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Implementing Cognition-Oriented Treatments for Older People with MCI in Australian Memory Clinics

Alex Bahar-Fuchs, Deakin University, Melbourne, Australia
Kerryn Pike, Griffiths University, Gold Coast, Australia
Loren Mowszowski, University of Sydney, Sydney, Australia
Alessandra Lee, University of Sydney, Sydney, Australia
Adam Bentzelven, University of New South Wales, Sydney, Australia
Inga Mehrani, University of New South Wales, Sydney, Australia
Isabelle Frisken, University of Sydney, Sydney, Australia
Alison Hutchnison, Deakin University, Melbourne, Australia
Sharon Naismith, University of Sydney, Sydney, Australia



Objective:

There is good evidence that cognition-oriented treatments (COTs) including cognitive training and rehabilitation benefit older adults, including those with mild cognitive impairment or dementia. Despite this, there remains a research-to-practice gap where these interventions are not readily available in clinical practice. This paper will describe and present preliminary findings from an ongoing pilot/feasibility implementation study of COT delivery for people with MCI in the Australian Memory Clinic Network.

Participants and Methods:

The Australian Dementia Network (ADNeT) Working Group on Cognitive Interventions is tasked with bridging the evidence-practice gap in Australian Memory Clinics. We have conducted a scoping review of COT implementation efforts around the world, a multi stakeholder survey to understand needs in gaps, have developed and delivered a clinician-training toolkit to assist clinicians in choosing and implementing interventions, and commenced an implementation study in 2023 using the RE-AIM Implementation Framework (Glasgow et al. 2019; www.re-aim.org), assessing Reach, Efficacy, Adoption, Implementation, and Maintenance of COTs in six participating clinics throughout Australia. Outcomes were measured at baseline, at the end of a six-month active study phase, and at 12-months.

Results:

Our scoping review (Pike et al., Submitted) identified 29 eligible studies but only four have used formal implementation frameworks. Cognitive stimulation was the most frequent approach in these studies, and only a small proportion investigated cost-effectiveness and maintenance parameters. Findings from our stakeholder survey confirmed that clinicians believe it is very important to offer interventions as part of routine clinical practice, and that more training was required. Clinician participants in the implementation study are neuropsychologists (n=18) from six memory services from across Australia. Clinician participants were required to complete the Clinician Training Toolkit, which included a six-module eCourse and a full day in-person workshop. Feedback was received from 9 clinicians, of which 8 reported they were either ‘very satisfied” (n=6) or “slightly satisfied” (n=2) with both the content, and delivery of the toolkit. The remaining participant rated their satisfaction as ‘neutral’. Progress of the implementation study to date, including identified barriers and enablers will be described.

Conclusions:

This is the first study in Australia to address the evidence-practice gap in COT research and will inform the development of a larger implementation study to continue building the evidence base for the costs and benefits associated with incorporating these evidence-based approaches in clinical practice.

Category: Cognitive Intervention/Rehabilitation

Keyword 1: cognitive rehabilitation
Keyword 2: memory training
Keyword 3: dementia - Alzheimer's disease