Kritika Sharma, Aditi Dubey, Shubham Gupta, Kajal Fulara, Hina Narzari, Nilima Nilima, Sneha, Kamini, Sakshi Sharma, Varuna Sharma, Shikha Chaudhary, Phaniraj Vastrad, N. Priya Darshanraj, Sandip Bhattacharjee, Pradyut Datta, Gajraj Singh Shekhawat, Arnav Verma, V. Harshath Ajay, Jajur Rajappa Sandesh, Ambika Y. V., Bishakha Sen, Shalina Jamatia, Priyanka Kumari Meena, Hitesh Tiwari, Shaily Bhushan, Sagar P. M., Ripanjit Singh, Manish Acharjee, Vikram Raigar, Kalpna Sharma, Aishwarya Bhovi, Mailarappa Padiyappa Hooli, Shilpa K., Naveen M.R., Dipankar Deb, Pameli Jamatia, Pooja Sharma, Akhilesh Nagar, Tinku Yogi, Rishav Bhatia, Rishabh Gautam, Maroof Khan, Vaibhav Patil, Rajeev Aggarwal, Ashima Nehra, Kanika Vasudeva, Nimin Hafeez, Chanchal Goyal, Subarna Roy, Manish Barvaliya, Subrata Baidya, Shampa Das, P. K. Anand, Sunil K. Raina, Meenakshi Sharma, R. S. Dhaliwal, Abhik Sinha, Anu Gupta, Venugopalan Y. Vishnu, M. V. Padma Srivastava
SMRUTHI-India (Strategic Multimodal Intervention in at-risk Elderly Indians for Prevention of Dementia), was initiated across rural India to establish a cohort of at-risk elderly for primary dementia prevention. Dementia prevalence being 7.4% and higher rates in rural areas, culturally tailored psychoeducational materials are essential. The current study thus aimed to construct and validate a multimodal intervention in elderly. A multimodal intervention “Care Bundle Module (CBM)” booklet was developed, followed by content validation. It was pilot tested for feasibility and preliminary intervention effects in hospital setting (central site) using cohort multiple randomised controlled trial (cmRCT) design. Using purposive sampling, some high-risk participants were also selected from periphery sites and intervention was conducted using pre-post design to assess feasibility, usability, and acceptability in community setting. Change in Lifestyle for Brain health (LIBRA) index was assessed. Simultaneously, a booklet containing ten themes was developed into thematic animated videos, and revised based on behavioural science expert feedback. CBM was assessed for understandability and actionability using Patient Education Material Assessment ToolPrint/Audio-Visual (PEMAT-P/AV). Intervention was developed in three languages (Hindi, Kannada, Bengali). In hospital setting and across periphery sites respectively, median (IQR) age was 61 (57, 66) years, mean age: 64.9 ± 5.8 years; median LIBRA: −4.6 (p = 0.02) and −1.0 (p = 0.001) (intervention arms). Rural setting showed higher recruitment and retention rates with good adherence. Between 70 to 96%, participants rated booklet and videos as well understandable and actionable on PEMAT. CBM demonstrated high content validity, acceptability, and adherence across rural settings. This suggests feasibility to conduct multidomain interventions for at-risk elderly to foster healthy ageing. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=ODYxODY=&Enc=&userName=, Identifier CTRI/2024/01/061172.
Kira S. Birditt, Yee To Ng, Lizbeth Benson, Allison Doroshewitz, Angela Turkelson, Noelle E. Carlozzi, Sung Won Choi
Dementia caregivers often report poor mental health, which has implications for the quality of care, as well as care recipient well-being. Thus, it is imperative to identify modifiable factors that influence caregiver mental health and can be targeted through personalized interventions. The purpose of the present study was to examine the feasibility and acceptability of the Roadmap mHealth app, a positive activity intervention for dementia caregivers, and preliminary associations with caregiver mental health. A total of 20 dementia caregivers participated in a 14-day study, during which they received prompts to engage in Roadmap positive activities twice a day and complete nightly mobile surveys regarding their own and their care recipient’s mental health. Both caregivers and their recipients were asked to wear Fitbit® devices. Caregivers completed a feasibility and acceptability survey at the end of the study. Data were analyzed using descriptive statistics and 2-level multilevel linear models with days nested in participants. The app showed high feasibility, with caregivers engaging in Roadmap positive activities on 87% of the days and completing 95% of nightly surveys. All caregivers and 75% of their recipients wore Fitbits®. The Fitbit® and nightly surveys were acceptable (above 80% agreement), but there were some aspects of the app that may warrant improvement (72–78% agreement). Same-day positive activities were associated with lower caregiver depression, lower appraisals of caregiving as stressful, and higher caregiver positive mood. Overall, the Roadmap app is feasible and shows promising associations with caregiver mental health, but some improvements are needed to improve acceptability. A larger, fully powered randomized controlled trial is needed to evaluate whether the Roadmap app improves caregiver mental health.
Dementia prevention requires policies that address upstream, modifiable risk factors—particularly loneliness, depressed mood, and low social participation—which disproportionately affect linguistically diverse and historically marginalized communities. This Perspective argues that linguistic inclusion, cultural responsiveness, and trust-building practices should be treated as core quality domains in dementia prevention policy and delivery. We describe the Multimodal Intergenerational Social Contact Intervention (MISCI), a community-embedded program designed to reduce loneliness and depressed mood—established risk factors for dementia—through culturally meaningful intergenerational engagement. While MISCI outcomes are limited to feasibility, acceptability, and descriptive trends, we integrate these findings with existing literature to derive policy and systems recommendations. These include reimbursement pathways for social connection interventions, strengthened language access standards, equity-stratified reporting, and cross-sector partnerships. Aligning policy mechanisms with community-embedded programs may support scalable, culturally responsive approaches to reducing dementia risk while advancing health equity.
Ann Kristin Bjørnnes, Ellen-Karine Grov, Eva Elisabeth Hessevaagbakke, Katrin Lindeflaten, Christine Tschudi-Madsen, Malin Holmström-Rising, Christine Tørris, Johannes Hovland, Daniela Lillekroken
This study examined family caregivers’ experiences of dementia village care and explored their associations with caregiver reactions and residents’ thriving. The study utilized an explanatory sequential mixed-methods design. Thirty family caregivers completed questionnaires assessing caregiver reactions, health-related quality of life, and resident thriving. Subsequently, 16 of these caregivers participated in semi-structured interviews. Quantitative data were analysed using descriptive statistics and correlation analyses, while qualitative data were analysed using thematic analysis. Family caregivers reported high levels of caregiver esteem and low levels of burden, and residents were perceived as thriving, particularly through positive relationships with staff and high-quality care. Although admission was emotionally challenging, caregivers experienced relief, reassurance, and increased trust. Resident wellbeing was linked to meaningful activities, social engagement, supportive staff, and outdoor access. However, caregivers also reported challenges regarding communication, involvement in care decisions, and balancing resident autonomy with safety. Overall, caregiver experiences reflected an adaptive process marked by both trust and uncertainty. The findings indicate that dementia villages promote resident thriving through supportive environments, social relationships, and meaningful engagement. Family caregivers viewed the model positively and maintained active involvement post-admission, suggesting that dementia villages foster more sustainable care by bridging professional support with ongoing family partnership.
