Effects of ACT on the Executive Function and Emotional Distress of Older Adults With Subjective Cognitive Decline

Subjective cognitive decline (SCD) is often considered an early phase of dementia and is associated with emotional distress, without approved treatments. This study in China aimed to evaluate the effects of acceptance and commitment therapy (ACT) on cognitive and emotional distress among older adults with SCD.

The study used an experimental design of two sequential phases. First, the authors screened 158 older adults with a cross-sectional survey that used standardized SCD criteria and enrolled 34 individuals (mean±SD age=65.66±5.02 years, range 60-77 years) who met the inclusion criteria (SCD with emotional distress). Second, they implemented a two-group randomized controlled trial with repeated measures (baseline and posttest) over 7 weeks to compare the outcomes of ACT with the waitlist control group. The intervention group (N=15 after two participants dropped out) received weekly ACT sessions; the control group (N=17) received the intervention after the experiment. Outcomes included executive function, emotional distress, and psychological flexibility, which were assessed at baseline and posttest.

Compared with the waitlist control group, participants in the intervention group showed significant improvement in executive function, emotional distress, and psychological flexibility. No significant changes were observed in the control group in these areas.

The findings support the efficacy of ACT compared with a waitlist condition, but the design limits causal inference regarding ACT-specific mechanisms. Future trials incorporating active control conditions are needed to determine the mechanisms underlying ACT-related improvement.