Implementation and effectiveness of a multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres

Pei Ern Mary Ng,Shiou Liang Wee,Isaiah Chng,Teng Yan Yau,Tze Pin Ng,Sean Olivia Nicholas,Alvin Chan,Lin Kiat Philip Yap

doi:10.1038/s41598-021-83408-5

Abstract

To address the paucity of research investigating the implementation of multi-domain dementia prevention interventions, we implemented and evaluated a 24-week, bi-weekly multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres (SCs). It comprised dual-task exercises, cognitive training, and mobile application-based nutritional guidance. An RCT design informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework was adopted. Outcome measures include cognition, quality of life, blood parameters, and physical performance. Implementation was evaluated through questionnaires administered to participants, implementers, SC managers, attendance lists, and observations. The program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. It was implemented as intended; only the nutritional component was re-designed due to participants’ unfamiliarity with the mobile application. While there were no between-group differences in cognition, quality of life, and blood parameters, quality of life reduced in the control group and physical function improved in the intervention group after 24 weeks. The program was well-received by participants and SCs. Our findings show that a multi-domain program for at-risk older adults has benefits and can be implemented through neighborhood SCs. Areas of improvement are discussed.Trial registration: ClinicalTrials.gov NCT04440969 retrospectively registered on 22 June 2020.

Highlights

The efficacy of large multi-domain interventions for dementia prevention, which include varying combinations of diet and/or medication, physical and cognitive exercises and other lifestyle modifications, have been widely discussed
Comprehensive evaluation can help in determining the public health impact of interventions, aiding policy decision on resource a llocation[5,6]
The research team adapted the multi-domain intervention from the FINGER study and partnered business and community service providers to implement it at neighborhood senior centres (SCs)

Summary

Introduction

The efficacy of large multi-domain interventions for dementia prevention, which include varying combinations of diet and/or medication, physical and cognitive exercises and other lifestyle modifications, have been widely discussed. No study has examined the factors that support the implementation of these multi-domain interventions This lack of information on implementation methods impedes the research translation of effective. Comprehensive evaluation can help in determining the public health impact of interventions, aiding policy decision on resource a llocation[5,6]. This pilot project was conducted using a hybrid implementation-effectiveness design[10] that concurrently (1) evaluated the implementation and (2) assessed the effectiveness of a multi-domain dementiaprevention intervention program among community-dwelling adults at risk for mild cognitive impairment and dementia in Singapore. This paper presents the findings of the study and discusses the program effectiveness and implementation

Methods

Results

Conclusion