Effects of Nature-based Group Intervention on Cognition and Nature Connectedness Among Lonely Older Adults Living in Assisted Living Facilities-Secondary Analyses of an RCT.

OBJECTIVES

Nature experiences shared in peer groups according to the "Friends in Nature" (FiN) intervention in assisted living facilities (ALFs) reduced lonely participants' loneliness. Here we explored the effects of the FiN intervention of the H2020 RECETAS project on changes in the secondary outcomes of cognition, nature connectedness, and self-efficacy.

DESIGN

A randomized, controlled trial.

SETTING AND

PARTICIPANTS

Older adults suffering from loneliness and living in ALFs.

METHODS

Lonely, older adults from 22 ALFs in Helsinki, Finland, were randomized into (1) FiN group intervention once a week for 9 weeks (n = 162) or (2) usual care (n = 157). Participants were assessed at baseline and at 3, 6, and 12 months. Outcomes were changes in cognition measured with the Clock Drawing Test (CDT) and Verbal Fluency (VF), nature connectedness assessed with Nature Connection Index (NCI), and self-efficacy assessed with the General Self-Efficacy Scale.

RESULTS

Mean age of participants was 83 years (73% women). Prevalences of frailty phenotype and dementia were 66% and 55%, respectively. At 3 months, the change in CDT in the intervention group was 0.11 (95% CI, -0.19 to 0.42) and in the control group -0.31 (95% CI, -0.61 to 0.00) (P = .047 between changes); the difference declined at 6 and 12 months. VF was not affected by the intervention. For NCI, change from baseline to 3 months was +1.7 points (95% CI, -2.5 to +5.9) in the intervention group and -4.3 points (95% CI, -8.6 to -0.07) in controls (P = .007 between changes). No differences emerged in changes of self-efficacy.

CONCLUSIONS AND IMPLICATIONS: Group intervention according to the FiN method improved participants' cognition and nature connectedness compared with controls. The nature-based group intervention can be implemented in ALFs by training professionals to be facilitators of the FiN method.