Innovation Inspired by COVID: A Virtual Treatment Program for Patients With Mild Cognitive Impairment at Mayo Clinic

Abstract

Limited access to mental health and behavioral interventions is a public health issue that predated and is further worsened by coronavirus disease 2019 (COVID-19) social distancing restrictions. The Healthy Action to Benefit Independence and Thinking (HABIT) program is a cognitive rehabilitation and wellness program for patients with a diagnosis of mild cognitive impairment and their partners that involves groups of up to 32 people (16 dyads) at a time. Thus, the public health recommendation to avoid groups at the start of the COVID-19 pandemic immediately impacted our ability to offer this treatment protocol. This brief report provides patient and partner satisfaction data as well as clinical outcomes with a virtual adaptation of the HABIT program developed because of the COVID-19 pandemic. At the time of their participation, patients who attended in-person sessions had an average age of 74.4 years and those who attended virtual sessions had an average age of 75.4 years ( P =.60). Both groups had an average of 16.3 years of education ( P =.95). Approximately half of the patients in both groups were male (30 of 57 [53%]), most were White (54 of 57 [95%]) and were accompanied to the program by a spouse (50 of 57 [88%]). Overall, patient and partner satisfaction with the HABIT program remained high, ranging from a mean score of 5.8 to 6.6 on a rating scale of 1 to 7 for patients and partners, and clinical outcomes remained consistent with our face-to-face formatting when compared with pre–COVID pandemic sessions. The most notable changes across both formats were improvements in patient anxiety (Cohen's d =0.25 face-to-face; d =0.39 virtual), partner anxiety ( d =0.37 face-to-face; d =0.34 virtual), and partner depression ( d =0.37 face-to-face; d =0.35 virtual). This preliminary program evaluation suggests that transitioning the HABIT program to virtual formatting provides high-quality care similar to our in-person care models. Ongoing program evaluation is planned as we continue using virtual treatment for safety. Even after COVID-19 pandemic public health restrictions are lifted, these findings will have continued relevance to ongoing demand for telehealth.

The relationship between perceived stigma and perceived stress in cognitive decline: a survey of persons with mild cognitive impairment and their caregivers

“…Previous study evaluating the efficacy of the HABIT program demonstrated the ability of MCI patients to learn despite their memory impairment, as well as improvements in memory activities of daily living, sense of self-efficacy and quality of life in patients with MCI (Locke et al, 2021). For care partners, the HABIT program has been shown to improve mood, increase physical flexibility, and decrease anxiety (Locke et al, 2021). The participants in this study attended one full round (10 days) of the HABIT program.…”

“…The Healthy Action to Benefit Independence and Thinking (HABIT) program is a group-based cognitive rehabilitation and wellness program held four times per year and lasts for 10 days, for a total of 50 h of treatment (Locke et al, 2021). Admission to the HABIT program requires a diagnosis of MCI and allows a maximum of 10 dyads in Arizona and 14 dyads in Florida for each session.…”

“…The HABIT program is not specifically designed to alleviate perceived stigma or stress, but includes stress-related educational components such as tools for stress management, wellness education, readiness planning such as memory compensations, safety considerations, and advanced care planning, as well as group therapy sessions during which perceptions of stigma may be discussed if participants desire. Previous study evaluating the efficacy of the HABIT program demonstrated the ability of MCI patients to learn despite their memory impairment, as well as improvements in memory activities of daily living, sense of self-efficacy and quality of life in patients with MCI (Locke et al, 2021). For care partners, the HABIT program has been shown to improve mood, increase physical flexibility, and decrease anxiety (Locke et al, 2021).…”

Biological factors influencing depression in later life: role of aging processes and treatment implications

“…Interventions targeting memory deficits (such as the Mayo Clinic’s Healthy Action to Benefit Independence and Thinking (HABIT) program) [ 305 ] benefit Mild Cognitive Impairment both with in-person and virtual platforms. While this intervention has not been conducted in LLD, the approach could translate to other populations with primary memory issues.…”

An integrative approach to dementia care

“…This group-based program utilizes memory compensation training, yoga, support groups, and wellness interventions to promote healthy behaviors. Evaluation of the program demonstrated an ability to learn memory support system despite the presence of MCI, improved memory-related activities of daily living, and increases in measures of self-efficacy and quality of life ( Locke et al, 2021 ).…”