{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:04:50Z","timestamp":1769162690460,"version":"3.49.0"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pacific Psychiatry"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>There is a scarcity of naturalistic follow\u2010up studies on cognitive stimulating activities (CSAs), particularly in a real\u2010world setting and over long\u2010term. We thus investigated a pooled novel CSA intervention to prevent cognitive decline amongst community\u2010dwelling older adults without dementia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nested within a community\u2010based longitudinal follow\u2010up cohort study of community\u2010dwelling and multi\u2010ethnic older adults (<jats:italic>N<\/jats:italic>\u00a0=\u00a0991), a subset of the cohort (<jats:italic>n<\/jats:italic>\u00a0=\u00a0264) underwent four single\u2010blinded randomized controlled trials involving four novel CSAs, including mindfulness, horticulture, art therapy, and choral singing. At the cohort's 5\u2010year follow\u2010up, we examined if involvements in the CSAs improved cognition, compared to controls (<jats:italic>n<\/jats:italic>\u00a0=\u00a0727). The primary outcomes were changes in global cognition and specific cognitive domain scores measured by the mini\u2010mental state examination (MMSE). Exploratory subgroup analyses stratified by baseline cognitive status and the number of CSAs were also conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to the control group, there was a small improvement in the CSA group on the total MMSE score (<jats:italic>d<\/jats:italic>\u00a0=\u00a00.108) and MMSE\u2010immediate recall score (<jats:italic>d<\/jats:italic>\u00a0=\u00a00.199). Furthermore, subgroup analyses revealed medium effect sizes of improvements (<jats:italic>d<\/jats:italic>\u00a0=\u00a00.420) in cognitive domains in mild cognitive impairment (MCI) (vs. cognitively healthy) and those involved in two CSAs (vs. one CSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In summary, a CSA intervention improved cognition. MCI and those involved in two CSAs gained greater benefits from the CSAs. These sustained improvements in cognitive functions could have a significant impact on delaying or preventing dementia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/appy.12518","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T23:49:35Z","timestamp":1659570575000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A 5\u2010year community program in Singapore to prevent cognitive decline"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7348-0410","authenticated-orcid":false,"given":"Ted Kheng Siang","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine National University of Singapore  Singapore Singapore"},{"name":"Arizona State University, Edson College of Nursing and Health Innovation  Phoenix 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