A META-COGNITIVE GROUP INTERVENTION FOR OLDER ADULTS WITH SCD OR MCI: RCT AND QUALITATIVE EVALUATION
Bibliographic record
Abstract
Abstract We explored ASPIRE, a meta-cognitive group intervention aimed to improve engagement in daily activities of older adults with subjective cognitive decline (SCD) or mild cognitive impairment (MCI). We performed a double-blind randomized controlled trail, and complementary qualitative study. Participants were randomly assigned to ASPIRE (n=131) or a Brain Education control group (n=133). The primary quantitative outcome was improvement in performance of daily activities not trained in either intervention, using the Canadian Occupational Performance Measure (COPM). A linear mixed effects regression model found clinically significant improvement (change ≥ 2 points on the COPM) post intervention in 32.5% of untrained activities in ASPIRE; and 30.6% in Brain Education, with no significant group effects (exp(ß)=0.96, z=-0.15, p=.879). Improvements from pre- to post-intervention were found in both arms on secondary measures of subjective cognition and self-efficacy, with no significant group effects. Qualitative data were written responses about the experience of ASPIRE or Brain-Education collected post intervention, analysed using inductive thematic content analysis. ASPIRE participants were pleased with the Group Context, that included learning from, and helping others with shared experiences of cognitive concerns. They described ASPIRE as applicable to Everyday Life, providing practical strategies and motivating action through accountability to the group. Brain-Education participants were pleased with the Content, specifically the topic areas, described as interesting and stimulating. Both groups were pleased with the facilitation approach. We conclude that ASPIRE and Brain-Education have similar potential to improve subjective cognition, self-efficacy, and engagement in daily activities, but the mechanisms by which they work are different.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.056 | 0.116 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.007 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".