Background Art-based interventions may delay cognitive decline and improve health-related outcomes in older adults with mild cognitive impairment (MCI). Objective To examine the effects of the Creative Expressive Arts-based Storytelling (CrEAS) program compared to active and waitlist controls on neurocognitive and other health-related outcomes in older people with MCI. Design Three-arm parallel-group, randomised controlled design. Participants One-hundred and thirty-five adults with MCI (mean age: 70.93 ± 6.91 years). Methods Participants were randomly assigned to intervention (CrEAS, n = 45), active control (n = 45) or waitlist control (n = 45) groups. Interventions were applied once per week for 24 weeks. The primary outcome was global cognitive function; secondary outcomes were specific cognition domains (memory, executive function, language and attention) and other health-related outcomes (anxiety, depression and quality of life [QoL]). All variables were measured at baseline (T0), 24-week follow-up (T1) and 48-week follow-up (T2). Results Participants in the CrEAS group showed significantly higher global cognitive function (adjusted mean difference [MD] = −0.905, 95% confidence interval [CI] −1.748 to −0.062; P = 0.038) and QoL (adjusted MD = −4.150, 95% CI -6.447 to −1.853; P = 0.001) and lower depression symptoms (adjusted MD = 2.902, 95% CI 0.699–5.104; P = 0.011) post-intervention at the 24-week follow-up compared with the active control group. At 48-week follow-up, only the Auditory Verbal Learning Test Immediate recall score was significantly improved compared with the active control group (adjusted MD = −2.941, 95% CI −5.262 to −0.620; P = 0.014). Conclusions Older adults with MCI who participated in the CrEAS program improved their neuropsychological outcomes and QoL and reduced their rate of cognitive deterioration.

Background Given the aging population worldwide and the COVID-19 pandemic, which has been found to be associated with a deterioration in Alzheimer’s disease (AD) symptoms, investigating methods to prevent or delay cognitive decline in preclinical AD and AD itself is important. The trial described in this protocol aims to evaluate the effects of a staged integral art-based cognitive intervention (SIACI) in older adults with CIs (preclinical AD [SCD or MCI] and mild AD), in order to gather evidence on the effects of SIACI on cognition and psychological/psychosocial health gains and determine the mechanisms. Methods The planned study is a single-center, parallel-arm, randomized controlled trial with allocation concealment and outcome assessor blinding. A total of 88 participants will be randomized to two groups: (i) an intervention group that receives the 16-week, 24-session SIACI program and (ii) a waitlist control group (which will receive the SIACI program after completing the follow-up assessment). Global cognitive function, specific domains of cognition (memory, language, executive function, and visuospatial skills), and other health-related outcomes (quality of life, anxiety, depression, sleep quality, and physical activity level) will be measured at baseline, immediately after the intervention, and at the 6-month follow-up. Blood biomarkers, event-related potential (ERP)-P300, and magnetic resonance imaging (MRI) data will be collected at baseline and immediately after the intervention to explore the mechanisms of SIACI. Discussion The trial will elucidate the immediate and long-term effects of SIACI based on neuropsychological testing and blood biomarkers, and neuroscience involving ERP-P300 and MRI parameters will make it possible to explore the mechanisms of SIACI in older adults with CIs. The results will provide evidence on the effectiveness of an AT-based cognitive intervention, which may delay or even halt cognitive decline in preclinical AD and AD itself. Trial registration ChiCTR, ChiCTR2100044959. Registered 03 April 2021.

Background: Due to the heterogeneity of MCI, the key points of non-drug therapies cannot be determined. Exploring the characteristics among different MCI subgroups would therefore be beneficial in guiding the development of non-drug therapies. In the present study, weexplored subgrouping of older Chinese adults with MCI based on cognitive function and analyzed the characteristics of the resulting subgroups. Methods: A cross-sectional study was conducted between October 2018 and January 2022. The study enrolled a total of 1017 participants with MCI in Fujian, East China. Participants underwent a comprehensive neuropsychological test assessing memory, language, attention, and executive function and completed a questionnaire examining socioeconomic and clinical variables.Neuropsychological test scores were transformed to z-scores, which were then examined using latent class analysis. Correlations of socioeconomic and clinical variables with MCI subgroups were assessed using multinomial logistic regression analysis. Results: Three MCI subgroups were identified: (1) false-positive MCI (56.64%); (2) early MCI (36.28%); and (3) late MCI (7.08%). Age, data sources, marriage status, living status, and participation in intellectual activities differed significantly across the three MCI subgroups (P<0.05). Compared with the false-positive MCI group, participants with late MCI were less likely to participate in intellectual activity and more likely to live in a nursing home. Conclusions: Older Chinese adults with MCI can be classified into subgroups based on cognitive function. A large proportion of participants were classified in the false-positive MCI group, suggesting that conventional diagnostic criteria are susceptible to false-positive errors, resulting in patients being misdiagnosed as MCI in China. And further research to define the characteristics of different MCI subgroups could facilitate the development of non-drug therapies for MCI.

Background The cognitive benefits of early non-pharmacological approaches have been demonstrated in older adults with mild cognitive impairment (MCI). However, older adults living in nursing homes have more severe cognitive impairment problems and lower initiative and compliance to participate in complex interventions. Hence, it important to investigate more attractive and sustainable methods to prevent or delay cognitive decline. The present study adopts the self-determination theory (SDT) as a theoretical framework to innovatively develop an integrated art-based intervention for older adults with MCI in nursing homes in China and aims to evaluate its effects on cognitive function, mental health, and other health-related outcomes. Methods The study is a nursing home-based, cluster randomised controlled trial (RCT) that targets older adults (aged ≥ 60 years) with MCI in Fuzhou City, China. All nursing homes in the area covered by Fuzhou City are invited to participate. Eligible nursing homes are randomised to one of two groups: intervention group (receive a 14-week, 27-session intervention) and waitlist control group (receive the usual care). The SDT-based integrated creative art (SDTICA) program reasonably adopts the SDT as a theoretical framework to innovatively develop an integrated art-based intervention for older adults with MCI in nursing homes. The primary (global cognitive function and psychological indicator) and secondary (daily activity function, social function, and specific domains of cognitive function) outcomes will be measured at baseline, after the intervention, and during follow-up. Discussion This study aims to evaluate the effects of SDTICA program on neuropsychological outcomes in older adults with MCI and provide scientific evidence for art-based non-pharmacologic interventions in nursing homes, which may reduce dementia risk in older adults with MCI. Trial registration The trial was prospectively registered at the Chinese Clinical Trials Registry with the registration number ChiCTR2200061681 on 30 June 2022.

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