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.
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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
25
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.
Faculty of Psychology and Education Sciences
Coimbra, Portugal, Portugal
Feasibility outcomes (quantitative)
Recruitment rate
Time frame: During the intervention (at the end of the sessions) and 1-week after the intervention
Feasibility outcomes (quantitative)
Adherence
Time frame: During the intervention (at the end of the sessions) and 1-week after the intervention
Feasibility outcomes (quantitative)
Retention
Time frame: During the intervention (at the end of the sessions) and 1-week after the intervention
Feasibility outcomes (qualitative)
Acceptability (with Usefulness, Satisfaction, and Ease of use (USE) questionnaire) ranges from 7 to 49, with higher scores indicating greater acceptability.
Time frame: During the intervention (at the end of the sessions) and 1-week after the intervention
Feasibility outcomes (qualitative)
Accessibility (with Usefulness, Satisfaction, and Ease of use (USE) questionnaire) ranges from 15 to 105, with higher scores indicating greater accessibility.
Time frame: During the intervention (at the end of the sessions) and 1-week after the intervention
Feasibility outcomes (qualitative)
The intervention's usability (with Usefulness, Satisfaction, and Ease of use (USE) questionnaire) ranges from 8 to 56, with higher scores indicating greater usability.
Time frame: During the intervention (at the end of the sessions) and 1-week after the intervention
Preliminary efficacy data (screening)
Participants' sociodemographic (age in years).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' sociodemographic (marital status).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' sociodemographic (education level).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' clinical information (presence of medical diagnosis).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' clinical information (current medication).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' clinical information (sensory issues).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' clinical information (mobility deficits).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' clinical information (substance use).
Time frame: Screening
Preliminary efficacy data (screening)
Participants' clinical information (hospitalization).
Time frame: Screening
Preliminary efficacy data (screening)
Dementia risk was assessed using the Lifestyle for BRAin health (LIBRA) score, which ranges from -2.1 to 10.6, with higher scores indicating a greater risk of developing dementia.
Time frame: Screening
Preliminary efficacy data (screening)
Perceived Social Isolation: This was evaluated using the Questionnaire of Perceived Social Isolation (QPSI), which is scored on a scale of 1 to 5 per item, with higher scores indicating greater perceived social isolation.
Time frame: Screening and 1-week post-intervention
Preliminary efficacy data (screening)
Global cognition was assessed using Addenbrooke's Cognitive Examination - Revised (ACE-R), a scale with scores ranging from 0 to 100, where higher scores indicate better cognitive functioning.
Time frame: Screening and 1-week post-intervention
Preliminary efficacy data (Cognitive functions)
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.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Cognitive functions)
Processing Speed: Evaluated with the Symbol Search subtest of the Wechsler Adult Intelligence Scale-III (WAIS-III), scored by correct responses within a time limit, with higher scores representing faster processing speed.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Cognitive functions)
Working Memory: Assessed with the Month Ordering task, scored by the number of correct sequences, where higher scores indicate better working memory.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Cognitive functions)
Verbal Initiative: Measured with the Verbal Fluency Test (letters M, R, and alternate category), scored by the number of correct words produced, with higher scores indicating greater verbal initiative.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Psychosocial/ Mental Health indicators)
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.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Psychosocial/ Mental Health indicators)
Loneliness: Measured with the UCLA Loneliness Scale (UCLA LS-3), the score was 20 to 80, with higher scores reflecting greater perceived loneliness.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Psychosocial/ Mental Health indicators)
Social Networks: Evaluated using Lubben's Brief Social Network Scale (LSNS-6), scored from 0 to 30, where higher scores indicate a stronger social network.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Psychosocial/ Mental Health indicators)
Quality of Life: This is assessed using the World Health Organization Quality of Life (WHOQOL-BREF-7), scored on a scale of 1 to 5 for each item, with higher scores indicating better quality of life.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Psychosocial/ Mental Health indicators)
Life Satisfaction: This is measured using the Satisfaction with Life Scale (SWLS), scored from 5 to 25. Higher scores reflect greater life satisfaction.
Time frame: Baseline and 1-week post-intervention
Preliminary efficacy data (Perceived and performance-based functional status)
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.
Time frame: Baseline and 1-week post-intervention
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