Compensatory and Lifestyle-Based Brain Health Program for Subjective Cognitive Decline: Self-Implementation versus Coaching

Abstract

Although recent studies have explored the potential of multidomain brain health programs, there is a dearth of literature on operationalizing this research to create a clinical treatment program specifically for subjective cognitive decline (SCD). Patients seen by geriatricians in primary care and by behavioral neurology services at our institution presenting with SCD were recruited via a patient-appropriate flyer. After all participants had a 1-h brain health consultation with a neuropsychologist and were provided with program materials, they were randomized to attend a 10-week intervention designed to support program implementation (N = 10) or the control group of implementing the program on their own (N = 11). The program included (1) a calendar-based executive and memory support system for compensatory training and (2) training in healthy lifestyle. There were no significant differences between groups for any outcomes. Participants across both groups showed significant improvements with moderate effect sizes in compensatory strategy use, anxiety symptoms, and daily functioning, which were sustained through 6-month follow-up. They also increased physical activity by the end of the intervention period but did not sustain this through 6-month follow-up. Our pilot study demonstrates preliminary feasibility of a cognitive compensatory and lifestyle-based brain health program. Additional research is recommended to further develop two potentially scalable implementation strategies—coaching and self-implementation after brief consultation.

Recent contributions to the field of subjective cognitive decline in aging: A literature review

“…A recent systematic review of randomized control trials (RCTs) for interventions at the stage of SCD found that, overall, education programs, compared to cognitive training, physical training, or mind–body interventions, were most effective in improving memory function 133 . Several of these interventions, designed to support socialization and brain health education, appeared to support quality of life and holistic functioning in individuals with SCD 134,135 . Multimodal educational and health programs, involving combinations of brain health education, mindfulness practice, music listening, and/or exercise, were generally associated with increased subjective cognitive functioning post‐intervention or reductions in anxiety levels 136,137 .…”

“… 133 Several of these interventions, designed to support socialization and brain health education, appeared to support quality of life and holistic functioning in individuals with SCD. 134 , 135 Multimodal educational and health programs, involving combinations of brain health education, mindfulness practice, music listening, and/or exercise, were generally associated with increased subjective cognitive functioning post‐intervention or reductions in anxiety levels. 136 , 137 Another recent systematic review also found strong evidence for cognitive/mental/physical training on cognitive and non‐cognitive outcomes in SCD individuals.…”