Informing optimal strategies for public health interventions targeting mental health and cognitive functioning for older adults in Switzerland: A co-creation guided desk review

Objective: This desk review was conducted as part of the ADVANCE project, which aims to enhance our understanding of mental health promotion and prevention. The review's objective was to evaluate the current state of interventions that address mental health and cognitive functioning among older adults in Switzerland, focusing on the features of these interventions as well as Swiss-specific contextual factors that contribute to vulnerability and stigma.
Methods: We searched PubMed, PsycINFO, and Scopus for eligible studies from January 2018 until September 27th, 2023. We reviewed studies investigating interventions targeting mental health and cognitive functioning in older adults living in Switzerland and grey literature reporting on mental health, well-being, cognitive functioning, stigmatization, and stigma mitigation strategies. Core features of the interventions (intervention type, efficacy, delivery modes, recruitment, stigma-related aspects) and targeted populations (vulnerable groups and stigma sources) were extracted and descriptively summarised. In a co-creation process with differentstakeholder the extracted data resulted in four potential intervention
scenarios depicting the different key-design features target group, modality, recruitment.
Results: A comprehensive search resulted in 1046 records, with 25 peerreviewed articles and five grey literature reports meeting the inclusion
criteria. The population of older adults included in the studies encompassed a heterogeneous group, characterized by various vulnerabilities and stigma associated with age-related stereotypes and discrimination. Accordingly, the intervention types were also diverse, including mainly process based cognitive training or multimodal interventions. The interventions were implemented through a range of delivery modes, involving different combinations of location (on-site vs. digital) and format (individual vs. group). Participants recruitment included a wide range of recruitment sites and strategies. All four resulting potential intervention scenarios aimed to include a representative sample to encompass a broad range of vulnerabilities. The scenarios vary in their delivery modes, ranging from a 'fully digital - individual' mode to a more diverse mode that integrates various combinations of location and format. However, 'offliners' would currently be excluded from these scenarios.
Conclusion: The review highlights the complex nature of mental and cognitive health challenges along with the implementation of effective public health interventions. A key challenge highlighted is the inclusion of 'offliners' in scalable interventions. Addressing this issue is crucial for comprehensive public health strategies.