Development of a Model to Delay and Prevent Dementia in the Elderly through Community Network Participation: Yang Sisurat District, Maha Sarakham Province.

Abstract

      This participatory action research aimed to examine the problem situation, develop a model to delay and prevent dementia through the participation of community network partners, and evaluate the developed model. The study was conducted between October 2023 and September 2024 in Yang Sisurat District, Maha Sarakham Province. The target group consisted of 150 elderly individuals and 45 community network partners, including the elderly and their families, Village Health Volunteers (VHVs), community leaders, public health personnel/nurses, and representatives from local administrative organizations. The development process utilized two cycles of the PAOR (Plan, Act, Observe, Reflect) framework. Research instruments included the Abbreviated Mental Test (AMT), assessments for dementia prevention knowledge and behaviors, an assessment of the ability to perform activities of daily living (ADL), a satisfaction assessment, and an in-depth interview guide. Data were analyzed using descriptive statistics, the paired t-test, and content analysis.

      A situational analysis revealed that 65.33% of the elderly were at risk of cognitive impairment, and the community lacked the knowledge and systems required for systematic dementia prevention. The developed model, named "Hug Paeng Bueng Ngaeng Samong Dee Yang Sisurat" (Cherishing, Caring for, and Promoting Brain Health in Yang Sisurat), comprises three components: 1) a learning plan covering five areas—physical exercise, brain stimulation, nutrition, mental health, and sleep; 2) a care plan for home visits tailored to risk levels; and 3) an integrated care system combining onsite home visits and telenursing, involving families, Village Health Volunteers (VHVs), nursing teams, and network partners. The study evaluated the model using a sample of 150 participants. After implementing the model for six months, the mean AMT score increased from 7.85 ± 0.90 to 8.53 ± 0.89. The proportion of the group at risk for dementia decreased from 65.33% to 32.67%. Knowledge scores rose from 15.42 ± 3.21 to 22.18 ± 2.87, and desirable health behavior scores increased from 4.10 ± 0.95 to 4.52 ± 0.73; these changes were statistically significant (p < .001). Participants reported the highest level of overall satisfaction with the model (Mean = 4.79, SD = 0.45).