Effects Of A Behavior Oriented Health Education Program On The Management Of Cognitive Dysfunction In Older Adults With Mild Cognitive Impairment

Research Background:Recent studies have confirmed that the management of cognitive dysfunction produces considerable positive effects in individuals with mild cognitive impairment(MCI),However,compliance with participation in various cognitive dysfunction management strategies remains scant in older adults with MCI.Health education programs can improve the level of knowledge of the disease effectively,though it remains unclear as to whether health education programs are sufficient to promote behavior changes of older adults with MCI in the community.Research Purpose:First,the Trans-theoretical Model(TTM)was used as a theoretical framework to construct a health education program.And then,the study aims to provide insight into the effect of a TTM-based health education program on knowledge about MCI,behavior stage,compliance in cognitive dysfunction management,and cognitive function(general cognitive function,psychomotor speed)and other cognition-related health outcomes(depression symptoms,sleep quality)for older adults with MCI.Research Methods:This study is a randomized clinical trial.From March 2019 to August 2020,the older adults with MCI in the Huzhou community of Zhejiang province were randomly selected as participants.We recruit 100 participants with MCI who was randomly assigned to a TTM-based health education group and a standard health education group in a ratio of 1:1.The intervention group was receive a TTM-based health education program(1 session/week,45-60 min/session for 8weeks),while the control group was receive standard health education(1 session/2-week,45-60min/session for 8 weeks).Respectively in three-time points of at baseline(T0),post-intervention(T1),and a 3-month follow-up(T2)to evaluate all participants with MCI by using the MCI knowledge questionnaire,behavior stage questionnaire,the cognitive dysfunction management compliance Scale,the Chinese version of the Montreal Cognitive Assessment Basic(Mo CA-B),reaction time,Purdue Pegboard Test(PPT),the Chinese version of the 15-item Geriatric Depression Scale(GDS-15),The Pittsburgh Sleep Quality Index(PSQI).Statistical analyses will consist of the Wilcoxon test,the t-test,the Chi-square test,and 2(group)× 3(time)ANOVA with a 5% cut-off for significance.Research Results:In this study,a total of 100 participants with MCI were included.5 participants dropped out in the middle of the study,a total of 95 participants completed health education,including 47 in the intervention group and 48 in the control group,the retention rate in the intervention group was94%.1.Baseline survey: The MCI knowledge questionnaire score was 11.24±3.36.The total of the cognitive dysfunction management compliance scale was 112.37±11.93.Mo CA-B score was19.73±1.63.2.Level of knowledge of MCl: There were significant differences in the knowledge of MCI between the two groups in terms of group-time interaction effect(P<0.05).Simple effect analysis showed that compared with the control group,the knowledge of MCI in the intervention group was significantly increased at T1 and T2(P<0.05).3.Behavior stage: Post intervention,the participants in the intervention group were transferred form pre-contemplation stage,contemplation stage to preparation stage,action stage and maintenance stage,with 4 cases,12 cases and 3 cases,respectively.A total of 32 participants developed into the action stage and maintenance at the 3-month follow up.At T1 and T2,the differences between the two group were statistically significant(P < 0.05).Further analysis showed that there were differences between the two groups in the contemplation stage and action stage(P<0.05).4.Level of compliance of participation in cognitive dysfunction management: There were significant differences in the compliance of participation in cognitive dysfunction management,susceptibility,severity,benefits,barriers and self-efficacy between the two groups in terms of group-time interaction effect(P<0.05).At T1,the simple effect analysis of inter-group factors on the total score of compliance,susceptibility,benefits and barriers was statistically significant(P<0.05).At T2,the simple effect analysis of inter-group factors on the total score of compliance except barrier and the influence of all dimensions had statistically significance(P<0.05).5.Cognitive function: There were significant differences in the score of Mo CA-B between the two groups in terms of group-time interaction effect(P<0.05).Simple effect analysis showed that compared with the control group,the score of Mo CA-B in the intervention group was significantly increased at T1 and T2(P<0.05).Psychomotor speed: There were significant differences in the reaction time,PPTR,PPTL,PPTB and PPTA between the two groups in terms of group-time interaction effect(P<0.05).Simple effect analysis showed that compared with the control group,the score of reaction time in the intervention group was significantly decreased at T2(P<0.05),the score of PPTR,PPTL,PPTB and PPTA in the intervention group was significantly increased at T2(P<0.05).6.Other cognition-related health outcomes: Depression symptoms was only time factor(P<0.05)in depression symptoms scores,and no inter-group factor or interaction.Sleep quality were significant differences in the score of PSQI between the two groups in terms of group-time interaction effect(P<0.05).Simple effect analysis showed that compared with the control group,the score of PSQI in the intervention group was significantly decreased at T2(P<0.05).Research Conclusion:This study verified the effectiveness of TTM-based health education,that is,it can promote the level of knowledge of MCl,individual behavior change,improve the level of compliance of participation in cognitive dysfunction management and,as well as improve cognitive function and sleep quality.In addition,this study program is harmless,easy to implement,and feasible in the community.It has a certain practical and promotional significance.