The Brain Gym: A Community Multimodal Stimulation Program for People with Mild Cognitive Impairment and Dementia in Matanzas, Cuba. Preliminary Report
Bibiana Valhuerdi Porto1, Camelia Valhuerdi Porto3, Sara Iris Santos2, Francisco Rodriguez2, Nora Liss Gomez Dominguez2, Rudbeckia Porto Alvarez1, Yahn Alejandro Castro Rey4, Adolfo Valhuerdi Cepero2
1Medical University of Matanzas, 2Mental Health, Medical University of Matanzas, 3Neurology, Johns Hopkins Hospital, 4Physical therapy, University of Matanzas
Objective:
To describe the design and pilot implementation of The Brain Gym, a multimodal stimulation model integrating cognitive, sensory, affective, and motor strategies for individuals with mild cognitive impairment (MCI) and dementia in Matanzas, Cuba.
Background:
Dementia and MCI represent an expanding global health challenge, with most affected individuals living in low- and middle-income countries. The 10/66 Dementia Research Group has documented high dementia prevalence in Latin America. While Cognitive Stimulation Therapy improves cognition and quality of life, and Multisensory Stimulation enhances mood and engagement, the combined use of multiple modalities remains underexplored. The Brain Gym integrates these approaches within a community-based framework.
Design/Methods:
A 12-week intervention pilot study (March–June 2024) enrolled patients with MCI or mild-to-moderate dementia from the 10/66 cohort and University Memory Clinic. Exclusion criteria included reversible causes, logistical barriers, or family refusal. Sessions occurred three times weekly (2 hours each) combining guided movement, self-massage, rosemary aromatherapy, choral singing (Cielito Lindo), folkloric dance (Le Salute), color stimulation, memory recall, and caregiver journaling. Assessments included the MMSE, MoCA, ADL, IADL, and Zarit Caregiver Burden Scale at baseline (T0) and post-intervention (T1).
Results:
Of 126 screened, 24 (19%) completed the program (58% women, ages 62–89). Adherence reached 93% with no adverse events. Participants demonstrated up to 2-point MoCA gains (88% in the indivisuals with baseline MOCA 18-23) and improved IADL performance. Caregivers reported reduced stress, fewer nighttime agitation episodes, and enhanced communication. Thematic analysis identified improved connection, identity, and presence.
Conclusions:
This pilot suggests that The Brain Gym is a feasible, low-cost, and culturally adaptable model for multimodal rehabilitation in MCI and dementia. It may help stabilize/ improve cognitive function, improve daily activity performance, and reduce caregiver burden. Future prospective studies and clinical trials are warranted to validate its impact and scalability across diverse settings.
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