# Daily Engagement in Meaningful Activities Professional (DEMA-Pro) intervention for seniors with subjective cognitive decline and living at home > **NIH NIH R61** · INDIANA UNIVERSITY INDIANAPOLIS · 2020 · $451,789 ## Abstract ABSTRACT More than 4.4 million patients receive home health services following discharge from the hospital or rehabilitation facility. A substantial number (70%) are older adults with subjective cognitive decline (SCD), an early clinical sign of Alzheimer's disease and related dementia. SCD is associated with diminished activity performance, poor quality-of-life and other adverse health outcomes (e.g., depressive symptoms). Home health patients with SCD often require more time, structure, and guidance to complete tasks and adjust to new skills and environments. Support is especially important during this high-risk period of transition between care settings. However, engagement in meaningful activities can help improve patient and informal caregiver outcomes, including improved physical and mental health, higher quality-of-life, and reduced risk of cognitive decline and mortality. Poor engagement in meaningful activities results in rapid patient decline that may otherwise be preventable. For those with SCD who might otherwise decline and progress to preclinical ADRD, new care delivery models that promote engagement in meaningful activities to enhance patient outcomes are needed. Because informal caregivers are usually unprepared, lack confidence in their new caregiver role, and have difficulty providing support, it is vitally important to include these caregivers in new care delivery models. We propose a new home health care delivery model in partnership with Kindred at Home (KAH), Gentiva Health Services, a division of Humana that encompasses 400 sites across 40 states. Our proposed telephone- delivered care model, Daily Engagement in Meaningful Activities-Professional (DEMA-Pro) is a Positive Health intervention that is strengths-based, family-centered, and tailored to patient/caregiver goals and values. DEMA- Pro addresses the core problem of diminished engagement in meaningful activities among SCD patients at home by: 1) coaching patient-caregiver dyads to problem-solve; 2) teaching the dyads self-management and communication skills; and 3) enhancing naturally occurring patient-caregiver interactions necessary to accomplish self-identified, mutually agreed upon goals. DEMA-Pro builds on five preliminary studies that demonstrated high feasibility, acceptability, and positive preliminary effects on health outcomes (physical function, mood, and QoL). DEMA-Pro will be refined for delivery by home health services staff to patients with SCD and their informal caregivers. Thus, the purpose of this application is to conduct a pragmatic cluster randomized controlled trial (RCT) of DEMA-Pro to improve outcomes in home health service patients with SCD. In the R61 phase, we will establish the trial's organizational structure and processes and pilot test DEMA-Pro in 4 home health services sites. In R33 phase, we will conduct a full pragmatic RCT in 40 Kindred KAH sites comparing DEMA-Pro to usual care. Consist with the spirit of a pragmatic trial, we will ... ## Key facts - **NIH application ID:** 10112658 - **Project number:** 1R61AG070265-01 - **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS - **Principal Investigator:** Yueh-Feng Yvonne Lu - **Activity code:** R61 (R01, R21, SBIR, etc.) - **Funding institute:** NIH - **Fiscal year:** 2020 - **Award amount:** $451,789 - **Award type:** 1 - **Project period:** 2020-09-30 → 2022-08-31 ## Primary source NIH RePORTER: https://reporter.nih.gov/project-details/10112658 ## Citation > US National Institutes of Health, RePORTER application 10112658, Daily Engagement in Meaningful Activities Professional (DEMA-Pro) intervention for seniors with subjective cognitive decline and living at home (1R61AG070265-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10112658. Licensed CC0. --- *[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*