Comparing the group and individual applications of a cognitive enhancement program involving a workbook for older adults with mild cognitive impairment in a rural area.

INTRODUCTION: Providing cognitive enhancement programs for older adults with mild cognitive impairment (MCI) is challenging because of structural barriers and substantial differences in participants' motivation to engage. This study aimed to examine the effectiveness of group versus individual approaches to ensure an effective intervention delivery, especially in rural areas where these problems are more prevalent. METHODS: This quasi-experimental pretest-posttest study with non-equivalent groups was conducted in a rural South Korea from August to November 2023. Thirty-two participants with MCI completed a 12-week workbook-based cognitive enhancement program in either a community-based or a home-based group format. The Korean-Montreal Cognitive Assessment (K-MoCA), Korean Instrumental Activities of Daily Living (K-IADL), and the Korean version of Short-Form Geriatric Depression Scale (SGDS-K) were administered pre- and post- intervention. Program satisfaction was measured post-intervention. RESULTS: In within-group analyses, the community-based group improved on K-MoCA (p = .015), especially in visuospatial/executive function (p = .033) and delayed recall (p = .019), and on K-IADL (p = .006). The home-based group showed no significant changes. No statistically significant between-group differences were observed for cognitive function, K-IADL, or depression change scores, whereas program satisfaction was higher in the community-based group. CONCLUSION: The community-based workbook program may help improve cognition and daily functioning among older adults with MCI in rural areas. These findings suggest that a community-based delivery format may be a practical and acceptable option for older adults with MCI in rural settings. Larger studies are needed to confirm its effectiveness relative to a home-based group format.