-related distress. Psychotropic drug use was analyzed according to the Anatomical Therapeutic Chemical classification system. Statistical analyses included Friedman and Cochran’s Q tests, with effect sizes estimated using Cohen’s d and h. The observational nature of the study implies that observed changes may be subject to limitations such as Hawthorne effects. Results: Significant reductions were observed across all global NPI dimensions over time (p < 0.001), including symptom frequency, severity, clinical relevance, and caregiver-related distress. The proportion of participants with at least one clinically relevant symptom decreased from 93.1% at baseline to 35.8% at 12 months (p < 0.001). Significant longitudinal reductions were also observed in psychotropic drug use, with the mean number of psychotropic drugs per participant decreasing from 2.38 to 1.57 (p < 0.001). Reductions were observed in anxiolytic and antipsychotic use, as well as in as-needed prescriptions. Conclusions: The “Los Filabres” protocol was associated with significant longitudinal reductions in BPSD and psychotropic drug use in nursing home residents with dementia. These findings suggest that structured person-centered non-pharmacological interventions based on the identification of unmet needs may help support dementia care and more individualized pharmacological management in long-term care settings. These findings should be interpreted cautiously due to the observational pre–post design and absence of a control group. Full article
(This article belongs to the Special Issue Novel Research and Care Strategies for Older Adults with Stroke and/or Dementia)
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16 pages, 226 KB  
Article
“The Window of Opportunity”: A Qualitative Exploration of Individual Reminiscence in Care Home Settings
by Aoife Conway, Rosemary Bradley, Assumpta Ryan, Claire McCauley, Brighide Lynch, Deirdre Harkin and Sarah Penney
Healthcare 2026, 14(2), 276; https://doi.org/10.3390/healthcare14020276 - 21 Jan 2026
Viewed by 639
Abstract
Background: Care homes are complex care environments where supporting residents’ identity, wellbeing, and sense of personhood is central to person-centred care. Reminiscence is widely recognised as a psychosocial approach that can support these outcomes. However, existing evidence has largely focused on group-based interventions, [...] Read more.
Background: Care homes are complex care environments where supporting residents’ identity, wellbeing, and sense of personhood is central to person-centred care. Reminiscence is widely recognised as a psychosocial approach that can support these outcomes. However, existing evidence has largely focused on group-based interventions, with comparatively limited attention given to how individual reminiscence is implemented and sustained within care home practice. Methods: This study was an implementation-focused qualitative exploration of staff experiences of introducing and embedding individualised reminiscence in care home practice. Care home staff participated in four monthly workshops that introduced principles of individualised reminiscence and supported them to plan and implement reminiscence with at least one resident. Participants used either the InspireD digital reminiscence app (n = 19) or non-digital approaches such as life story books (n = 2), depending on local preferences and perceived suitability. Three focus groups were conducted with 21 care home staff to explore experiences of implementing individualised reminiscence and perceptions of its impact on residents, staff, and families. Data were analysed using reflexive thematic analysis. Results: Four interrelated themes were identified: (1) reminiscence within pressured systems; (2) resident experience and identity; (3) adapting and sustaining practice; and (4) families as partners in reminiscence. Participants described challenges associated with workload pressures, role expectations, and variability in family involvement, which influenced how reminiscence was adopted in practice. Despite these constraints, participants described perceived benefits for residents, including perceived improvements in mood, engagement, and expressions of identity. Participants also discussed perceived increased staff confidence, strengthened staff–resident relationships, and enhanced awareness of person-centred care practices. Conclusions: Findings highlight the perceived potential of individualised reminiscence to support person-centred and relational care in care homes, while identifying key contextual influences on implementation. Further research is needed to examine sustainability and effectiveness using comparative and mixed-method designs. Full article
(This article belongs to the Special Issue Novel Research and Care Strategies for Older Adults with Stroke and/or Dementia)

Review

Jump to: Research

18 pages, 761 KB  
Review
Transtheoretical Model (TTM)-Based, TTM-Informed and TTM-Congruent Behaviour Change Interventions for Adults with Mild Cognitive Impairment and Dementia Risk: A Scoping Review
by Wei Ting Foo, Xiaoting Huang, Shawn Zhi Zheng Lin and Anupama Roy Chowdhury
Healthcare 2026, 14(13), 1898; https://doi.org/10.3390/healthcare14131898 - 30 Jun 2026
Viewed by 283
Abstract
Background/Objectives: Mild cognitive impairment (MCI) is a clinically important state associated with an increased risk of future cognitive decline and dementia. Behaviour change interventions may support risk reduction and self-management in cognitively vulnerable adults. However, the extent to which the transtheoretical model (TTM) [...] Read more.
Background/Objectives: Mild cognitive impairment (MCI) is a clinically important state associated with an increased risk of future cognitive decline and dementia. Behaviour change interventions may support risk reduction and self-management in cognitively vulnerable adults. However, the extent to which the transtheoretical model (TTM) has been used in this population has not been clearly mapped. This scoping review examined TTM-based, TTM-informed, and TTM-congruent behaviour change interventions for adults with MCI, subjective cognitive concerns, or elevated dementia risk. Methods: This scoping review followed Joanna Briggs Institute guidance and was reported in accordance with PRISMA-ScR. The protocol was prospectively registered on the Open Science Framework. PubMed, PsycINFO, ScienceDirect, Scopus, Web of Science, CENTRAL, ProQuest Dissertations, and medRxiv were searched from inception to 30 September 2025. Eligible studies included randomised, nonrandomised, quasi-experimental, and qualitative designs. Data were charted using a piloted extraction form and were synthesised narratively. Results: Eight unique studies, represented across nine publications, were included. Only one trial explicitly operationalised the TTM in a clinically defined MCI cohort; most studies were more appropriately classified as TTM-informed or TTM-congruent. Recurrent intervention components included readiness alignment, goal setting, self-monitoring, personalised feedback, prompts and cues, problem solving, reinforcement, and relational support. Behavioural outcomes were more consistently favourable than cognitive outcomes, particularly for adherence, self-management, diet, and sustained physical activity engagement. Cognitive findings were heterogeneous: some smaller studies reported short-term improvements, whereas the largest rigorous trial found no significant cognitive benefit. Conclusions: Current evidence does not support strong claims regarding TTM-specific cognitive efficacy in MCI. Instead, it suggests that TTM-informed and TTM-congruent interventions may be useful for strengthening behavioural regulation, risk reduction, and maintenance of health-related routines in cognitively vulnerable adults. More rigorous studies are needed to test the TTM constructs prospectively and to determine whether proximal behavioural change translates into durable cognitive or functional benefit. Full article
(This article belongs to the Special Issue Novel Research and Care Strategies for Older Adults with Stroke and/or Dementia)
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15 pages, 416 KB  
Review
Artificial Intelligence for the Early Detection of Patients with Cognitive Impairment: A Scoping Review
by María Moreno-Pineda, Víctor Ortiz-Mallasén and Águeda Cervera-Gasch
Healthcare 2026, 14(6), 768; https://doi.org/10.3390/healthcare14060768 - 18 Mar 2026
Viewed by 998
Abstract
Background/Objectives: Cognitive impairment affects multiple brain functions, and its early detection is essential to prevent progression to dementia; artificial intelligence has shown considerable potential in this field. This scoping review aims to map the impact of artificial intelligence–based tools for the early detection [...] Read more.
Background/Objectives: Cognitive impairment affects multiple brain functions, and its early detection is essential to prevent progression to dementia; artificial intelligence has shown considerable potential in this field. This scoping review aims to map the impact of artificial intelligence–based tools for the early detection of cognitive impairment by identifying the main technologies used, examining their effectiveness, and exploring their ethical implications. Methods: A scoping review was conducted between April and May 2025 following the PRISMA-ScR methodological framework; the review protocol was previously registered on the Open Science Framework. PubMed, Scopus, and Cochrane databases were searched using natural language and controlled vocabulary terms via Medical Subject Headings. The search was limited to articles published between 2020 and 2025, in English or Spanish, with free full-text access. Methodological quality was assessed using CASPe, JBI, and MMAT. Results: A total of 14 studies were included after the selection and critical appraisal process. The findings show that artificial intelligence–based tools such as deep-learning models applied to neuroimaging, speech and gait analysis, electronic health record analysis, and mobile health applications demonstrate promising accuracy in detecting early cognitive changes. These technologies enable the identification of subtle patterns that may be difficult to detect using conventional clinical assessments. Conclusions: AI-based tools can provide substantial support for clinical decision-making by effectively identifying subtle changes that are imperceptible to human intelligence. However, their use also raises ethical issues related to patient privacy and data security. Full article
(This article belongs to the Special Issue Novel Research and Care Strategies for Older Adults with Stroke and/or Dementia)
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