Finding Meaning in Aging (FMA) improves Brain Health: Path Analysis of a Realist Controlled Trial

Research Objectives To evaluate a place-based model for brain health, and investigate the effects and mechanisms of a multicomponent realist intervention. Design Realist controlled trial offered participants three programs, namely horticulture, mindfulness, and dance group therapy, to address Cohesion, At-homeness, and Playfulness (CAP) respectively over eight weeks. Setting Study was conducted in community settings in partnership with community organizations. Mindfulness and dance programs were conducted online, whereas the horticulture program was conducted in-person at a park. Participants Participants were healthy adults aged 50 to 94 who were able to provide consent. A total of 39 persons attended one or more program(s) of their choosing. Specific programs were recommended to some participants based on their CAP personalities. Control group comprised 39 persons who did not attend any of the programs offered. Interventions FMA Mindfulness Therapy involved reading and discussing the psychological challenges of aging in a non-judgmental group setting, including topics such as suffering, growth, choice, and change. Dance Movement Therapy involved individual-led movements, seated exercises with resistance bands, and group choreography of a collective portrait. Horticulture Therapy involved planting, harvesting, and learning about various plants from food security and Indigenous perspectives. Main Outcome Measures Depressive symptoms were measured using Patient Health Questionnaire (PHQ-2). Loneliness was measured using UCLA Loneliness Scale (ULS-3). Self-rated memory was measured using an item with five options ranging from poor to excellent. Animal Fluency Test (AFT) and Rey's Auditory Verbal Learning Test (RAVLT) assessed semantic fluency and delayed recall. Test scores were adjusted for age, sex, education, and income if significantly correlated. A global Brain Health (BH) index was created. Results Total attendance (r=.196, p=.070) improved BH at time=2 through increased Playfulness at time=1 (r=.284, p=.002), controlling for mental health at time=0. Full mediation was found. Mindfulness (r=.215, p=.046) improved BH through increased sense of At-homeness (r=.227, p=.025). Horticulture (r=.192, p=.078) improved BH through Playfulness (r=.278, p=.003). Conclusions CAP is a promising model for prevention. Author(s) Disclosures Nothing to disclose. To evaluate a place-based model for brain health, and investigate the effects and mechanisms of a multicomponent realist intervention. Realist controlled trial offered participants three programs, namely horticulture, mindfulness, and dance group therapy, to address Cohesion, At-homeness, and Playfulness (CAP) respectively over eight weeks. Study was conducted in community settings in partnership with community organizations. Mindfulness and dance programs were conducted online, whereas the horticulture program was conducted in-person at a park. Participants were healthy adults aged 50 to 94 who were able to provide consent. A total of 39 persons attended one or more program(s) of their choosing. Specific programs were recommended to some participants based on their CAP personalities. Control group comprised 39 persons who did not attend any of the programs offered. FMA Mindfulness Therapy involved reading and discussing the psychological challenges of aging in a non-judgmental group setting, including topics such as suffering, growth, choice, and change. Dance Movement Therapy involved individual-led movements, seated exercises with resistance bands, and group choreography of a collective portrait. Horticulture Therapy involved planting, harvesting, and learning about various plants from food security and Indigenous perspectives. Depressive symptoms were measured using Patient Health Questionnaire (PHQ-2). Loneliness was measured using UCLA Loneliness Scale (ULS-3). Self-rated memory was measured using an item with five options ranging from poor to excellent. Animal Fluency Test (AFT) and Rey's Auditory Verbal Learning Test (RAVLT) assessed semantic fluency and delayed recall. Test scores were adjusted for age, sex, education, and income if significantly correlated. A global Brain Health (BH) index was created. Total attendance (r=.196, p=.070) improved BH at time=2 through increased Playfulness at time=1 (r=.284, p=.002), controlling for mental health at time=0. Full mediation was found. Mindfulness (r=.215, p=.046) improved BH through increased sense of At-homeness (r=.227, p=.025). Horticulture (r=.192, p=.078) improved BH through Playfulness (r=.278, p=.003). CAP is a promising model for prevention.