Offering the Right Treatment to the Right Patient with MCI
This week’s blog comes to us from Lise De Wit, MS, a graduate student at the University of Florida (UF) who has worked with the HABIT team to help analyze the results of one of our recent research trials funded by the Patient-Centered Outcomes Research Institute (PCORI). This project was led by Dr. Glenn Smith, Emeritus Professor of Mayo Clinic, who is now the Elizabeth Faulk Professor and Chair at the Department of Clinical and Health Psychology of the University of Florida. We’ve previously reported on comparative effectiveness outcomes and patient preferences for treatments in MCI from this project. Dr. Smith was also one of the original developers of the HABIT Healthy Action to Benefit Independence & Thinking® program and continues to actively collaborate on HABIT research projects with the Mayo HABIT Team.
Memory compensation training
For this project, we explored what factors impact who benefits from the calendar system taught in HABIT, otherwise known as the Memory Support System (MSS). The MSS is a compensatory rehabilitation system that was developed by the HABIT team to help individuals with Mild Cognitive Impairment (MCI) compensate for their memory loss. (Questions about MCI? Click here to find out more.) Briefly, during MSS training, individuals are taught to use a calendar/notebook system for compensatory written reminders. These reminders are things like important appointments, tasks, or experiences/thoughts. The training focuses on the consistent use of this system multiple times per day. Earlier research has shown that this system improves individuals’ ability to complete daily activities and improves self-efficacy. (See what former patients are saying about the MSS calendar here, here or here!)
Who is most likely to benefit?
There is a current trend in health care that focuses on offering treatments to those who are most likely to benefit from them. This strategy also gives researchers the opportunity to develop alternative treatments for those individuals who are unlikely to benefit. So, who learns and uses the MSS calendar the best? We found that individuals with MCI that had less severe cognitive impairment were more likely to have learned the use of the MSS calendar by the end of the two-week training. This is important because those individuals who learned the use of the calendar by the end of the two week training were more likely to continue to use this system 6, 12, and 18 months post-training.
Overall, our results suggest that offering MSS calendar training as early as possible for those with MCI, when cognitive impairment is mild, might be of most benefit, and might have implications for ability to benefit from the calendar long-term. These results reinforce the notion that it is important for clinicians and researchers to find methods to detect and treat MCI as early as possible to prevent or delay progression to dementia.
A big thanks
The data generated from the PCORI trial has provided a wealth of information for research projects for several graduate students at UF. My graduate student colleagues and I would like to thank Drs. Melanie Chandler, Dona Locke, and Julie Fields of the Mayo Clinic’s HABIT Team and our mentor Dr. Glenn Smith for allowing us to work with them as part of our doctorate research. We wish to acknowledge all the sites who participated in the trial, including Mayo Clinic Arizona, Florida, and Minnesota, and the University of Washington. Importantly, we also wish to express our gratitude to the patients and partners who were a part of this study: your participation helps us to better our treatments, and this type of research would not be possible without you.
If you wish to read the full academic paper, you can find that here.
De Wit, L., Chandler, M., Amofa, P., DeFeis, B., Mejia, A., O’Shea, D., Locke, D.E., Fields, J.A. and Smith, G.E., (2019). Memory Support System training in mild cognitive impairment: Predictors of learning and adherence. Neuropsychological rehabilitation, 1-13.