Engagement with behaviour change in people with mild cognitive impairment and mild frailty: a qualitative study

Rookes, TA ORCID: 0000-0001-6330-7059, Frost, R ORCID: 0000-0003-3523-0052, Barrado-Martín, Y ORCID: 0000-0002-9912-6345, Catchpole, J, Armstrong, M ORCID: 0000-0001-6773-9393, Gardner, B, Gould, RL, Cooper, C, Hammond, C, Marston, L ORCID: 0000-0002-9973-1131 and Walters, KR ORCID: 0000-0003-2173-2430 (2026) Engagement with behaviour change in people with mild cognitive impairment and mild frailty: a qualitative study. BMJ Open, 16 (5). ISSN 2044-6055

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Abstract

Background: Many older people experience Mild Cognitive Impairment (MCI), which may compromise the effectiveness of health promotion programmes. Objectives: We explored engagement with behaviour change among participants scoring 18-25 on the Montreal Cognitive Assessment receiving HomeHealth, a health promotion intervention supporting older adults with mild frailty to maintain independence in England (). Methods: Of the 46 semistructured process evaluation interviews, 29 participants scored in the MCI range, purposively selected for demographic characteristics and degrees of cognitive impairment and the seven support workers. Results: Thematic analysis resulted in three themes: Navigating the impact of MCI; Addressing memory as a goal in the intervention; and Adapting Behaviour Change Interventions for MCI. Participants had varied opinions about whether their memory was problematic and whether anything could be done to help. Many reported not discussing memory concerns with support workers. Barriers to engagement in behaviour change included limited social support and not acknowledging memory problems. Facilitators included setting goals which increased or were linked to existing health behaviours, using reminders/prompts and actively involving family members. Conclusions: Implementing these facilitators into existing and new health promotion interventions delivered to older adults, with suspected but unacknowledged MCI, could overcome the current barriers people with MCI face when trying to engage and benefit from interventions.

Item Type:	Article
Uncontrolled Keywords:	Behavior; QUALITATIVE RESEARCH; Dementia; Cognition; PUBLIC HEALTH; Psychosocial Intervention; Humans; Health Behavior; Qualitative Research; Social Support; Aged; Aged, 80 and over; Frail Elderly; Middle Aged; Health Promotion; England; Female; Male; Interviews as Topic; Cognitive Dysfunction; Frailty; Behavior; Cognition; Dementia; PUBLIC HEALTH; Psychosocial Intervention; QUALITATIVE RESEARCH; Humans; Cognitive Dysfunction; Aged; Male; Female; Qualitative Research; Aged, 80 and over; Frailty; Health Promotion; England; Health Behavior; Frail Elderly; Social Support; Interviews as Topic; Middle Aged; 5203 Clinical and Health Psychology; 4203 Health Services and Systems; 4206 Public Health; 42 Health Sciences; 52 Psychology; Behavioral and Social Science; Neurosciences; Aging; Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD); Brain Disorders; Dementia; Clinical Research; Clinical Trials and Supportive Activities; Acquired Cognitive Impairment; Alzheimer's Disease; Neurodegenerative; 3.1 Primary prevention interventions to modify behaviours or promote wellbeing; 7.1 Individual care needs; Mental health; 3 Good Health and Well Being; Humans; Cognitive Dysfunction; Aged; Male; Female; Qualitative Research; Aged, 80 and over; Frailty; Health Promotion; England; Health Behavior; Frail Elderly; Social Support; Interviews as Topic; Middle Aged; 1103 Clinical Sciences; 1117 Public Health and Health Services; 1199 Other Medical and Health Sciences; 32 Biomedical and clinical sciences; 42 Health sciences; 52 Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Divisions:	Public and Allied Health
Publisher:	BMJ
Date of acceptance:	20 March 2026
Date of first compliant Open Access:	27 May 2026
Date Deposited:	27 May 2026 10:34
Last Modified:	27 May 2026 10:34
DOI or ID number:	10.1136/bmjopen-2025-103314
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28669

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