Reviving social interaction for healthy aging
Description
APROACH: Reviving social interaction for healthy aging: participatory engagement of older adults in dementia prevention in rural African and Montreal contexts
This study pilots a real-life participatory intervention that could prevent cognitive loss while improving care of older adults. Observational studies associate dementia with reduced social contact. Formal trials of social activity as dementia prevention suggest social engagement might reduce age-related cognitive loss. Social interventions improved aspects of executive function, loss of which defines some dementias.
Our pilot explores three mechanisms of participatory research with older adults and their caregivers: 1) engage in governance to balance personal and collective interests; 2) analyse and apply local evidence, and 3) support innovation to address shared interests. If the mechanisms of participatory research key off corresponding elements of executive function, this could revitalize cognitive capacity and prevent or delay dementia in an affordable and realistic way.
In southern Botswana, participants will be women and men aged 65 years or older receiving an old age pension in two rural communities. In Montreal, we will recruit older-adult family members of residents with moderate to advanced dementia living in a long-term care home. We will document their use of and problems with services, social networks and support mechanisms. A participatory intervention in one group will begin with older adults identifying challenges in living conditions, using fuzzy cognitive mapping or art-based techniques. With a focus on collaborative solutions, the intervention will collate evidence, discuss solutions, and share results for local actions. Visual/arts-based methods will clarify the participant needs, levelling the playing field for those with hearing and visual disabilities.
In before-after and time-matched comparisons, we will compare intervention participants with older adults in the control group receiving the usual care for their situation. We will measure deterioration using standard neuro-psychology tools, in addition to ecologically valid real-world assessments. We will establish the feasibility of measuring reduced risk of dementia, while improving wellbeing, social engagement, healthcare, and adherence to existing therapies. Economic analysis will focus on intervention cost, quality of life and sustainability. Indicative statistical analysis will assess variances and potential confounders to inform design of a larger multi-centre study of the impact of authentic participation in preventing dementia.
Research Settings: Botswana and Montreal.
Dates: 2024 to 2027
Funding: Institutes of Health Research (CIHR): Appl. # 507532 Total: $888,165 (Canadian dollar)
Principal investigator: Neil Andersson, Anne Cockcroft, Machelle Wilchesky