Article

Dementia
The World Cup effect: Using 11(5) 699702
! The Author(s) 2011
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dementia DOI: 10.1177/1471301211429177

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Chiara A. Solari
West London Mental Health NHS Trust, UK

Luke Solomons
Berkshire Healthcare NHS Foundation Trust,UK

Abstract
Engagement of older men with dementia in traditional activities in healthcare settings can be
challenging. During the World Cup 2010, we used a football quiz to engage memory clinic
attendees and gauge enthusiasm for a regular football reminiscence project. Based on reports
from carers, all of the men who had previously been interested in football were stimulated by the
activity and half of the male participants wished to continue a football-themed project beyond the
trial period.

Keywords
activities, dementia, engagement, football, men

Introduction
There is growing evidence of a discrepancy in help-seeking behaviours between the sexes and
this is particularly true of mental illness: men are less likely to report or accept treatment for
depression (Addis and Mahalik, 2003). Among other things, this phenomenon has been
attributed to stereotypical gender roles, in other words traditional masculinity (Addis
and Mahalik, 2003). A study by Cohen-Manseld and colleagues (Cohen-Manseld et al.,
2010a) examined the use of dierent stimuli for engaging those with dementia. It found that
women showed more attention and longer duration of engagement than men; they also
showed more positive attitudes to the various stimuli presented. It has been suggested
that people with dementia engage better with a stimulus that has some personal meaning
to them, be that through previous employment, personal identity or gender-specic activities
(Cohen-Manseld et al., 2010b). At present, however, very few stimuli are provided that
specically target men with dementia.

Corresponding author:
Chiara A. Solari, The Paddock Centre, Broadmoor Hospital, Crowthorne, Berkshire. RG45 7EG
Email: c.solari@doctors.org.uk
700 Dementia 11(5)

As a consequence, men with dementia present particular challenges for those who support
them, both in terms of their willingness to seek help and their ability to engage with help
when it becomes available. This is important because studies have shown that lack of
stimulation in dementia patients has been linked to a decline in their physical health,
functioning and it impacts their behaviour: verbal and physical agitation have been
directly correlated with under-stimulation (Cohen-Manseld et al., 2010a). Mental activity
is also thought to play a protective role against cognitive decline. A recent study which aimed
to engage and stimulate men with dementia has had promising results. The football
reminiscences project used football memorabilia as the subject of one-to-one or group
discussions over a 12-month period. Participants were engaged and their memories
stimulated and carers corroborated the success of the project (Glasgow Caledonian
University, 2010)
We ran a World Cup survey for patients and their carers in a memory clinic to gauge
levels of interest and engage patients. The project ran for the duration of the World Cup
Tournament 2010 in order to harness the excitement created by the media.

Aims
The aim of this study was to establish whether our patients could be engaged by a football-
based activity and whether they and their carers felt we should extend this project beyond the
World Cup and set up a regular group with a football focus. We predicted that, as with the
football reminiscences study (Glasgow Caledonian University, 2010), this activity would
help to engage men using the service and stimulate their memories.

Methods
We created a questionnaire that comprised the following:

. a quiz with World Cup questions relevant to the era of our focus group;
. a number of questions related to general interest in the World Cup and demand for an
ongoing football-focus group;
. a section for carers to give their opinions.

The questionnaire was distributed to all service users attending the Beechcroft Memory
Clinic in Newbury for the 1-month duration of the World Cup Tournament 2010. Service
users completed the questionnaire prior to their appointment.

Results
We received a total of 29 responses and from these we were able to determine some
demographic information regarding our service users: 3/4 of our respondents were female
(21) and the largest proportion of respondents were over 80 years old, as would be expected
from a survey of people attending dementia clinics.
Twenty participants reported having watched matches and, of these, 70% found the
World Cup exciting and enjoyed it. Eleven respondents remembered a match clearly and
10 remembered Englands World Cup win in 1966 most vividly.
Solari and Solomons 701

Table 1. Percentage of participants who would wish to continue a football-

themed activity beyond the World Cup Tournament 2010 by gender

% All % Men % Women

Yes 31 37 29
No 45 38 47
Question not 24 25 24
answered

Table 2. Carers reports of interest in the World Cup

% interested in
% Interested in % Interested in World Cup interested in
2010 World Cup football in the past football in past

Yes 49 55 87
No 41 35 13
Question not 10 10 0
answered

We asked our respondents whether they would wish to continue a football-themed project
beyond the World Cup. The results are illustrated in Table 1 and are divided into results for
both sexes combined and then results for the sexes individually.
We asked carers whether they felt that the World Cup Tournament had brought interest
into the lives of the people they care for and whether those they care for had been interested
in football in the past (see Table 2). Of those who had been interested in football in the past
87% were reportedly stimulated by the 2010 World Cup. The 13% who had been interested
but were not stimulated by the current Tournament were all women. All of the men who had
been interested in football in the past were objectively stimulated by the 2010 World Cup
Tournament.

Answers to open-ended questions

We asked participants to suggest ways that we could continue a football project beyond the
World Cup; suggestions included an informal football discussion group, watching matches
communally and forming a Memory Clinic football team.
Examples of memories from respondents included:

. . . watching the 1966 nal with my brother . . . I was 11 and he was 16 . . .

Man, 55 years old
England winning the World Cup in 1966 . . . watching a 12 inch black and white TV whilst on
holiday in Folkestone.
702 Dementia 11(5)

Woman, 76 years old

Ghana v USA 2010 . . . Ghana won! It was exciting to see a small African country beat the
mighty USA!
Woman, 88 years old

Conclusions
Approximately half of the men who took part in our survey felt that they would like to
continue a football-based group beyond the World Cup: this nding conrms past research
that elderly males are reticent to engage with groups. However, based on carer report, all of
the men participating in the survey who had once been interested in football were stimulated
and engaged by the 2010 World Cup Tournament. This highlights an obvious discrepancy
between self and carer report.
This quick and dirty survey has a number of confounders including small sample size,
but broadly conrmed our hypothesis. The results would be more illuminating were we to
replicate it with a larger sample of our focus group. It would also be interesting to include
Mini Mental State Examination (MMSE) scores in the data to see whether answers could be
related to cognitive function and also to explore the relationship between cognitive function
and the degree of engagement and stimulation of participants. It also lays the foundation for
starting a local football reminiscence programme.

Funding
This research received no specic grant from any funding agency in the public, commercial, or not-
for-prot sectors.

Conflict of interest statement

The authors declare no conicts of interest in preparing this article.

References
Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. American
Psychologist, 58, 514.
Cohen-Manseld, J., Marx, M. S., Dakheel-Ali, M., Regier, N. G., & Thein, K. (2010a). Can persons
with dementia be engaged with stimuli? American Journal of Geriatric Psychiatry, 18, 351362.
Cohen-Manseld, J., Thein, K., Dakheel-Ali, M., & Marx, M. S. (2010b). The underlying meaning of
stimuli: Impact on engagement of persons with dementia. Psychiatry Research, 177, 216222.
Glasgow Caledonian University (2010). University news and events. Football reminiscences help men
with dementia: GCU aims to roll out research project to other countries. From: http://
www.gcu.ac.uk/newsevents/news/bydate/2010/8/name,11304,en.html.

Chiara A. Solari is a CT3 with the Oxford Deanery, currently working in Forensic Psychiatry
at Broadmoor Hospital, West London Mental Health NHS Trust.

Luke Solomons is a consultant old age and liaison psychiatrist at Berkshire Healthcare NHS
Foundation Trust.