Reducing risk factors for cognitive decline through psychological interventions: a pilot randomized controlled trial

Viviana M. Wuthrich*, Ronald M. Rapee, Brian Draper, Henry Brodaty, Lee-Fay Low, Sharon L. Naismith

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)


    Objectives:Modifiable factors associated with increased risk of cognitive decline include emotional (anxiety, depression), cognitive (low social and mental stimulation), and health factors (smoking, alcohol use, sedentary lifestyle, obesity). Older adults with anxiety and depression may be at heightened risk due to direct and indirect impacts of emotional distress on cognitive decline.Design:Randomized controlled trialSetting:Community sample attending a university clinic. Participants: 27 participants (female = 20) aged over 65 years (M = 72.56, SD = 6.74) with an anxiety and/or mood disorder. Interventions: two cognitive behavioral therapy (CBT) interventions (face-to-face or low intensity) that targeted emotional, health, and cognitive risks for cognitive decline.Measurements:Participants completed diagnostic interviews; self-report measures of anxiety, depression, quality of life, and lifestyle factors at baseline; post-treatment; and 3-month follow-up.Results:Both interventions resulted in significant and sustained improvements in depression, anxiety, quality of life, and physical and social activity. At post-treatment, face-to-face CBT demonstrated significantly greater improvements in emotional symptoms, alcohol use, and memory (exercise approached significance). At 3-month follow-up, gains were maintained and there were significantly greater increases in mental activity for face-to-face CBT, with social activity approaching significance. Conclusions: This study demonstrates the feasibility of CBT interventions to reduce emotional as well as lifestyle risk factors associated with cognitive decline in at-risk older participants. Large studies are needed to evaluate the long-term impact on cognitive decline. The trial was registered with the Australian and New Zealand Clinical Trials Registry (Trial Registration No. ACTRN12618000939291).

    Original languageEnglish
    Pages (from-to)1015-1025
    Number of pages11
    JournalInternational Psychogeriatrics
    Issue number7
    Early online date24 Oct 2018
    Publication statusPublished - Jul 2019


    • prevention
    • dementia
    • anxiety
    • depression
    • cognitive decline
    • geriatric
    • lifestyle


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