Associate Professor Yvonne Lu Seeks to Promote Engaging and Meaningful Activity Among Patients with Mild Cognitive Impairments

By Rachel Leshinsky

September is “Healthy Aging Month” and Indiana University School of Nursing has a number of research scientists working to combat and alleviate issues that affect the elderly.

Associate Professor Yvonne Lu, PhD, RN, concentrates her research on improving care for older adults with cognitive impairments and their family caregivers.

“I focus on helping patients maintain a healthy lifestyle,” said Lu. “Nearly one in four people experience memory change and memory loss is underdiagnosed – medication doesn’t always fix the problem.”

Her current project examines an intervention for patients with mild cognitive impairments (MCI), defined by the Mayo Clinic as “an intermediate stage between the expected cognitive decline of normal aging and the more-serious decline of dementia.” Lu says that early intervention can enhance their ability to manage or live with the symptoms of memory loss which include feeling frustrated, forgetting important events, losing train of thought, feeling overwhelmed when making decisions, getting lost in familiar environments and becoming increasingly impulsive.

Lu’s approach is more holistic than other treatments because she doesn’t prescribe medication or physical exercise. Instead, she uses a family-centered and strengths-based intervention she developed called Promoting Engagement in Meaningful Activity (PRIMA). Patients and caregivers are empowered to use active listening and problem-solving approaches to increase their agreement in perceptions of functional ability of persons with MCI, and enhance engagement in and satisfaction with self-identified meaningful activities. This will help patients and caregivers assess, prioritize, and achieve agreed-upon meaningful activity goals while creating a long-term plan with their physicians that promotes their strengths and identifies what is valuable to the patient. This gives patients and caregivers the sense of confidence, which in turn makes them feel responsible, attentive, and aware of their care plan, treatment, and health.

While each patient is different, Lu offered some tips that every adult aged 60 and older could employ to help curb MCI. Her suggestions include:

  • Promote engagement
  • Self-identify meaningful activity
  • Maintain a healthy lifestyle through maintain good sleeping habits, eating healthy meals and staying active

WebMD recommends additional practices for healthy aging such as staying social, eating high-fiber foods, taking a brisk walk and practicing yoga or tai chi.

“Some patients don’t want to meet friends for meals or participate in other social activities because they are embarrassed that they have forgotten people’s names or how to perform tasks,” Lu said. “PRIMA is a tailored approach to promoting engagement because it alleviates the psychological ailments that are associated with memory loss.”

Lu has tested a small randomized sample using PRIMA and says she has had promising results.

“From our small-scale research, I found that PRIMA improves depressive symptoms, quality of life, and functional performance, while increasing a sense of confidence and helping patients and caregivers communicate better,” she said.

Lu is preparing to recruit 200 participants for an R01 study that will demonstrate the clinical intervention on a larger scale. She hopes her findings are significant because adults with MCI are at a greater risk of developing dementia. The disorder affects 47 million people worldwide and there are 9.9 million new cases every year, according to the World Health Organization. That means that an estimated 5 per 100 people age 60 and older are coping with disease.