BACKGROUND

• Apathy is a common and clinically important neuropsychiatric symptom among older adults with and without dementia.
• It is associated with accelerated cognitive decline, functional disability, social withdrawal, and reduced quality of life.
• Access to effective non-pharmacological interventions remains limited in many rural communities.
• Guided by Socioemotional Selectivity Theory (SST), this study evaluated whether a digitally supported reading program could reduce apathy through emotionally meaningful engagement and social connection.

OBJECTIVE

To evaluate the effectiveness of an 8-week digital reading intervention in reducing apathy among rural community-dwelling older adults with and without dementia and explore the mechanisms underlying observed changes.

METHODS

• Single-group, pre–post mixed-methods pilot study
• 28 community-dwelling older adults (≥60 years)
• Conducted across three rural communities in Northern British Columbia, Canada
• Weekly facilitated eBook club sessions with independent reading using Kobo eReaders
• Apathy assessed using the 3-item Geriatric Depression Scale–Apathy Subscale (GDS-3A) before and after the intervention
• Semi-structured interviews explored participants' experiences and mechanisms of change

RESULTS

• Apathy prevalence decreased from 50% (14/28) at baseline to 7% (2/28) post-intervention.
• Mean GDS-3A score decreased from 1.54 ± 1.20 to 0.64 ± 0.75.
• Significant improvement in apathy was observed:
  • Z = –4.01
  • p < 0.001
  • Effect size (r) = 0.76

HOW IT WORKED

Enhanced Emotional Regulation (Positivity Effect)

Emotionally meaningful narratives promoted enjoyment, comfort, and renewed motivation to engage in reading.

Emotionally Meaningful Social Connections

Small-group discussions fostered trust, belonging, and supportive relationships through shared reading experiences.

Adaptive Coping

Accessible eReader technology supported independent reading and sustained engagement despite physical or cognitive limitations.

DISCUSSION

• The intervention demonstrated promising potential as a non-pharmacological strategy for reducing apathy in rural older adults.
• Findings support Socioemotional Selectivity Theory, highlighting the importance of emotionally meaningful activities in later life.
• The combination of meaningful reading, peer interaction, and accessible technology may promote sustained motivation and social engagement.
• These findings provide preliminary evidence supporting digitally enabled reading programs as a community-based approach to healthy aging.

IMPLICATIONS

• Digital reading programs offer a low-cost, scalable, and person-centred approach to addressing apathy.
• Community organizations, libraries, and dementia support programs could integrate structured reading groups into existing services.
• The intervention may complement social prescribing, community dementia care, and aging-in-place initiatives, particularly in rural and underserved communities.
• Larger randomized controlled trials are needed to evaluate long-term effectiveness and implementation at scale.

CONCLUSIONS

• An 8-week digital reading intervention significantly reduced apathy among rural older adults with and without dementia.
• Improvements were supported by enhanced emotional regulation, meaningful social connections, and adaptive coping through accessible digital technology.
• Digital reading programs show promise as a scalable, theory-informed, non-pharmacological intervention to support healthy aging and dementia care in rural communities.

KEY MESSAGE

Digital reading programs may represent a scalable, person-centred, and non-pharmacological strategy for reducing apathy and supporting healthy aging among rural older adults with and without dementia.