R.RAYMOND1, M.ONG1, J.CHEW1, P.CHEW1, Z.ZENG2, B.TAN2, N.ALI1, W.S.LIM1, C.MIAO2, J.J.CHIN1
Tan Tock Seng Hospital1, Nanyang Technological University2
Cognitive training and physical activity interventions may protect against cognitive decline, but are resource-intensive and lack robust evidence supporting efficacy. We developed ADL+, a novel digital tool delivering personalised, app-based home and community cognitive-physical interventions. We aim to evaluate its efficacy on cognitive function and activity levels in at-risk older adults.
Using a quasi-experimental study design, we enrolled sixty-six functionally-independent, community-dwelling older adults(71.3±5.6years) with subjective memory complaints (AD8≥2,no dementia)to a 6-month intervention using ADL+ (N=33), or a control group (educational package). Outcomes included changes in cognitive scores measured using neuropsychological test battery(NTB) total and domain Z-scores(memory, executive function and processing speed) and activity levels(Frenchay Activities Index, FAI) at baseline and 6-months. Analysis of covariance(ANCOVA) was used to assess changes in mean scores from baseline between intervention and control, adjusted for baseline scores and covariate imbalances.
All participants completed 6-month assessments. Both intervention and control groups were similar at baseline, except for higher Geriatric Depression Scale(GDS) scores in the control group (P=0.002). At 6-months, estimated mean change in NTB Z-scores favoured the intervention group for processing speed (increase of 0.27, 95%CI:0.10-0.34,P=0.039), adjusted for baseline NTB and GDS. We also observed a significant beneficial effect of intervention on activity levels (FAI increase 2.0, 95%CI:0.52-3.5,P=0.009), but not for NTB total, memory and executive function domains.
Our preliminary findings suggest that ADL+ could improve cognitive processing speed and activity levels in older adults at risk of cognitive decline. Further studies are required to ascertain the longer-term efficacy and feasibility of this intervention.