Remote multicomponent intervention for older adults with cognitive impairment in community settings: multisite randomised controlled trial
Geon Young Jang, Sungyang Jo, Ji Yeon Baek, Eunju Lee, Sunghwan Ji, Il-Young Jang, Chan Mi ParkAbstract
Background
Cognitive impairment is common among community-dwelling older adults and represents a pragmatic target for community-level intervention. This study evaluated the effectiveness of a scalable, remotely delivered multicomponent intervention for older adults with cognitive impairment, integrated into community and primary care settings.
Methods
This 6-month, parallel-group, randomised controlled trial was performed at two public health centres in South Korea, enrolling adults aged 60–80 years with cognitive impairment and preserved functional independence. Participants were randomly assigned (1:1) to a videoconference-based exercise and nutritional support programme or to usual health promotion services. The primary outcome was change in the Montreal Cognitive Assessment–Korean version (MoCA-K) score at 6 months; secondary outcomes included cognitive, functional, physical performance, frailty and depressive measures at 6 and 12 months.
Results
Among 140 participants (mean age 75.0 years; 60% female), equal numbers were randomised to intervention and control groups. At 6 months, the intervention group showed greater improvement in MoCA-K scores compared to the control group [2.3 points; 95% confidence interval (CI) 1.4–3.1], and the difference was sustained at 12 months (1.1 points; 95% CI 0.3–2.0). The intervention was also associated with improvements in functional status and frailty at both time points. No intervention-related adverse events were reported.
Conclusions
A remotely delivered multicomponent intervention improved cognition, functional independence and frailty in older adults with cognitive impairment identified through community-based screening. These findings support the effectiveness of scalable interventions integrated into community and primary care settings, particularly when access to in-person care is limited.
Trial Registration
Clinical Research Information Service (CRIS), KCT0004547; https://cris.nih.go.kr; registered on 12 December 2019.