Motivational readiness for behavioral change and cognitive decline in at-risk older adults

Objectives: This study examined whether motivational readiness for behavioral change predicted cognitive outcomes in older adults who participated in a multidomain lifestyle intervention program. Methods: Data from 92 community-dwelling older adults with mild cognitive impairment or subjective cognitive decline who completed a 24-week intervention were analyzed. The participants were classified into the contemplation and action stages based on the Korean Readiness to Change Questionnaire. Cognitive function was measured pre- and post-intervention using the Repeatable Battery for the Assessment of Neuropsychological Status. Hierarchical logistic regression was used to examine the associations between stage of change and cognitive outcomes, controlling for demographic and baseline cognitive variables. Results: Participants in the action stage demonstrated significantly lower odds of cognitive decline than those in the contemplation stage (adjusted odds ratio [OR] = 0.28, p = 0.031); the association remained significant after adjusting for age, sex, education, and baseline cognition. Conclusion: Motivational readiness for change significantly influenced cognitive outcomes following the multidomain intervention. Assessing and enhancing readiness prior to program implementation can optimize intervention effectiveness and support cognitive health among older adults at risk for dementia.