# Influencing factors of initiation and maintenance of multidomain interventions in patients with mild cognitive impairment: a qualitative study

## TL;DR

This study explores what helps or hinders patients with mild cognitive impairment to start and continue multidomain interventions aimed at preventing dementia.

## Contribution

The study identifies specific factors influencing initiation and maintenance of multidomain interventions in MCI patients using a qualitative approach.

## Key findings

- Behavior initiation is influenced by perceived disease threat, cognitive biases, and economic tradeoffs.
- Behavior maintenance is supported by positive experiences, self-regulation, and external support.
- Frailty and comorbidities negatively impact intervention maintenance.

## Abstract

Mild cognitive impairment (MCI) is a critical period for the prevention of dementia, and multidomain interventions can effectively delay and improve patients’ cognitive decline. However, it remains a great challenge concerning the initiation and maintenance of interventions for MCI patients currently.

To explore influencing factors of the initiation and maintenance of multidomain interventions in patients with MCI.

This study was conducted with the recruitment of patients with MCI admitting to the Department of Neurology, Cognitive Center, and Cognitive Training Nursing Clinic of a Grade A Tertiary Hospital in Nanjing, as well as those identified through community screening, between September 2024 and February 2025 via purposive sampling. Data were collected via face-to-face semi-structured interviews. Meanwhile, data analysis for theme extraction in the study was performed through a deductive-inductive approach under the guidance of the multi-theory model (MTM).

This study extracted two themes and eleven subthemes: Behavior initiation (perceived disease threat triggering service seeking and participation; disease cognitive biases and cognitive anosognosia hindering intervention initiation; perceived benefits of interventions; cognitive expectations of rehabilitation outcomes; barriers to accessing and utilizing intervention resources; economic cost–benefit tradeoffs). Behavior maintenance (positive experiences during interventions; self-regulation during interventions; diverse external support; high time preference during interventions; impact of frailty and comorbidities).

Multidomain interventions for patients with MCI are affected by complex and multiple factors. These factors should be considered in the clinical setting, with the formulation of targeted intervention strategies to improve patients’ participation in and adherence to multidomain interventions. Furthermore, it may contribute to the transformation of the interventions from effective to practical implementation and delay the progression of the disease.