Community-based Multi-domain Intervention to Detect and Delay Cognitive Decline in Community-dwelling Older Adults: A Pilot Study

NCT07099040 | Not Yet Recruiting DMC

• 2 other identifiers: 202503-0001NICTran2023-0014
• Study Type: interventional
• Target: 170
• Locations: 0 countries
• Sites: N/A

Brief Summary

The incidence of cognitive impairment and its burden are increasing with a rapidly ageing population. In Singapore, the prevalence of dementia among older adults aged 60 and above is approximately 10%, which will translate to approximately 152,000 older adults living with dementia by the year 2030. Using 2013 data as estimates, the total annual cost of dementia was already estimated at S$532 million while cost per person was estimated at S$10,245 per annum, and a further increase in corresponding costs is expected through 2030 with the projection of increase in persons with dementia (PWDs). There is thus an urgent need for (i) effective, scalable, and sustainable interventions that are widely accessible to detect and delay cognitive decline and frailty in our community-dwelling older adults, and (ii) providing support for their caregivers. This study aims to test the feasibility of a community-based multi-domain intervention for detecting and delaying cognitive impairment for the older population.

Conditions

Mild Cognitive Impairment; Mild Cognitive Impairment (MCI)

Keywords

Multi-domain intervention; Pilot study; Community-based intervention; Cognitive Impairment

Outcome Measures

Primary Outcomes (1)

• Care recipients' cognition measured by the Montreal Cognitive Assessment (MoCA)

  The MoCA (Montreal Cognitive Assessment) scoring ranges from 0 to 30, with a higher score indicates better cognitive function.

  From enrollment to the end of month 6

Secondary Outcomes (16)

• Care recipients' physical function measured by short physical performance battery (SPPB)

  From enrollment to the end of month 6

• Care recipients' frailty measured by FRAIL scale

  From enrollment to the end of month 6

• Care recipients' health-related quality of life measured by EuroQol 5-Dimension 5-Level (EQ-5D-5L)

  From enrollment to the end of month 6

• Care recipients' health state on a EuroQol Visual Analogue Scale (EQ VAS)

  From enrollment to the end of month 6

• Caregivers' caregiving burden measured by Zarit burden interview (ZBI)

  From enrollment to the end of month 6

Study Arms (2)

Intervention

EXPERIMENTAL

Twice of physical activity at the AAC with home-based exercises once to twice a week, and once a week of cognitive activity at the AAC, with once to twice a week of home-based activity

Behavioral: Social support; Behavioral: Health coaching; Behavioral: Physical Activity; Behavioral: Cognitive activity

Control

NO INTERVENTION

Usual care

Interventions

Social support BEHAVIORAL

Psychoeducation will be provided for enrolled participants and their caregivers by Community Resource, Engagement \& Support Team (CREST). Visits from CREST teams will be provided on an ad hoc basis, based on older adult participants' needs and circumstances.

Intervention

Health coaching BEHAVIORAL

Health coaching aims to control risk factors of dementia by community nurses (CMNs) and wellbeing coordinators (WBCs). These include addressing chronic conditions and lifestyle aspects (diet, exercise, habits stress management, and sleep). Care recipients are encouraged to proactively manage their health journey and establish Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) goals with the support of WBCs and CMNs. This multi-faceted approach has the potential to not only address older individuals' immediate health concerns but also foster long-term lifestyle changes. The frequency of visits are once or twice a month, depending on recipients' health status and cognitive functions. Flexible scheduling is based on individual needs and community nurses' usual practice at the Community Health Post at AACs.

Intervention

Physical Activity BEHAVIORAL

Physical Activity that focuses on improving resistance and balance for care recipients. Physical activity will be conducted 2 times/week at the Active Ageing Centres (AACs) with care recipients for a duration of 1-hour and 1-2 times/week at home.

Intervention

Cognitive activity BEHAVIORAL

Cognitive activity will be delivered to enrolled care recipients by Community Resource, Engagement \& Support Team (CREST) and AAC staff. With the incorporation of using SilverPad as part of the cognitive activities, care recipients will undergo 1-hour weekly cognitive activity. Youth volunteers will also be engaged to help facilitate the sessions. This will be augmented with additional 1-2 times weekly home-based training sessions supervised by caregivers.

Intervention

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Older Adults:
• years and older with cognitive concerns or (self-reported or observer reported),
• English and/or Mandarin speaking,
• no physical disabilities that preclude study participation,
• willing to complete all study-related activities,
• no known diagnosis of major cognitive impairment,
• able to provide consent.
• Caregivers:
• years and older,
• English and/or Mandarin speaking,
• able to provide consent
• have at least 6-month experience of taking care of older adults with mild cognitive impairment.
• Service providers:
• years and older,
• English and/or Mandarin speaking,

You may not qualify if:

• Older adults
• Known diagnosis of moderate dementia and above,
• Montreal Cognitive Assessment (MoCA) score \<18,
• Has difficulty in basic activities of daily living,
• disorders that affects safe engagement in the intervention (e.g. symptomatic cardiovascular disease, revascularization within 1 year, major depression or anxiety with ongoing treatment, underlying malignancy),
• Severe vision or hearing impairment or any other disorders preventing cooperation as judged by the study team,
• Major illness with life expectancy \<6 months,
• Institutionalized,
• Planned major surgery within the duration of the multi-domain intervention,
• Physical disabilities that preclude study participation.
• Caregivers:
• aged below 21 years old,
• not being the primary family caregiver of at least one older individual,
• not being able to read, write, and converse in English/Mandarin,
• their family members (older adults) have not participated in the pilot test for at least one month (1 session of cognitive activity/week, 2 sessions of physical activity/week).

Sponsors & Collaborators

• Singapore General Hospital: lead
• Singapore Health Services: collaborator

MeSH Terms

Conditions

Cognitive Dysfunction

Interventions

Exercise

Condition Hierarchy (Ancestors)

Cognition Disorders; Neurocognitive Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Central Study Contacts

Research coordinators

CONTACT

62223222; impress.minds@singhealth.com.sg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 23, 2025
• First Posted: August 1, 2025
• Study Start: August 12, 2025
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: August 1, 2025

Record last verified: 2025-07