Between 2008 and 2010, a cluster randomized controlled trial assessing 460 community-dwelling individuals aged 60 years and older, was conducted in a geriatric community mental health center in Suwon, Republic of Korea. The intervention program based on the principles of contingency management was developed in a way that could be delivered by ordinary primary health workers. According to the research design, group A (n = 81) received standard care services, group B (n = 80) received bimonthly (once every 2 months) telephonic care management, group C (n = 111) received monthly telephonic care management and educational materials similar to those in group B, group D (n = 93) received bimonthly health worker-initiated visits and counseling and group E (n = 94) received bimonthly health worker-initiated visits, counseling, and rewards for adherence to the program.
The primary outcome was the change in Mini-Mental State Examination (MMSE) scores from baseline to the final follow-up visit at 18 months. Group E showed superior cognitive function to group A (adjusted coefficient ß = 0.99, p = 0.044), with participation in cognitive activities being the most important determining factor among several health behaviors (adjusted coefficient ß = 1.04, p < 0.01). The study showed that engaging in cognitive activities, in combination with positive health behaviors, may be most beneficial in preserving cognitive abilities in community-dwelling older adults.
Full bibliographic information:
Lee K.S., Lee Y., Back J.H., Son S.J., Choi S.H., Chung Y.-K., Lim K.-Y., Noh J.S., Koh S.H., Oh B.H., Hong C.H. Effects of a Multidomain Lifestyle Modification on Cognitive Function in Older Adults: An Eighteen-Month Community-Based Cluster Randomized Controlled Trial. Psychother Psychosom 2014;83:270-278.