"Taking Charge" after a diagnosis of cognitive impairment or dementia: a randomized controlled trial

Self-directed programs can steer positive trajectories after life-changing health events. This study evaluated if one such program (Take Charge) could improve quality of life (QoL) after diagnosis of mild cognitive impairment (MCI) or mild dementia compared with lifestyle education.

Two-arm, open-label, randomized controlled trial including people with MCI or mild dementia in Adelaide, Australia. Participants were assigned to Take Charge intervention (n = 80) or control group (lifestyle education with waitlist option) (n = 80). The primary outcome was QoL measured using the Physical Component Summary (PCS) score of the Short Form 36 (SF-36) at three months following baseline comparing Take Charge to control. Secondary outcomes included the mental component summary (MCS) score of SF-36, hope, mood (depression scale), and activity engagement at three and six months. A subset of participants participated in an interview about their experiences with Take Charge.

Participants had a mean age of 79.6 years (SD 7.2) and 51.2% were female. The mean Mini-Mental State Examination score was 24.2 (SD 3.2). No significant differences were found in PCS scores between groups at three months (-0.53; 95% CI: -4.23, 3.17; p = .78). However, interviews suggested that those actively engaged in Take Charge felt more positive about the future.

There was no significant difference between the Take Charge and control groups, and Take Charge did not improve physical health-related QoL for people living with MCI or mild dementia. More work is needed to establish the appropriateness and efficacy of self-directed programs for this population.