Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial

ABSTRACT

Objectives

To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology.

Methods

Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index).

Results

The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed.

Conclusions

Results provide evidence of the HEPPI’s feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology.

Clinical Implications

Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.

KEYWORDS:

• Homebound older adults
• mild cognitive impairment
• depressive and anxious symptomatology
• cognitive-emotional intervention program
• pilot randomized controlled trial

Clinical implications

• Non-pharmacological multi-component interventions targeting the cognitive and emotional needs of homebound older adults could help enhance their mental health, reducing cognitive decline and depressive or anxious symptomatology.

• Home-delivered cognitive-emotional interventions may improve the homebound older population’s access to mental healthcare resources, helping it overcome restrictions to leave home.

 Data Availability Statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Ethical principles

This study was conducted in accordance with the Declaration of Helsinki and was reviewed and approved by the Ethics and Deontology Committee of Research of the Faculty of Psychology and Educational Sciences, University of Coimbra.

Acknowledgments

The authors are grateful to the study participants and appreciate the collaboration of formal and informal caregivers who give their best every day to support and take care of highly vulnerable older people.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Role of the Funders/Sponsors

The principal investigator designed and executed the study, performed the literature review, conducted the statistical analysis, and wrote the manuscript. The co-investigators assisted in the design and execution of the study, statistical analysis, and manuscript writing. All authors read and approved the final manuscript before submission. The funding entity had no role in the design, implementation, and analysis of the study or approval and decision to publish the manuscript.

Additional information

Funding

This study was supported by Foundation for Science and Technology under Grant SFRH/BD/146170/2019.