A CULTURE COMPARISON OF APATHY REDUCTION AND ENHANCED SOCIAL CONNECTEDNESS BETWEEN A MEXICO CITY WHOLE BRAIN FITNESS PROGRAM AND 25 IDENTICAL PROGRAMS IN THE USA

Abstract

Perceived loneliness and apathy are associated with dementia and linked to accelerated physical and mental decline. Research suggests that environmental and social stimulation can increase purposeful engagement and reduce apathy and perceived loneliness. In 2014, Vanderbilt's Center for Quality Aging conducted a 12-month prospective, longitudinal pilot of the Circle of Friends (COF), Belmont Village Senior Living program for mild to moderate dementia, (MoCA 13 to26) comparing COF with program eligible, but non-enrolled Assisted Living residents. Performance-based neuropsychological instruments and standardized observations showed that COF participants spent significantly more time engaged in purposeful activities (no apathy or isolation) relative to a control group and COF participants showed maintenance of cognitive functioning in some domains. These results have been consistent with 3 years of program evaluation for all 25 Belmont Village facilities for 1,076 residents. Belmont Village opened a Senior Living in Mexico City a year ago, translating and adapting COF for the Mexican culture, but otherwise providing the same 7-day-per-week Whole Brain Fitness program conducted by trained staff: aerobic/weight exercises; 6 domains of cognitive functioning; heart-healthy diet; and social connections. These first Mexican residents have families who have countered the culture bias against placement. The residents are a homogenous population with similarities of life story, background and prior home life. The group is 10 single women and two married women all of whom moved from a home of learned helplessness into Belmont. The OARS assessment confirmed that all had had reduced social contacts and felt lonely despite household servants and daily family visits. A comparison of these 12 residents with a female subset of 425 USA residents who are direct move-ins showed similar trends between the two groups in activity participation, enhanced social connection and reduced apathy, defined as 4 hours per day of purposeful activity, recorded daily. USA: No apathy/high social engagement = 71% MEX: No apathy/high social engagement = 92% USA: 6 months MoCA maintained/improved = 46% MEX: 6 months MoCA maintained/improved = 75% USA: 6 months CLOCK maintained/improved = 49% MEX: 6 months CLOCK maintained/improved = 100%.