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

NCT ID: NCT07099040

Last Updated: 2025-08-01

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 170 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-08-12
• Study Completion Date: 2026-09-30

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)

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

Intervention

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

Group Type: EXPERIMENTAL

Social support

Intervention Type: 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.

Health coaching

Intervention Type: 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.

Physical Activity

Intervention Type: 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.

Cognitive activity

Intervention Type: 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.

Control

Usual care

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Social support

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 Type: BEHAVIORAL

Health coaching

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 Type: BEHAVIORAL

Physical Activity

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 Type: BEHAVIORAL

Cognitive activity

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 Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

Older Adults:

• 60 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:

• 21 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:

• 21 years and older,
• English and/or Mandarin speaking,
• able to provide consent.

Youth Volunteers:

• volunteers from Youth Corps Singapore (YCS)
• English and/or Mandarin speaking,
• able to provide assent

Exclusion Criteria

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).

Care providers:

• not working for the older population,
• Not being able to read, write, and converse in English/Mandarin,
• have not provided service during the period of the pilot test for at least one month (1 session of cognitive activity/week, 2 sessions of physical activity/week).

• Minimum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Singapore Health Services

OTHER

Sponsor Role: collaborator

Singapore General Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Central Contacts

Research coordinators

Role: CONTACT

impress.minds@singhealth.com.sg

62223222

Other Identifiers

NICTran2023-0014

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

202503-0001

Identifier Type: -

Identifier Source: org_study_id