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This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health. [ABSTRACT FROM AUTHOR]

• A home-delivered non-pharmacological intervention contributed to reducing the immediate total and social loneliness of homebound older adults. • The decrease in perceived social loneliness mediated the improvement of depressive symptom levels. • Social loneliness may be a relevant target of intervention to improve depressive symptomatology. The present study aimed to explore whether the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered ten-week cognitive-emotional intervention, was effective in reducing self-reported loneliness among homebound older adults presenting mild cognitive impairment and psychological symptomatology. Effects of HEPPI in total, social, and emotional loneliness, compared with a treatment-as-usual group, were investigated at post-intervention and 3-month follow-up. In addition, the potential role of social and emotional loneliness as mediators of the HEPPI impact on episodic memory and symptoms of depression and anxiety was examined. This study built upon the data of a previously conducted randomized controlled trial. Participants were randomly assigned to the HEPPI group (n = 98) or the treatment-as-usual group (n = 101) and completed baseline, post-intervention, and 3-month follow-up assessments, including measures of loneliness (UCLA - Loneliness scale), episodic memory (Wechsler Memory Scale-III), depressive symptoms (Geriatric Depression Scale-30), and anxiety symptoms (Geriatric Anxiety Inventory). Data were analyzed on an intention-to-treat basis employing linear mixed models and mediation analyses for repeated measures. ClinicalTrials.gov identifier: NCT05499767. Compared with usual care controls, the HEPPI participants reported a significant immediate decrease in total and social loneliness, but these effects were not maintained at a 3-month follow-up. The reduction in immediate perceived social loneliness significantly mediated the improvement of depressive symptoms. The current findings suggest that HEPPI potentially reduced total and social loneliness of the homebound older population immediately post-intervention, and such decrease in social loneliness may be a relevant mechanism for improving their short-term depressive symptomatology. [ABSTRACT FROM AUTHOR]

Homebound older adults who rarely or never leave home due to multiple physical, psychological, and social vulnerabilities benefit from home healthcare services to support home-based living. This study explored the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a 10-week cognitive-emotional intervention program for homebound older adults with mild cognitive impairment and depressive or anxiety symptoms. A pilot randomized two-arm controlled trial was conducted. Participants were randomly assigned to one of the two conditions: HEPPI (n = 27) and wait-list control (n = 24). Outcome measurements were conducted at baseline and post-intervention. Primary outcomes included the feasibility and acceptability of the HEPPI. Secondary outcomes were changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and an individual level (Reliable Change Index). HEPPI was feasible as demonstrated by recruitment and retention rates of 82% and 100%, respectively. Acceptability of the HEPPI was high, with all participants expressing willingness to use it again. No differences were found between groups at baseline. The intervention group reported significant increases in cognitive, emotional, and functional domains from baseline to post-intervention, compared to the control group. Clinical change data showed differences between groups in the distributions by clinical change categories. These results point out the feasibility, acceptability, and preliminary efficacy of the HEPPI in improving the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. Our findings call attention to the mental health needs of the homebound population and highlight the importance of providing these older adults with a home-delivered evidence-based multi-component non-pharmacological intervention. [ABSTRACT FROM AUTHOR]