---
title: "Pilot RCT of Participatory Dementia Prevention for Older Adults in Rural Botswana and Urban Montre"
id: "bmj-open-6-authentic-participatory-research-with-older-adults-for-cognitive-health-aproach"
canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-6-authentic-participatory-research-with-older-adults-for-cognitive-health-aproach"
content_type: "clinical_feed_article"
specialty: "Neurology"
source_name: "BMJ Open"
source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e121064?rss=1"
published_at: "2026-09-30T12:06:10.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Pilot RCT of Participatory Dementia Prevention for Older Adults in Rural Botswana and Urban Montre
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-6-authentic-participatory-research-with-older-adults-for-cognitive-health-aproach
- **Specialty:** [Neurology](https://medichelpline.com/clinical-feed/neurology.md)
- **Primary Source:** BMJ Open
- **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e121064?rss=1)
- **Published At:** 2026-09-30T12:06:10.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- This pilot randomised controlled trial tests the feasibility and acceptability of **participatory research** as a dementia prevention intervention for socially isolated adults aged 65+ in rural Botswana and urban Montreal. - The intervention is grounded in three features of authentic participatory research: shared governance, use of evidence and innovation, which the authors link to elements of **executive function**. - Social isolation is the target risk factor because it increases dementia risk and social engagement interventions may protect cognition by supporting executive processes. - The study will recruit at least 100 participants in Botswana and 100 in Montreal who are not in paid or voluntary employment and not married. - In Botswana, randomisation occurs at the community level: one community receives immediate intervention and the control community receives it after 18 months. - In Montreal, individual participants are randomised to immediate or delayed intervention groups before they are grouped by shared concern. - The six-step intervention asks individuals to identify priority concerns, form groups by shared concern, discuss solutions, share concerns with stakeholders, implement solutions and perform self-evaluation. - Primary cognitive assessment uses the **Frontal Assessment Battery** to measure executive function; additional questionnaires assess integral brain health, physical health and social isolation at baseline, 18 months and 33 months. - The study will analyse narratives of change after intervention periods to capture participant experience. - Ethical approvals were obtained from McGill University (18 Sept 2024, A06-M27-24A), Botswana Ministry of Health (24 June 2024, HPRD 6/14/1) and CIUSSS West-Central Montreal REC (3 March 2025, 2025-4112) for clinic-related recruitment. - Dissemination plans include community meetings in Botswana, stakeholder briefings, research meetings in Montreal, academic presentations and peer-reviewed publications. - Trial registration: ISRCTN14273485.
## Clinical Analysis & Structured Key Points
Introduction Increasing numbers of older adults live with dementia especially in low- and middle-income countries. Most prevention relies on controlling conditions that increase the risk of dementia, such as hypertension, diabetes and sight and hearing loss. Recent pharmacological treatments have limited efficacy and are prohibitively expensive. Social isolation increases the risk of dementia and evidence suggests interventions to increase social engagement can reduce the risk possibly by supporting executive function. Three key features of authentic participatory research - shared governance, use of evidence and innovation - align with elements of executive function. Our pilot tests the feasibility and acceptability of participatory dementia prevention in Montreal, Canada and rural Botswana. Methods and analysis This pilot randomised controlled trial will recruit women and men aged 65 years and older who are socially isolated (not in paid or voluntary employment, not married) in urban Montreal and two rural communities in Botswana. In Botswana, we will randomly allocate participants in one community to receive the intervention immediately while the control community will receive the intervention after 18 months. In Montreal, individual participants will be randomly allocated to immediate or delayed intervention groups before or after their grouping by shared concern. We aim to recruit at least 100 participants in Botswana and 100 in Montreal. The intervention has six steps: individuals identify priority concerns; participants join groups with shared concerns; groups discuss the concern and potential solutions; groups share the concern and possible solutions with other stakeholders; implementation of solutions; and self-evaluation of the process. We will measure executive function using the Frontal Assessment Battery, and apply a questionnaire to measure integral brain health, physical health and social isolation at baseline, at 18 months and at 33 months. We will analyse narratives of change at the end of the intervention periods to understand participants' experience of the intervention. Ethics and dissemination The McGill University Faculty of Medicine and Health Sciences Institutional Review Board approved the entire project on 18 September 2024, Study number: A06-M27-24A. The Psychosocial Research Committee (REC) of CIUSSS West-Central Montreal Research Ethics Board (REB) approved recruitment of clinic-related participants in Montreal on 3 March 2025, Project 2025-4112. The Health Research and Development Division of the Ministry of Health, Botswana, approved the study in Botswana on 24 June 2024, Reference number: HPRD 6/14/1. In Botswana, we will disseminate the findings in community meetings in the two pilot communities and with government and non-government stakeholders convened by the Ministry of Health and the Social Development Department of the Ministry of Local Government and Traditional Affairs. In Montreal, we will disseminate the findings in research meetings and in other relevant fora. We will give oral and poster presentations about the study in relevant local, national and international academic conferences and meetings and publish papers about the findings in peer-reviewed, indexed academic journals. Trial registration number ISRCTN14273485 .
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