Effects of a case management intervention with cognitive stimulation in older people with cognitive impairment and high risk of falling: a randomized clinical trial

• Grant number: 24/23097-4
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: July 01, 2025
• End date: June 30, 2028
• Field of knowledge: Interdisciplinary Subjects
• Principal Investigator: Juliana Hotta Ansai
• Grantee: Daiene de Morais
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Two main health problems affecting elderly people are cognitive impairment and falls. The simultaneous occurrence of these variables can significantly impact the mental health and quality of life of elderly people, with cognitive impairment being an important risk factor for the occurrence of falls. Although previous protocols work on fall prevention, none have associated case management with cognitive stimulation, including the domain of social cognition, in elderly people with cognitive impairment and high risk of falls. This project aims to evaluate the effects on the incidence of falls and on neuropsychological functions, including the domain of social cognition, of elderly people with high risk of falls and cognitive impairment through a case management intervention, through a randomized, single-blind, controlled clinical study. The sample will consist of an Intervention Group (IG) and a Control Group (CG) (n=100). The IG will participate in a case management intervention with cognitive stimulation, including social cognition training. Case management, carried out remotely, will involve multidimensional assessment, explanation of fall risk factors, implementation of an intervention proposal based on the identified risks, elaboration of an individualized fall intervention plan, monitoring and review of the plan over 16 weeks. The CG, as well as the IG, will participate in a physical exercise program focused on fall prevention. All volunteers will be evaluated initially, after 16 weeks, after 6-month and 12-month follow-ups. The evaluation will consist of clinical and sociodemographic data, cognitive and neuropsychological measures, fNIRS and falls. For data analysis, a significance level of p¿0.05 will be adopted. All ethical aspects will be respected. Pilot applications of the procedure and instruments that are intended to be used will be carried out. It is expected that the intervention protocol can become a permanent program to be used by institutions focused on the care of the elderly. (AU)