Functional ability is associated with higher adherence to behavioral interventions in mild cognitive impairment

Priscilla A Amofa Sr; Brittany DeFeis; Liselotte De Wit; Deirdre O'Shea; Andrea Mejia; Melanie Chandler; Dona E C Locke; Julie Fields; Vaishali Phatak; Pamela M Dean; Julia Crook; Glenn Smith

doi:10.1080/13854046.2019.1672792

Functional ability is associated with higher adherence to behavioral interventions in mild cognitive impairment

Clin Neuropsychol. 2020 Jul;34(5):937-955. doi: 10.1080/13854046.2019.1672792. Epub 2019 Oct 13.

Authors

Affiliations

¹ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
² Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, USA.
³ Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
⁴ Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, USA.
⁵ Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
⁶ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
⁷ Division of Biomedical Statistics and Informatics, Mayo Clinic Florida, Jacksonville, FL, USA.

Abstract

Objective: Behavioral interventions during early memory decline hold promise in delaying the development of dementia. In the present study, participants in a multimodal behavioral intervention study were assessed for post-intervention adherence and predictors of adherence.Methods: Participants (N = 272, mean age = 75.04 ± 7.54) diagnosed with amnestic Mild Cognitive Impairment (aMCI) were assigned to intervention groups receiving four out of five behavioral intervention components, including yoga, memory compensation training, computerized cognitive training, support groups, and/or wellness education. Length of the intervention was 10 days, 4 h per day, with post-intervention follow-up at 6, 12, and 18 months.Results: Two-hundred and thirty-seven participants completed the 6-month post-intervention follow-up measures, 228 participants completed the 12-month measures, and 218 participants completed the 18-month measures. Participants fully adhered to a mean of 2 out of the 4 taught intervention components. Eighty-nine percent of participants were at least partially adherent to one or more taught intervention components at 6-, 12-, and 18-month post-intervention follow-up. Physical activity was the most adhered to intervention while group support was the least adhered to intervention across all three follow-up time-points. Higher educational level, higher baseline depressive symptoms, higher baseline global cognitive functioning, and better baseline and concurrent functional abilities were associated post-intervention adherence.Conclusion: Changes in functional abilities are associated with disease progression among persons with aMCI. In the present study, individuals with aMCI who have higher education, higher depressive symptoms, and better baseline functioning abilities are more likely to adhere to behavioral intervention components over time. Post-intervention adherence also associates with concurrent daily function.

Keywords: MCI; aging; cognitive intervention; multimodal behavioral intervention; post-intervention adherence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cognitive Dysfunction / diagnosis*
Cognitive Dysfunction / psychology
Female
Health Behavior / physiology*
Humans
Male
Neuropsychological Tests / standards*

Abstract

Publication types

MeSH terms

Grants and funding