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| ID | Type | Description | Link |
|---|---|---|---|
| NICTran2023-0014 | Other Grant/Funding Number | National Medical Research Council |
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| Name | Class |
|---|---|
| Singapore Health Services | OTHER |
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | 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 |
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| Control | No Intervention | Usual care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Social support | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Care recipients' cognition measured by the Montreal Cognitive Assessment (MoCA) | The MoCA (Montreal Cognitive Assessment) scoring ranges from 0 to 30, with a higher score indicates better cognitive function. | From enrollment to the end of month 6 |
| Measure | Description | Time Frame |
|---|---|---|
| Care recipients' physical function measured by short physical performance battery (SPPB) | The Short Physical Performance Battery (SPPB) assesses lower extremity function in older adults by evaluating standing balance, gait speed, and repeated chair stands, with scores ranging from 0 to 12, where higher scores indicate better function. | From enrollment to the end of month 6 |
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Inclusion Criteria
Older Adults:
Caregivers:
Service providers:
Youth Volunteers:
Exclusion Criteria:
Older adults
Caregivers:
Care providers:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Research coordinators | Contact | 62223222 | impress.minds@singhealth.com.sg |
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| Health coaching | 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. |
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| Physical Activity | 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. |
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| Cognitive activity | 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. |
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| Care recipients' frailty measured by FRAIL scale | The FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight) is a clinical screening tool used to identify frailty in older adults. Scoring breakdown:
Higher scores indicate worse outcomes/greater frailty: The five components are scored as follows:
| From enrollment to the end of month 6 |
| Care recipients' health-related quality of life measured by EuroQol 5-Dimension 5-Level (EQ-5D-5L) | EuroQol 5-Dimension 5-Level (EQ-5D-5L) For the individual dimension scores (Mobility, Self-care, Usual activities, Pain/discomfort, Anxiety/depression):
| From enrollment to the end of month 6 |
| Care recipients' health state on a EuroQol Visual Analogue Scale (EQ VAS) | For the EuroQol Visual Analogue Scale (EQ VAS):
| From enrollment to the end of month 6 |
| Caregivers' caregiving burden measured by Zarit burden interview (ZBI) | The Zarit Burden Interview-12 (ZBI-12) or Short Version of Zarit Burden Interview:
Scoring interpretation:
| From enrollment to the end of month 6 |
| Care recipients' ability to perform more complex tasks necessary for independent living within the community - Measured by Lawton scale iADL | Each item in iADL is rated based on the person's ability to perform the task independently, with some versions scoring: 0 = unable or needs help 1 = independent Total scores range from 0 (low function, dependent) to 8 (high function, independent). | From enrollment to the end of month 6 |
| Feasibility outcome - Acceptability, collected from the Acceptability of Intervention Measure (AIM) | AIM has 4 items describing participants' acceptance of the intervention. Each item has 5 possible options, with scoring
| At the end of months 2, 4, and 6 |
| Feasibility outcome - Perceived appropriateness, collected from the Intervention Appropriateness Measure (IAM) | IAM has 4 items describing participants' acceptance of the intervention. Each item has 5 possible options, with scoring
| At the end of months 2, 4, and 6 |
| Feasibility outcome - Perceived feasibility, collected from the Feasibility of Intervention Measure (FIM) | FIM has 4 items describing participants' acceptance of the intervention. Each item has 5 possible options, with scoring
| At the end of months 2, 4, and 6 |
| Feasibility outcome - Care recipients' perceptions of the intervention, collected from qualitative interview | Month 6 |
| Feasibility outcome - Acceptability, collected from the Acceptability of Intervention Measure (AIM) | AIM has 4 items describing participants' acceptance of the intervention. Each item has 5 possible options, with scoring
| Month 6 |
| Feasibility outcome - Perceived appropriateness, collected from the Intervention Appropriateness Measure (IAM) | IAM has 4 items describing participants' acceptance of the intervention. Each item has 5 possible options, with scoring
| Month 6 |
| Feasibility outcome - Perceived feasibility, collected from the Feasibility of Intervention Measure (FIM) | FIM has 4 items describing participants' acceptance of the intervention. Each item has 5 possible options, with scoring
| Month 6 |
| Feasibility outcome - Caregivers' perceptions of the intervention, collected from qualitative interview | Feasibility outcome - Caregivers' perceptions of the intervention, collected from qualitative interview |
| Feasibility outcome - Acceptability, collected from the Acceptability of Intervention Measure (AIM) | AIM has 4 items describing participants' acceptance of the intervention. Each item has 5 possible options, with scoring
| From enrollment to the end of month 6 |
| Feasibility outcome - Caregivers' perceptions of the intervention, collected from qualitative interview | Month 6 |
| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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