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Reasoning Exercises in Assisted Living: a cluster randomized trial to improve reasoning and everyday problem solving
Kristine Williams1, Ruth Herman2, Daniel Bontempo3
1College of Nursing, University of Iowa, Iowa City, IA, USA.
Clinical Interventions in Aging
|July 17, 2014
Summary
Cognitive training through Reasoning Exercises in Assisted Living (REAL) significantly improved problem-solving and functional status in residents, potentially extending their independence and assisted living stays.
Area of Science:
- Gerontology
- Cognitive Science
- Rehabilitation Science
Background:
- Assisted living residents face risks of cognitive and functional decline.
- These declines can necessitate nursing home placement, impacting quality of life.
- Early intervention is crucial for maintaining independence in this population.
Purpose of the Study:
- To evaluate the efficacy of the Reasoning Exercises in Assisted Living (REAL) cognitive training program.
- To determine if REAL can slow cognitive and functional decline in assisted living residents.
- To assess the impact of REAL on self-care abilities and residency duration.
Main Methods:
- A randomized controlled trial was conducted across thirteen Midwestern assisted living facilities.
- Participants included residents with Mini Mental State Examination scores between 19-29.
- Intervention groups received 3 weeks of either REAL training or a vitamin education control, alongside a no-treatment control group.
Main Results:
- The REAL group demonstrated significant improvements in everyday problem-solving (EPCCE) and functional status (DAFS) immediately post-intervention and at 3-month follow-up.
- Control groups showed no significant gains in cognitive or functional measures.
- Post hoc analyses confirmed the superior benefits of REAL training compared to both attention and no-treatment controls.
Conclusions:
- The REAL program effectively enhances everyday problem-solving skills in assisted living residents.
- These improved skills may enable residents to maintain self-care and prolong their stay in assisted living.
- REAL offers a valuable intervention for the growing population of assisted living residents at risk for decline.
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