Feasibility of a Remote Multidomain Lifestyle Intervention for Older Adults With Mild Cognitive Impairment
Tej Shah, MPH1, Manju Ramakrishnan, MPH, MBBS2, Aiden Bergey, Yuyao Zhang, MPH1, Ambar Kulshreshtha, MD, PhD2
1. Rollins School of Public Health, Emory University, 2. Department of Family and Preventive Medicine, Emory University School of Medicine
Background
oMild cognitive impairment (MCI) is an intermediate stage to dementia.
oLifestyle factors such as exercise, diet, and sleep are modifiable targets linked to cognitive health.
oMultidomain Interventions are promising, but few remote programs have focused on adults already diagnosed with MCI.
oPRISEM was designed to test the feasibility and acceptability of a remote lifestyle intervention for this population.
Data and Methods
oSingle-arm pilot and feasibility study of a 6-month remote lifestyle intervention for adults with MCI
oPRISEM included 17 group-based Zoom sessions focused on diet, physical activity, and stress management
oFeasibility outcomes included retention, attendance, and acceptability
oBaseline and 6-month assessments captured cognitive, behavioral, and psychosocial outcomes
oPre–post changes were analyzed using paired parametric or nonparametric tests with effect sizes
Results
o45 participants enrolled; 24 retained
oMean attendance was 70.5%, >90% in later sessions
oAcceptability - 4.60–4.71/5 for feedback items
oSignificant improvements were observed in:
-Physical activity (p = 0.038)
-Dietary quality (p = 0.017)
-Perceived stress (p = 0.015)
oCognitive and other psychosocial outcomes showed small, non-significant changes
Conclusions
oPRISEM recruited and retained adults with diagnosed MCI, including 29% African American participants, supporting the feasibility of remote lifestyle interventions in a diverse, clinically important population.
oPRISEM produced promising preliminary signals in physical activity, diet, and perceived stress
oRemote delivery may support more inclusive and scalable intervention models for MCI
Limitations
oSingle-arm pilot study without a control group
oSmall sample size and moderate retention
oHigh educational attainment may limit generalizability
Future Directions
oConduct a randomized controlled trial with a larger sample size.
oStrengthen early retention and onboarding support
oExplore tailoring the intervention based on baseline stress, activation, or psychosocial burden
oLarger controlled studies with longer follow-up are needed to evaluate cognitive and psychosocial effects.
