Meta-cognitive intervention shows promising functional and cognitive engagement in older adults with subjective or mild cognitive decline

A randomized controlled trial published in the Journal of Prevention of Alzheimer’s Disease (2024) evaluated the effectiveness of the ASPIRE (Adult Strategies Put Into Real-world Environments) program—a 10-week meta-cognitive group intervention designed to help older adults with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) maintain independence in everyday life.

The double-blind study enrolled 264 community-dwelling adults (mean age 70.8 years) in the Toronto region, randomized to ASPIRE or a Brain Education active control arm. Participants attended group and individual sessions focused on improving daily performance in personally meaningful tasks. The primary outcome was improvement in untrained daily activities, measured by the Canadian Occupational Performance Measure (COPM), with secondary measures including mood, subjective cognition, self-efficacy, and quality of life.

After the intervention, 32.5% of ASPIRE participants and 30.6% of controls showed clinically significant improvement in untrained activities (≥2-point COPM increase). Satisfaction with performance improved in about half of the participants in both arms, and these gains were maintained at six months. Both interventions improved subjective cognition, executive self-efficacy, and perceived health, with ASPIRE participants also showing meaningful engagement in self-selected functional goals.

While ASPIRE was not superior to the control condition for untrained tasks, it proved safe, feasible, and beneficial for motivation and perceived control over daily functioning—key factors in preventing cognitive and functional decline. The authors suggest that combining metacognitive training with social learning and ongoing support could enhance and sustain benefits over time.

These findings emphasize the importance of early, behavior-based cognitive interventions that target not only memory but also daily life adaptation and emotional well-being, supporting a proactive model of aging and dementia prevention.

#CognitiveHealth #AgingResearch #Neurorehabilitation #Metacognition #AlzheimersPrevention

Editorial Note

This text was prepared with the support of artificial intelligence and critically reviewed by a qualified professional to ensure scientific accuracy and reliability.