Change in Depression, Confidence, and Physical Function Among Older Adults With Mild Cognitive Impairment.

This is a secondary analysis of a small pilot randomized trial, not a primary efficacy study. Only 16 DEMA post-intervention observations were analysed after one DEMA participant died, one progressed to AD, and one withdrew before posttest and follow-up. Several follow-up analyses could not be run because of limited sample size. The intervention combined self-selected meaningful activity, problem-solving therapy, a Self-Management Tool kit, and nurse-delivered family support, so the contribution of any single component cannot be separated. Significant findings were mostly at posttest and did not continue through follow-up. Depression score changes were not statistically significant, and confidence did not predict depression. The sample was mostly male, mostly Caucasian, and most had late-stage MCI with PHQ-9 scores below 5, limiting generalizability. Target activities were self-selected, which may introduce bias and limit generalizability to broader MCI populations.

The parent study was NIH-funded (R21NR013755). The authors declare no conflict of interest.

Do not conclude that the DEMA program reliably reduces depression or that meaningful activity alone caused the gains. Depression score changes were not statistically significant, gains did not persist at follow-up, and DEMA included problem-solving therapy, a Self-Management Tool kit, nurse support, and family-centered goal setting, so one component cannot be isolated.