Take Charge was a pilot program for older adults with mild memory problems that used education and psychosocial support to sustain or enhance everyday cognitive skills. The year-long program used a "personal trainer" approach to brain fitness. Volunteers met twice a month with a Take Charge staff member to develop and implement individualized activity care plans to encourage cognitive activity, management of everyday stress, physical exercise, and a healthy diet.
Older adults with Mild Cognitive Impairment (a memory condition that can be a precursor to Alzheimer’s disease) were invited to enroll at WAI-affiliated dementia diagnostic clinics in Beloit, LaCrosse, Madison, and Richland Center, WI. A total of 38 volunteers met all enrollment criteria, and 30 completed the year-long study by the fall of 2008.
There were 22 women and 16 men, ranging in age from 60 to 88 years. All but three were retired, and all had at least a high-school education. Activity levels varied widely at the start of the study, and some participants were already very active at the time they enrolled.
Many participants chose to increase time spent on favorite mental or physical exercises, such as reading, doing word games, walking, or Tai chi. Others committed to new activities such as enrolling in a local gym or taking a foreign language course. One began writing a series of autobiographical stories, another resumed playing the cello after a lapse of many years, and several others took advantage of free concert tickets donated by a local symphony.
Nearly all participants (93%) stated that they would recommend Take Charge to others. Eighty-seven percent reported that they became more mentally active as a result of study participation, and 90% with high baseline stress found the stress reduction training helpful. Two-thirds of the participants reported benefits from the diet and exercise coaching, but only 38% said they increased their physical activity as a result of Take Charge. Participants’ family members reported that the Take Charge volunteers remained stable, on average, in their everyday cognitive function and ability to do complex everyday tasks. This is a good outcome for individuals whose memory losses often worsen over time.
The average number of novel information processing activities that participants engaged in on a daily basis increased from 2.8 to 3.7 activities during the cognitive stimulation portion of the study. The average hours of moderately vigorous physical activity stayed about the same (3.2 to 3.4 hours per day) during the exercise segment. Some participants were already exercising at high levels when they started Take Charge, while others had mobility or health conditions that limited their ability to exercise.
The goal of the Take Charge pilot study was to determine if the individualized activity care plan approach was feasible and acceptable to participants. There was no control condition, so we don’t know if this approach was better than other brain fitness approaches, or even no intervention at all. A controlled test, where Take Charge is compared to usual care, will be an important next step.
If you have questions about the Take Charge study, please contact Asenath La Rue, PhD, at the WAI at firstname.lastname@example.org or 608-829-3308.
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