HEPPI: a randomized controlled trial of the efficacy of a cognitive-emotional intervention for homebound older adults

Abstract

Objectives

This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms.

Methods

Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767.

Results

Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention.

Conclusions

This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.

Keywords:

• Homebound older adults
• mild cognitive impairment
• depressive symptoms
• anxiety symptoms
• multi-component intervention
• randomized controlled trial
• linear mixed models

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 bound to the home.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

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

Additional information

Funding

The present study was supported by the Portuguese Foundation for Science and Technology (ID: SFRH/BD/146170/2019).