Ageing well: Pilot evaluation of a dual‐task training program in a rural community

Abstract

ObjectiveThis pilot trial examined the feasibility and effectiveness of “Ageing Well,” a community‐based program for improving cognitive skills and mobility of rural older people.Design and settingThe non‐randomised, wait‐list–controlled pilot trial was conducted at a regional NSW university clinic.ParticipantsTwenty‐three community‐dwelling adults aged 60+ who had begun to experience a decline in their physical or cognitive abilities or both.InterventionsDual‐tasking activities simultaneously challenged participants' motor and cognitive abilities. Student facilitators encouraged participants to progress through increasing complex functional tasks in a range of contexts, including a café, supermarket and a simulated “home.”Main outcome measuresThe Patient Reported Evaluation of Cognitive State measured the impact of an individual's cognitive state in terms of how much they were “bothered” by problems with their cognition. Functional mobility was measured by the Timed Up‐and‐Go, a test of static and dynamic balance, and the Six Minute Walk Test.ResultsIntervention participants' Patient Reported Evaluation of Cognitive State ratings in relation to impacts on their performance of everyday skills improved substantially, whereas the control group did not change. Intervention participants walked 12% further in the Six Minute Walk Test post‐intervention, while the control group distance did not change. Timed Up‐and‐Go time was reduced by 1 second in the intervention group.ConclusionsThere is a strong interest in this dual‐tasking program among older community‐dwelling residents in this rural setting. The results of this pilot study support the feasibility and effectiveness of the Ageing Well program. But further trials are warranted.

Age‐friendly interventions in rural and remote areas: A scoping review

“… 32 , 33 There were studies that indicated the limited access to services such as palliative care, general health clinics, mental health, and specialty health services. 15 , 34 , 35 Factors such as geographical isolation, 36 financial constraints, 30 , 37 transportation issues, 18 , 38 and lack of rural health facilities and healthcare staff 39 , 40 were identified as complicating access to healthcare.…”

Understanding the enablers to implementing sustainable health and well‐being programs for older adults in rural Australia: A scoping review

“…As such, there was a need to consider creative solutions during the design phase that allowed for flexibility in how the intervention was implemented or modified to suit older people living in different rural communities, given the variability of access to health services 27,32 . One way to address this variability was to offer preventative approaches either through specific programs or screening, which was seen as beneficial for older rural community members 21,33,34 . For this to succeed, local stakeholder engagement was needed during the design phase to understand where the gaps were for individual communities and what cost‐effective approaches would be most suitable 21 rather than making assumptions about what was needed.…”

“…27,32 One way to address this variability was to offer preventative approaches either through specific programs or screening, which was seen as beneficial for older rural community members. 21,33,34 For this to succeed, local stakeholder engagement was needed during the design phase to understand where the gaps were for individual communities and what cost-effective approaches would be most suitable 21 rather than making assumptions about what was needed. Early identification of specific community needs related to access and availability of evidence-based resources to support program implementation at a community level was also seen as important.…”

Understanding What Older People Value in the Design of a Community-Based Healthy Ageing Program, a Qualitative Study

“…Participants in the Program were screened to ensure they were independent community-dwelling (with or without supports), ambulant (with or without a walking aid), and had sufcient English language skills and cognitive ability to understand verbal instructions in a group setting, without a formal diagnosis of cognitive impairment as determined by the Mini Mental State Examination. Te Ageing Well Program was a ten-week group-based program where participants attended for one hour per week and were involved in undertaking a range of individualised simulated functional activities in small groups with a focus on improving mobility and cognition skills, alongside targeted education sessions to support the development of knowledge and strategies to facilitate ageing well [23].…”