Explore end-user evaluations and feedback focused on lifestyle change in a large-scale multidomain online intervention targeting modifiable risk factors for dementia.

Online survey and semi-structured interviews at conclusion of the Maintain Your Brain (MYB) randomized controlled trial. Participants were 55-77 years of age at baseline, and had engaged in assessments, brain training, nutrition and physical activity, and mental health modules over three years. Of 5,260 participants invited, 2,386 completed online surveys and 1,589 of these respondents provided free text comments. Nearly 250 survey respondents agreed to be contacted for additional interviews; 70 of these were invited, 40 interviewed. Survey respondents and interview completers endorsed whether they had made lifestyle changes because of MYB participation and whether they would continue healthy lifestyle changes going forward. Interview participants endorsed whether they thought similar programs can be useful in delaying or preventing dementia, whether their views regarding this type of program had changed over time, answered open-ended follow-up questions and provided additional feedback. Data were summarized using descriptive statistics and explored using multiple qualitative methods.

Of survey respondents, 90.5% endorsed intention to continue a healthier lifestyle; 63.2% endorsed that lifestyle changes had occurred. Interview participants thought similar programs could be useful in delaying or preventing dementia, but some were unsure. Trial participation had not changed many individuals’ views about online lifestyle programs. Survey free-text and interview comments indicated diversity in pre-intervention knowledge, lifestyle and health-related behavior. Many respondents reported improved knowledge and awareness, some detailed relevant and continued lifestyle change. Those who were already well informed and/or leading healthy lifestyles explained that trial participation had confirmed their existing practices. Trial characteristics, personal characteristics, social relationships and significant events impacted whether respondents had made and/or continued changes. More flexible, adaptive individually tailored goals and timely feedback were requested to better support change.

Surveyed participants who engaged in the 3-year MYB online multidomain dementia risk reduction program reported lifestyle changes and intention to continue having a healthier lifestyle. Older adults in this study suggested that similar online programs need to provide flexible, individualized guidance and feedback to support lifestyle change.

To test vitamin D3 and omega-3s for late-life depression prevention under the National Academy of Medicine framework for indicated (targeting subthreshold depression) and selective (targeting presence of high-risk factors) prevention.

VITamin D and OmegA-3 TriaL (VITAL) is a 2x2 factorial trial of vitamin D3 (2000 IU/day) and/or omega-3s (1 g/day) for cardiovascular and cancer prevention (enrollment: November 2011-March 2014; end date: December 31, 2017). In this targeted prevention study, we included 720 VITAL clinical sub-cohort participants who completed neurobehavioral assessments at baseline and 2 years (91.9% retention). High-risk factors were: subthreshold or clinical anxiety, impaired activities of daily living, physical/functional limitation, medical comorbidity, cognitive impairment, caregiving burden, problem drinking, and low psychosocial support. Co-primary outcomes were: incident major depression (MDD), adjudicated using DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition); change in mood (Patient Health Questionnaire-9 [PHQ-9]). We used exact tests to determine treatment effects on MDD incidence and repeated measures models to determine treatment effects on PHQ-9.

11.1% had subthreshold depression, 60.8% had ≥1 high-risk factors, MDD incidence=4.7% (5.0% among completers), and mean PHQ-9 change=0.02 points. Among those with subthreshold depression, the MDD risk ratio (95% confidence intervals)=0.36 (0.06 to 1.28) for vitamin D3 and 0.85 (0.25 to 2.92) for omega-3s, compared to placebos; results were also null among those with ≥1 high-risk factors [vitamin D3 vs. placebo: 0.63 (0.25 to 1.53); omega-3s vs. placebo: 1.08 (0.46 to 2.71)]. There were no significant differences in PHQ-9 change comparing either supplement with placebo.

Neither vitamin D3 nor omega-3s showed benefits for indicated and selective prevention of late-life depression; statistical power was limited.

There is great concern about the care of the older adults in institutions, especially in recent years. One of the reasons is the cases of elder abuse, not only highlighted by academic and scientific sources, but also by the media. Humanization, respect, empowerment and non-infantilization are key elements to promote good treatment in nursing homes (López et al., 2021).

The aim of this study was to evaluate the care in nursing homes using the Professional good care scale in nursing homes (Pérez-Rojo et al., 2021).

The sample for this study consisted of 269 employees working in different older adults nursing homes in Spain (182 nursing aides and 87 other nursing home professionals: nurses, occupational therapists, psychologists, physiotherapists, social workers, sociocultural animators, speech therapists). The employees' evaluations of themselves (their own performance) and their own evaluation of their coworkers in the nursing home (the overall good care in the nursing home) in these two groups of professionals (nursing aides and nursing home staff that care residents) were assessed and compared. T-test were used for data analyses.

The results showed no significant differences between the two groups of professionals when they considered their own performance.

However, statistically significant differences were found when they considered the overall performance in their residency in humanization (p<.001), non-infantilization (p<.001) and in the overall score of the good care scale (p<.001). Good care in nursing homes was significantly perceived as less frequent among nursing aides.

It is important for the evaluation of good care of older adults by the staff to assess both their perception of themselves and their assessment of their coworkers. Good care is the result of a complex construct in which a wide range of factors converge. Therefore, it is essential to contemplate the most accurate assessment of it. To evaluate and promote good care, it seems appropriate to assess the overall performance of all the employees of the nursing home and not only the assessment that each one makes of the treatment he/she gives to the older adults with whom he/she works.

Positive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.

When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.

This study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.

A cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.

The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.

In total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).

Factors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.

We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI).

Prospective cohort study with assessments every 2 years (for up to 6 years).

Community, Sydney, Australia.

Four hundred and eighty one people were classified into three groups: those with MCI at baseline and MCI or dementia at follow-up assessments (n = 92); those who fluctuated between cognitively normal and MCI throughout follow-up (cognitively fluctuating) (n = 157), and those who were cognitively normal at baseline and all reassessments (n = 232).

Cognitive and physical function measured over 2–6 years follow-up. Falls in the year following participants’ final assessment.

In summary, 27.4%, 38.5%, and 34.1% of participants completed 2, 4, and 6 years follow-up of cognitive and physical performance, respectively. The MCI and cognitive fluctuating groups demonstrated cognitive decline, whereas the cognitively normal group did not. The MCI group had worse physical function than the cognitively normal group at baseline but decline over time in physical performance was similar across all groups. Decline in global cognitive function and sensorimotor performance were associated with multiple falls in the cognitively normal group and decline in mobility (timed-up-and-go test) was associated with multiple falls across the whole sample.

Cognitive declines were not associated with falls in people with MCI and fluctuating cognition. Declines in physical function were similar between groups and decline in mobility was associated with falls in the whole sample. As exercise has multiple health benefits including maintaining physical function, it should be recommended for all older people. Programs aimed at mitigating cognitive decline should be encouraged in people with MCI.