Six-month outcomes of a multidomain RCT lifestyle and memory support intervention among older adults with subjective...

This study evaluated a multidomain 6-month intervention combining training in memory strategies (e.g., goal setting, to-do lists, calendar scheduling) and lifestyle modifications (physical exercise, cognitive/social engagement, well-being exercises) supported by a digital application. The target intervention group is compared to an education only group.

Participants were 270 older adults with subjective cognitive decline. Primary outcomes included global cognition and everyday function. Secondary outcomes included engagement in health behaviors, compensation strategy use, and other measures of health and well-being. We also examined baseline participant characteristics that predicted treatment response based on components of Self-Determination Theory (competence, relatedness, autonomous motivation), health literacy, demographics, and baseline dementia risk. Using an intent-to-treat framework, multiple linear regression models evaluated intervention effectiveness.

At 6 months, no intervention group differences in cognition or everyday function were detected. However, the intervention group demonstrated significantly better well-being outcomes (i.e., gratitude) (p = .04). Lower baseline competence and autonomous motivation were associated with greater intervention effects on global cognition (ps <.04) and self-perceived stress (ps <.05), while higher autonomous motivation was associated with greater effects on everyday functioning (p = .026). Less education was associated with greater intervention benefits on social activity engagement (p = .03). Lower baseline dementia risk was associated with greater intervention benefits on moderate physical activity (p = .01).

Combined training in healthy lifestyles and cognitive compensation may enhance aspects of emotional well-being. Further, particular participant characteristics may help determine who most benefits from this type of dementia risk reduction intervention.