Effectiveness of a Meta-Cognitive Group Intervention for Older Adults with Subjective Cognitive Decline or Mild Cognitive Impairment: The ASPIRE Randomized Controlled Trial
Notice bibliographique
Résumé
BACKGROUND: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) can lead to functional and cognitive decline, increasing dementia risk. There is a pressing need for interventions that prevent this deterioration. The ASPIRE (Adult Strategies Put Into Real-world Environments) intervention was developed to improve performance of daily activities. OBJECTIVES: The primary objective was to determine whether ASPIRE was more effective than a Brain Education control intervention in improving performance and satisfaction with daily life activities that were not specifically trained in the intervention. Secondary objectives were to explore: 1) whether ASPIRE was more effective in improving self-reported health and quality of life, and performance on cognitive tests; and 2) maintenance of change over six-months. DESIGN: Double-blind, two-armed, parallel randomized controlled trial, with a six-month follow-up period. SETTING: Community based, Greater Toronto Area. PARTICIPANTS: Two-hundred sixty-four older adults (aged 70.8 ± 6.6 years) with SCD or MCI, randomized to ASPIRE (n=131) or a Brain Education active control arm (n= 133). INTERVENTION: ASPIRE is a 10-week meta-cognitive group intervention focusing on strategy acquisition and application to improve performance of individualized daily activity identified by each participant as important. It involves setting goals, creating tailored plans, and iteratively modifying these plans with support from the group members and facilitator. MEASUREMENTS: Performance of and satisfaction with daily activities was rated on a 10-point Likert scale using the Canadian Occupational Performance Measure (COPM). Secondary outcome were subjective cognition, depression, anxiety, self-efficacy, quality of life, and cognitive tests of memory and executive functions. RESULTS: Post-intervention, clinically significant improvement of untrained activities (two points or more on the COPM) was found in 32.5% in ASPIRE; and 30.6% in the control arm, with no significant between group differences (Performance: (exp(β ̂) =0.96, z=-0.15, p=.879); Satisfaction: (exp(β ̂) =0.94, z=-0.29, p=.775). The improvements remained stable over six months in both arms. No significant group effects were found on the secondary outcomes, but improvements were found on subjective cognition and self-efficacy in both arms post intervention. CONCLUSION: Both a meta-cognitive strategy approach and an adult learning activity resulted in positive changes in subjective cognition, self efficacy, and, to a certain extent, engagement in daily activities.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,003 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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