Home-based, caregiver-assisted multimodal exercise and cognitive training via videoconferencing for older adults with mild dementia: A mixed-methods pilot study

Background Evidence on the effects of caregiver-assisted combined exercise and cognitive interventions for persons with dementia (PwD) is inconsistent. Objective This study aimed to evaluate the feasibility and preliminary effects of a home-based Caregiver-Assisted Multimodal Exercise and Cognitive Training (CA-MECT) intervention via videoconferencing for persons with mild dementia in comparison with exercise or cognitive training alone and the control condition. Methods Thirty-three participants were randomized into a combined intervention, exercise, cognitive training, or control group. The combined intervention was a 12-week caregiver-assisted home-based sequentially combined multimodal exercise and cognitive training via videoconferencing. The exercise and cognitive training groups received a 12-week home-based Caregiver-Assisted Multimodal Exercise (CA-ME) and Caregiver-Assisted Cognitive Training (CA-CT), respectively, while the control group received health education. Validated instruments were used to evaluate cognitive, psychological, functional, and health-related quality of life (HRQoL) outcomes. Results CA-MECT was feasible, safe, and highly acceptable for PwD and their caregivers. Exploratory analyses suggested that compared with the control group, the CA-MECT participants showed potential improvements in global cognition, immediate recall, attention, number and severity of neuropsychiatric symptoms (NPS), and caregivers’ distress, though no clear benefits were observed in functional ability or HRQoL. When compared with single-component interventions, CA-MECT appeared to yield more favorable outcomes for immediate recall (versus CA-CT) and NPS severity (versus CA-ME), whereas its effects on processing speed were less favorable than both comparators. Conclusions CA-MECT is feasible and shows promise in improving cognition and NPS among PwD. Future studies are warranted to fully explore its efficacy and sustainability.