Pilot Testing a Couples-Focused Intervention for Mild Cognitive Impairment

Abstract

The purpose of this pilot study was to evaluate the acceptability, feasibility, and potential benefits of the multi-component Daily Enhancement of Meaningful Activity (DEMA) intervention, which was tailored to help couples facing mild cognitive impairment (MCI) work together to meet goals, remain engaged in meaningful activities, and adapt to changes over time. Using a single-group design, 10 persons with MCI and their family caregivers were recruited to receive DEMA over six bi-weekly sessions. Data were collected pre- and at one week and three months post-intervention. Consent, session, and questionnaire completion rates indicated the program and study procedures were well accepted. Qualitative and quantitative findings indicated positive trends in meaningful activity performance and maintenance of health-related outcomes, as well as high program satisfaction. The DEMA is a potentially promising intervention that will need further testing in a randomized clinical trial.

Assessing clustering of metabolic syndrome components available at primary care for Bantu Africans using factor analysis in the general population

“…IDF recommended WC as the most frequently used anthropometric index to define abdominal obesity [6]. Paradoxically, WC, BP, lipid, and glucose levels were similar among men and women in this study as reported in the same general population [10]. However, WC cutoff points differ by ethnic groups and gender worldwide [1,4].…”

“…Contrary to the previous myths, non communicable diseases (Diabetes, hypertension, MS, atherosclerosis) are no longer rare in Africa [10-14]. The extent is increasing and it is thought to be due to the shifting from traditional African customs to the Western lifestyle [15-18].…”

“…Before the advent of the consensus of the definition of the MS using International Diabetes Federation(IDF) [6], Experts from WHO and EGIR required the measurement of serum insulin levels, diabetes mellitus(DM) or glucose intolerance, hypertension, triglycerides, HDL-Cholesterol(C), body mass index(BMI), and waist circumference(WC) with different cutoff points [7,8]. However, MS characterizes by international cutoff points [6-9], are limited to detect efficiently bantu Africans at higher cardiometabolic(CDM) risk(hypertension, DM, atherosclerosis) in comparisons with ethnic specific definition of MS [10]. Africans have low or normal lipid profile [11,12] and a high level of HDL-C [13].…”

Feasibility and Effect Sizes of the Revised Daily Engagement of Meaningful Activities Intervention for Individuals With Mild Cognitive Impairment and Their Caregivers

“…The DEMA conceptual framework (Figure 1) was developed based on: gerontological theory (Lawton, 1990), the Model of Human Occupation (Kielhofner, 2002), components of Problem-Solving Therapy (PST) (Unützer et al, 2002), and findings from two phenomenology studies of patients living with MCI and their caregivers and a three-phase DEMA intervention development study (Lu & Haase, 2009; Lu, Haase, & Farran, 2007; Lu, Haase, & Weaver, 2013). Based on the framework, the DEMA intervention has several features.…”

“…DEMA is described in detail in another publication by Lu and her colleagues (2013). DEMA was tailored to patient and caregiver congruence in level of awareness of functional ability and to their types and frequencies of meaningful activity and perceived barriers to engaging in these activites.…”