Search

Background and objectivesIn the absence of a cure for dementia, investigation of novel strategies aimed at delaying or preventing the onset of dementia are gaining momentum. In this regard, using the RE-AIM framework, we outline steps taken to adapt and implement an evidence-based cognitive training program for older adults ‘at risk’ of developing dementia within a clinical setting of a major metropolitan hospital. The primary aim was to explore feasibility (or ‘reach’), tolerability (or ‘implementation’), and acceptability (or ‘adoption’). The secondary aim was to explore the most sensitive clinical outcomes and measurement tools (i.e. ‘efficacy’) to inform a subsequent formal feasibility randomised controlled trial. MethodThis was an exploratory feasibility pilot study, using a pre-post single-arm study design. We conducted this study within the Older People’s Mental Health Service at St Vincent’s Hospital, Sydney, Australia. Seventy-nine participants, with a mean age of 78 years (SD=5.8, range=67-94) were enrolled. All enrolled participants engaged in ‘Club Connect’ an adaptation of a 10-week, group-based multifaceted program, comprised of psychoeducation and computer-based cognitive training. At baseline and follow-up, all participants completed a battery of neuropsychological tests and several questionnaires related to mood and psychosocial functioning. ResultsImplementing cognitive training within a clinical setting was feasible, well tolerated and accepted by participants. Further, cognitive training was associated with large to very large effect size improvements in verbal learning, memory for verbal and visual information, and semantic fluency, as well as quality of life, and reductions in anxiety and stress. We also found small to medium effect size improvements for other cognitive and psychosocial outcomes. ConclusionsOur preliminary findings support the feasibility of translating a group-based cognitive training program into the clinical setting, and provide key data to facilitate the next phase of implementation.