The effects of a memory and thinking exercise program on elderly people with little schooling: changes in mental abilities and well-being

INTERVENTION: This is a randomized controlled trial with three parallel arms, conducted with older adults who are illiterate or have low educational levels, up to 4 years of formal education, residing in the East Zone of the city of São Paulo, participants of Elderly Community Centers or Retirees and Pensioners Associations in the region. A total of 90 older adults aged 60 years or older, of both sexes, will be recruited and, after screening and verification of eligibility criteria, will be randomized into three groups of 30 participants each, homogeneous in relation to sociodemographic variables such as age and years of schooling. The Training Group receives the multicomponent cognitive stimulation program adapted from the SUPERA method. The Active Control Group receives only educational guidance on aging, health and well being, as well as social interaction activities, using educational booklets and texts. The Passive Control Group receives no intervention during the study period. At the end of the five assessment time points, participants in the Active Control Group and the Passive Control Group will be entitled to receive the cognitive stimulation program offered to the Training Group. The study adopts assessor blinding, so that neuropsychological assessments are conducted by professionals external to the scientific team, properly trained and without knowledge of the group allocation of participants, thus ensuring the impartiality of outcome measurements. Participants will be excluded if they are under 60 years of age, have more than 4 years of schooling, show scores indicative of depressive symptoms on the 15 item Geriatric Depression Scale equal to or greater than 5, perform below the cutoff point on the Mini Mental State Examination, score equal to or greater than 2 on the CAGE questionnaire for alcohol use screening, score equal to or greater than 3 on the Pfeffer Questionnaire, as well as participants with sensory or motor limitations that compromise task performance, uncontrolled chronic conditions, psychiatric disorders, evidence of cerebrovascular disease or a diagnosis of dementia. The cognitive stimulation program is a multicomponent intervention adapted from the SUPERA method, as described by Lima‐Silva and colleagues in 2021, developed specifically for illiterate older adults with low educational levels, conducted by educators certified by the Supera Institute of Education, in partnership with the School of Arts, Sciences and Humanities of the University of São Paulo and the Cognitive and Behavioral Neurology Group of the Faculty of Medicine of the University of São Paulo. Sessions are conducted in person, in groups, with weekly frequency and duration of 2 hours each, with a total intervention duration of 18 months. The protocol is organized into three integrated components, namely an educational component on memory and aging, the practice of cognitive tasks using compensatory strategies, and the generalization of learned strategies to activities of daily living. The cognitive domains targeted include episodic memory, working memory, attentio CONDITION: Cognitive Aging ; Aging G07.345.124 PRIMARY OUTCOME: It's expected to find an assessment of the impact of the multicomponent cognitive stimulation program on participants' overall cognitive performance, including episodic memory, working memory, attention, executive functions, language, and information processing speed. The instruments used to measure this outcome are the Addenbrooke's Cognitive Examination (ACE‐R), the Short Cognitive Performance Test (SKT), the Verbal Fluency Test, and the Trail Making Test SECONDARY OUTCOME: It's expected to observe an assessment of the impact of the program on participants' psychosocial variables, including symptoms of depression and anxiety (GDS‐15 and DASS‐21), perceived quality of life (CASP‐19), social support network (MMRI), beliefs about old age, purpose in life, and overall life satisfaction. These outcomes complement the primary outcome by capturing the broader effects of the intervention on the psychological and social well‐being of older adults INCLUSION CRITERIA: Be aged 60 years or older; have up to 4 years of formal education, considered low education level; reside in the East Zone of São Paulo; be an active participant of Elderly Community Centers or Retirees and Pensioners Associations in the region; not have previously participated in any cognitive intervention, such as memory training workshops or digital literacy programs; present preserved cognition, with a score above the cutoff on the Mini‐Mental State Examination; not present significant depressive symptoms on the Geriatric Depression Scale, with a score below 5 points; score below 2 points on the CAGE questionnaire for alcohol use; score below 3 points on the Pfeffer Functional Activities Questionnaire for functionality; not have a diagnosis of dementia, psychiatric disorders, or cerebrovascular disease; not present visual, auditory, or motor limitations that could compromise participation in the study activities