Aging, Healthy, Old Age; Dementia, Risk Reduction
Conditions
Keywords
Dementia risk reduction, Older adults, Multidomain programs, Residential and Daycare Facilities, Social Isolation, Loneliness
Brief summary
Dementia and mild cognitive impairment (MCI) deeply impact individuals' well-being and are expected to increase due to population aging, with global cases projected to rise to 152.8 million by 2050. Social isolation, accounting for 4% of dementia cases, emerges as a critical modifiable risk factor, particularly in institutionalized older adults, where it significantly raises dementia risk. To address these challenges, the REMINDER program was developed as a tailored, multidomain intervention to reduce dementia risk, emphasizing social and cognitive engagement and advancing its adaptation and evaluation in Residential and Daycare Facilities (RDF). To assess the feasibility of REMINDER in older adults supported by RDF (recruitment, adherence, retention, acceptability, accessibility, and usability) and explore potential changes in cognitive and psychosocial outcomes.
Detailed description
Implementing DRR programs in RDFs presents several unique challenges, including participant diversity in educational levels, physical and cognitive health, motivation, and logistical constraints within institutional settings. A feasibility study is essential to identify and determine how to overcome these barriers. Specifically, this study explores acceptability, accessibility, adherence, and usability to optimize the REMINDER intervention for RDF settings. By addressing these practical concerns, the feasibility trial will ensure the intervention is effective and implementable, laying the groundwork for a successful full-scale RCT that meets the needs of older adults in RDFs (resulting in an adapted version, the REMINDER4Care). By creating an engaging and well-accepted tool, we look forward to amplifying the RDF tools available to reduce the risk of dementia in their residents. Objectives The primary objectives of this study were as follows: 1. To evaluate the acceptance rate of RDF and participants to join the research; 2. To determine the suitability of participant eligibility criteria by estimating feasible eligibility and recruitment rates; 3. To measure participant adherence and retention through attendance rates across all intervention sessions and trends over time; 4. To assess the feasibility of the REMINDER program in clinical settings, including its acceptability, accessibility, and usability. Secondary objectives included exploring preliminary changes in cognitive and psychosocial outcomes from baseline to post-intervention while acknowledging that the study was not powered to detect statistically significant effects.
Interventions
OTHERREMINDER intervention
The REMINDER intervention includes 20 face-to-face group sessions, each approximately 60 to 75 minutes, held twice a week over ten weeks. This program aims to optimize memory, attention, executive function, and emotional regulation while promoting lifestyle habits that protect the aging brain. The sessions include brain health education, cognitive exercises, compensatory memory strategies, training for managing personally relevant goals (with goal setting), and stress management techniques (compassion-based therapies, relaxation methods, and mindfulness). As for the structure of the sessions, each starts with a mindfulness exercise and concludes with a review of the homework assignments. Every session includes a psychoeducation component focused on a specific topic, a time for sharing and reflection, and a practical activity.
Sponsors
University of Coimbra
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Individuals aged 65 years and older * RDF users * Those with elementary reading and writing skills.
Exclusion criteria
* Have a clinical diagnosis of dementia and/or MMSE scores below the cutoff for the presence of dementia (MMSE \< 22-27, depending on education level) * Have a psychiatric or neurological condition that impairs cognition in the long term * Have sensory and functional deficits that compromised their participation in the neuropsychological assessment and throughout the intervention sessions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility outcomes (quantitative) | During the intervention (at the end of the sessions) and 1-week after the intervention | Recruitment rate |
| Feasibility outcomes (qualitative) | During the intervention (at the end of the sessions) and 1-week after the intervention | Acceptability (with Usefulness, Satisfaction, and Ease of use (USE) questionnaire) ranges from 7 to 49, with higher scores indicating greater acceptability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preliminary efficacy data (screening) | Screening | Participants' sociodemographic (age in years). |
| Preliminary efficacy data (Cognitive functions) | Baseline and 1-week post-intervention | Episodic Memory: Measured with Word Lists I and II from the Wechsler Memory Scale-III (WMS-III), scored based on correct recalls, with higher scores reflecting better memory performance. |
| Preliminary efficacy data (Psychosocial/ Mental Health indicators) | Baseline and 1-week post-intervention | Depressive Symptoms: Assessed using the Geriatric Depression Scale (GDS-30), a 30-item scale with scores ranging from 0 to 30, where higher scores indicate greater depressive symptoms. |
| Preliminary efficacy data (Perceived and performance-based functional status) | Baseline and 1-week post-intervention | Functional capacity: This is assessed using the UPSA-2-PT (UCSD Performance-Based Skills Assessment - 2nd version), scored from 0 to 100 points, with higher scores indicating better functionality. |
Countries
Portugal
Outcome results
None listed