A combined community-based cognitive behavioral therapy (CBT) and exercise intervention aimed at preventing disability among older minority and immigrant adults improved mood and physical functioning and demonstrated acceptability, according to a study published in the American Journal of Geriatric Psychiatry.
The Positive Minds-Strong Bodies randomized controlled trial evaluated concurrent mental and physical health through 10 individual CBT sessions and 36 group exercise training sessions over the course of 6 months. Community health workers administered sessions focused on psychoeducation, mindfulness, cognitive restructuring, and self-care planning. Exercise trainers administered approximately 3 sessions per week, including a series of 10 functional exercises with 3 sets of 10 repetitions for 12 to 14 weeks.
Participants aged 60 years and older were randomly assigned to receive the intervention (n=153) or enhanced usual care (n=154), defined as biweekly calls from research staff measuring patient health, generalized anxiety, and geriatric depression. Staff also offered support if the participant expressed concern, as well as a National Institutes of Health booklet about caring for one’s mental and physical health.
Of the participants, 69.5% identified as immigrants and 66.1% spoke a primary language other than English. At baseline, approximately 57.5% of participants rated their physical health as poor or fair, 87.3% reported chronic conditions, and 66.7% had intermediate to minimal physical impairment.
At 6 months, intent-to-treat analyses revealed improved functioning on the Short Physical Performance Battery (t[1775.7]=2.1; P =.03) and the Late Life Function and Disability Instrument (t[663.5]=2.4; P =.02), as well as reduced psychosocial distress, per the Hopkins Symptom Checklist (t[817.3]=−3.1; P <.01). At 12 months, effects remained significant for the Late Life Function and Disability Instrument and Hopkins Symptom Checklist, and disability days significantly decreased. Approximately 77.6% of intervention participants attended more than half of the Positive Minds sessions, 53.4% attended more than half of the Strong Bodies sessions, and 79% of participants rated their sessions as “very satisfied.”
“This trial shows that [Positive Minds-Strong Bodies] is a promising preventive intervention that moves culturally-competent services into the community to meet [patient] needs,” the investigators concluded.
Alegría M, Frontera W, Cruz-Gonzalez M, et al. Effectiveness of a disability preventive intervention for minority and immigrant elders: the Positive Minds-Strong Bodies randomized clinical trial [published online August 13, 2019]. Am J Geriatr Psychiatry. doi:10.1016/j.jagp.2019.08.008