Cognitive Health Promotion Project in the Community

Phase 1

Completed

Interventions: Behavioral: Lifestyle Counseling Usual Care
Behavioral: Lifestyle Counseling Telephone, Bimonth
Behavioral: Lifestyle Counseling Telephone, Month
Behavioral: Lifestyle Counseling Visit, Bimonth
Behavioral: Lifestyle Counseling Visit, Reward

Brief Summary: This study was based on baseline data derived from a large prospective study called the Suwon Project (SP), a cohort comprising random clustering samples of elderly people, all of whom are ethnic Koreans aged over 60 years.

Detailed Description: There is growing evidence supporting the protective effect of health behaviors against cognitive decline and dementia in older persons. With this increasing evidence and a better understanding of the underlying mechanisms, lifestyle modification is likely to be increasingly promoted as a convincing strategy for maintaining cognitive health in later life.

The study protocol included cognitive screening through the Korean version of the Mini-Mental State Examination (K-MMSE), which has been validated for the Korean-speaking population ({YW, 1997 #88}Kang YW et al., 1997), recording of the subject's medical history. A Korean study in the community defined the cut-off point of K-MMSE score during the screening of dementia as 17/18 points; the sensitivity and specificity of the findings were 91% and 86%, respectively ({YW, 1997 #88}Kim et al., 2003). Based on these results, we defined cognitive impairment (CI) as the group that had a K-MMSE score lower than 17, and not cognitive impairment (NCI) was defined as the group that had a K-MMSE score higher than 18.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

those with a history of significant hearing or visual impairment that rendered participation in the interview difficult
those with a history of neurological disorders (e.g., stroke, Parkinson's disease, or active epilepsy)
those with psychiatric illness (e.g., schizophrenia, mental retardation, severe depression, or mania)
those taking psychotropic medications, or those with significant alcohol and other substance abuse.

Arm && Interventions

Group	Intervention	Description
Lifestyle Counseling Usual Care	Lifestyle Counseling Usual Care	Usual care participants in the group A received no additional services.
Lifestyle Counseling Telephone, Bimonth	Lifestyle Counseling Telephone, Bimonth	Participants in the group B received bimonthly telephonic care management based on manual.
Lifestyle Counseling Telephone, Month	Lifestyle Counseling Telephone, Month	Participants in the group C received monthly the same telephonic care management and educational materials as those in the group B.
Lifestyle Counseling Visit, Bimonth	Lifestyle Counseling Visit, Bimonth	Participants in the group D received health educator-initiated visit counseling bimonthly.
Lifestyle Counseling Visit, Reward	Lifestyle Counseling Visit, Reward	Participants in the group E received health educator-initiated visit counseling bimonthly and reward.

Primary Outcome Measures

Name	Time	Method
Change of Cognitive Function Measured by a Mini Mental State Examination Scores on a Scale According to Study Group	baseline and 18 months	The mini-mental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It ranges from 0 to 30 points. The higher scores mean better outcome. It is also used to estimate the severity of cognitive impairment at a given point in time and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document an individual's response to treatment. In the time span of about 10 minutes it samples various functions including arithmetic, memory and orientation.

Secondary Outcome Measures