A study to untangle the puzzle of urinary incontinence and frailty co-occurrence among older adults: The roles of depression and activity engagement.

AIMS: To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways. DESIGN: A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China. METHODS: Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism. RESULTS: A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant. CONCLUSION: The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence. IMPACT: What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers' understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence. REPORTING METHOD: The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The Mediating Role of Affective States in Short-Term Effects of Activity Engagement on Working Memory in Older Age.

INTRODUCTION: It has been shown that activity engagement is associated with cognitive ability in older age, but mechanisms behind the associations have rarely been examined. Following a recent study which showed short-term effects of activity engagement on working memory performance appearing 6 h later, this study examined the mediating role of affective states in this process. METHODS: For 7 times per day over 2 weeks, 150 Swiss older adults (aged 65-91 years) reported their present (sociocognitive/passive leisure) activities and affective states (high-arousal positive, low-arousal positive, high-arousal negative, and low-arousal negative) and completed an ambulatory working memory task on a smartphone. RESULTS: Multilevel vector autoregression models showed that passive leisure activities were associated with worse working memory performance 6 h later. Passive leisure activities were negatively associated with concurrent high-arousal positive affect (and high-arousal negative affect); high-arousal positive affect was negatively associated with working memory performance 6 h later. A Sobel test showed a significant mediation effect of high-arousal positive affect linking the time-lagged relationship between passive leisure activities and working memory. Additionally, sociocognitive activities were associated with better working memory performance 6 h later. Sociocognitive activities were associated with concurrent higher high- and low-arousal positive affect, which, however, were not associated with working memory performance 6 h later. Thus, a mediation related to sociocognitive activities was not found. DISCUSSION: Passive leisure activities could influence working memory performance through high-arousal positive affect within a timeframe of several hours. Results are discussed in relation to an emotional, and possibly a neuroendocrine, pathway explaining the time-lagged effects of affective states on working memory performance.

Activity engagement and cognitive function among chinese older adults: moderating roles of gender and age.

BACKGROUND: Many studies have found that engaging in activities, including physical exercise, social interaction, and cognitive training, is beneficial for preventing cognitive decline among older adults; however, the demographic differences in the association between activity engagement and cognitive functions remain understudied. This study investigates: (a) the influence of activity engagement on cognitive functions among Chinese older adults, and (b) the moderating roles of age and gender in these associations . METHODS: The data were derived from the China Health and Retirement Longitudinal Study in 2018, which included 9803 participants aged 60 or older. A multiple regression model was used to test the study hypotheses. RESULTS: Engaging in physical activity (b = 1.578, p < .001), social interaction (b = 1.199, p < .001), and cognitive activity (b = 1.468, p < .001) was positively associated with cognitive functions, whereas the effect of volunteer activities on cognitive functions was not significant (b = -.167, p = .390). Light- and moderate-intensity activities were beneficial for cognition (light: b = .847, p < .001; moderate: b = 1.189, p < .001), but vigorous-intensity activity was negatively related to cognition (b = -.767, p < .001). In addition, women and participants with advanced age appeared to benefit more from cognitive activities than their male and younger counterparts, respectively (gender: b = 1.217, p = .002; age: b = .086, p = .004). The adverse effects of vigorous-intensity activities (including agricultural work) on cognitive health were stronger for women and younger participants (gender: b = -1.472, p < .001; age: b = .115, p < .001). The protective effects of moderate-intensity activities on people's cognition increased with increasing age (b = .055, p = .012). CONCLUSIONS: The findings indicate that participating in physical, social, and cognitive activities can help older adults to maintain cognitive health. They suggest that older adults should select activities while considering activity intensity and their individual characteristics.

A Social-Ecological Approach to Understanding Activity Engagement Patterns Among Older Chinese Immigrants.

Few studies have focused on activity engagement among older immigrants. We aim to map the patterns of activity engagement and examine the associations with social-ecological factors in a sample of older Chinese immigrants. Participants were from the Population Study of Chinese Elderly in Chicago (PINE). Four patterns of activity engagement were identified through latent class analysis: restricted, diverse, informal social, and community-based social. Intrapersonal, interpersonal, cultural, and environmental factors distinguished latent classes of activity engagement. In particular, acculturation and family-oriented immigration differentiated the restricted from the diverse class membership. Positive attributes of social environment such as social network size, positive social support, and neighborhood cohesion were associated with the likelihood of categorization in the diverse, informal social, and community-based social groups relative to the restricted group. Findings point to the importance of positive attributes of social environment in enhancing engagement with life among older Chinese immigrants.

Couples' Cognition, Intimacy, and Activity Engagement: An Actor-Partner Interdependence Model Analysis.

OBJECTIVES: This study examines the actor and partner effects of cognition on activity engagement and the potential mediating role of intimate relationship in older couple dyadic context. METHODS: Data for this study were obtained from heterosexual couples who participated in the 2020 wave of the Health and Retirement Study. Constructing a dyadic model of couples' cognitions, activity engagement, and intimacy using structural equation modeling to analyze the relationship between variables and mediating effects. RESULTS: At the actor level, cognition was positively correlated with their activity participation. At the partner level, wives' cognition and husbands' activity engagement were positively correlated. Husband's cognitive score affect wife's subjective feelings about intimacy. The mediation effect of Wife's intimacy on the relationship between husband's cognition and wife's activity engagement was significant. CONCLUSIONS: In older couples, cognition influences activity engagement at a binary level, and this association is influenced by the level of intimacy. Improving intimacy can help increase activity engagement in older couples, which in turn promotes health. Clinical Implications Maintaining cognition helps older people enjoy good marriage and participation in activities. For women, the closer the partnership, the higher the frequency of participating in various activities.

Activity Engagement after Cancer in Community-Based Survivors.

This paper discusses the activity engagement in a sample of cancer survivors (n = 25) seeking community-based support. A modified version of the Activity Card Sort (ACSm) was used to measure activity engagement after cancer. On average, participants reported a 27% reduction in activity engagement since their cancer diagnosis. Findings provide direction for continued study of the needs of survivors in community-based cancer care and generate ideas on occupational therapy's unique role in community-based survivorship.

Activity engagement and psychological distress among Holocaust survivors during the COVID-19 pandemic.

OBJECTIVES: The COVID-19 pandemic may pose a specific threat for Holocaust survivors, as such threats may be linked with increased psychological distress. Moreover, research has demonstrated that engaging in planful problem-solving activities is associated with reduced distress. Accordingly, we aimed to examine the link between engaging in activities during COVID-19 and psychological distress among Holocaust survivors with varying levels of post-traumatic symptoms (PTS) and comparisons (not directly exposed to the Holocaust). DESIGN: A cross-sectional design composed of Holocaust survivors and a comparison group. SETTING: Participants were interviewed face-to-face, over the telephone, or filled the scales online at their leisure. PARTICIPANTS: Data were collected from 131 older Jewish Israelis (age range 76-94, M = 82.73, SD = 4.09), who were divided into three groups (comparisons; low-PTS survivors; high-PTS survivors). MEASUREMENTS: Participants completed scales assessing PTS, activity engagement, and psychological distress and provided additional sociodemographic, medical, and COVID-19-related information. RESULTS: When activity engagement was low, high-PTS survivors reported extremely high levels of psychological distress relative to low-PTS survivors and comparisons. However, when activity engagement was high, these group differences were considerably reduced, as the psychological distress of high-PTS survivors was significantly lower. CONCLUSIONS: The study highlights the importance of daily planning and activity engagement for Holocaust survivors with high PTS levels in reducing psychological distress. Clinicians are urged to take this factor into account when dealing with the psychological effects of COVID-19 on survivors and on traumatized older adults in general.

A Network Analysis of Potential Antecedents and Consequences of Pain-Related Activity Avoidance and Activity Engagement in Adolescents.

OBJECTIVE: This study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain. METHODS: Adolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor. RESULTS: Activity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement. CONCLUSIONS: This study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.

The Association between Reward Sensitivity and Activity Engagement: the Influence of Delay Discounting and Anhedonia.

AIM: Reward sensitivity affects individuals' motivation to engage in goal-directed behavior. Other concepts, critical for reward appraisal, that potentially influence activity participation encompass delay discounting and anhedonia. The aim of this study was to test the hypothesis that anhedonia and delay discounting influence the relationship between reward sensitivity and activity engagement. METHODS: In total, 37 inpatient patients with an alcohol use disorder (AUD) and 37 matched healthy controls completed the behavioral activation system scale (BAS scale), the Pleasant Activities List (PAL), the Snaith-Hamilton Pleasure Scale (SHAPS) and the Delay Discounting Task (DDT). RESULTS: Patients differed from controls on SHAPS, DDT-k, PAL substance-related activities (SRA), but not BAS and PAL non-substance-related activities (non-SRA). Correlational analyses revealed a strong correlation between BAS and PAL non-SRA in both patients (r = 0.53) and controls (r = 0.47), but also with PAL-SRA in patients (r = 0.40), although not controls (r = 0.09). BAS was negatively correlated with SHAPS in both groups and with DDT in controls. SHAPS was negatively linked to PAL non-SRA in both groups. The BAS-PAL non-SRA relationship was influenced by discount rates in controls. CONCLUSION: A strong link exists between reward sensitivity and engagement in non-SRA in both groups. Delay discounting affects the reward sensitivity and non-SRA association in healthy controls, while anhedonia did not impact the association between reward sensitivity and engagement in (non-)SRA in both conditions.

What Role Does Activity Engagement Play in the Association between Cognitive Frailty and Falls among Older Adults? Evidence from Rural Shandong, China.

INTRODUCTION: Previous studies have demonstrated the relationship between cognitive frailty and falls among older adults. Activity engagement (AE) is known to be related to falls in older adults but the subject has been limited to empirical study. This study aimed to explore the mediating role of AE between cognitive frailty and falls among older adults in rural Shandong, China. METHODS: A total of 3,242 rural seniors (age ≥60 years; 63.6% women) were included in this cross-sectional study. Regression and bootstrap analyses were performed to explore the mediating role of AE between cognitive frailty and falls. RESULTS: The prevalence of falls was 13.1% and the prevalence of cognitive frailty was 6.6% among the participants. AE mediated the association between cognitive frailty and falls (95% CI 0.077-0.223). However, the direct effect was no longer significant after being adjusted for AE (95% CI -0.037 to 0.684; p = 0.078). CONCLUSION: Cognitive frailty was found to be associated with falls among rural older adults, and AE mediated this association. More attention should be paid to promote AE among Chinese rural older adults with cognitive frailty.

The use of technology to promote meaningful engagement for adults with dementia in residential aged care: a scoping review.

INTRODUCTION: A considerable number of adults with dementia live in residential aged care facilities, where loneliness and boredom are common. Computer-based and electronic technologies have advanced significantly and there is potential for such technologies to improve engagement of residents with dementia. However, the nature and extent of the evidence supporting the use of these technologies is unclear. OBJECTIVES: The aim of this study was to investigate the use of computer-based and electronic technologies for enhancing meaningful engagement of adults with dementia living in residential aged care. METHODS: A scoping review was conducted. Nine databases were searched from 2008-2018. Included studies were summarized, compared and synthesized according to technology type. RESULTS: Twenty studies were included. Most studies were conducted in Australia (n = 7) and Europe (n = 8). Study designs were quantitative (n = 12), mixed methods (n = 5), descriptive (n = 2) or qualitative (n = 1). Studies aimed to investigate interaction, engagement, behaviors or quality of life (n = 14), to examine the feasibility of technologies (n = 3), or had both aims (n = 3). Technology type fell into two categories: robotics (n = 14) and multi-media computer programs (n = 6). Across both technology types, there were conflicting results in relation to positive impact on meaningful engagement. Studies only investigated the doing, belonging and connecting aspects of meaningful engagement. Additionally, there was a lack of consistency across studies in how activity, interaction and engagement were measured. CONCLUSION: The role and potential of new technologies to enhance meaningful engagement for those with dementia should focus on creating human-to-human interactions while taking individual preference and person-centered principles into account.

Cognitive Reserve Attenuates the Relation between Gastrointestinal Diseases and Subsequent Decline in Executive Functioning.

AIMS: We investigated whether the longitudinal relationship between gastrointestinal diseases and subsequent decline in executive functioning over 6 years differed by cognitive reserve. METHODS: We analyzed longitudinal data from 897 older adults (mean age 74.33 years) tested on TMT parts A and B in two waves 6 years apart. Participants reported information on education, occupation, leisure activity engagement, and gastrointestinal diseases. RESULTS: There was a significant interaction of gastrointestinal diseases with leisure activity engagement on latent change in executive functioning. Specifically, only for individuals with low (but not those with high) leisure activity engagement, gastrointestinal diseases significantly predicted a steeper subsequent decline in executive functioning across 6 years (i.e., increases in TMT completion time). CONCLUSION: Cognitive reserve may attenuate the detrimental influences of gastrointestinal diseases on subsequent decline in executive functioning.

Pain catastrophizing, activity engagement and pain willingness as predictors of the benefits of multidisciplinary cognitive behaviorally-based chronic pain treatment.

Pain catastrophizing and pain acceptance have been shown to be associated with improvements after participation in cognitive behaviorally-based treatment (CBT) for chronic pain. However, it is not yet clear how important each of these factors is relative to the other. Furthermore, it is also not clear if multidisciplinary pain treatment has the same impact on the two primary dimensions of pain acceptance (activity engagement and pain willingness), and whether their role in explaining treatment outcome differs as a function of the outcomes under study. The aim of this study was to examine the relative importance of changes in pain catastrophizing, activity engagement and pain willingness as predictors of the benefits of a multidisciplinary CBT for chronic pain. 186 adults with chronic pain participated. Pain catastrophizing and activity engagement, but not pain willingness, were significantly associated with treatment outcome. Moreover, each one evidenced different patterns of associations with outcomes. Specifically, while changes in both were associated with improvements in depressive symptoms, only catastrophizing was associated with improvements in pain intensity and only activity engagement was associated with improvements in pain-related disability.

Mindfulness, selfcompassion, and depressive symptoms in chronic pain: The role of pain acceptance.

OBJECTIVE(S): The aim of this study was to test a theory driven model in which pain acceptance (both pain willingness [PW] and activity engagement [AE]) mediates the relationships of mindfulness and selfcompassion with depressive symptoms, while controlling for pain intensity. METHODS: A path analysis was conducted using AMOS software to test a meditational model in a sample of women with chronic musculoskeletal pain (N = 231). RESULTS: Participants with higher levels of mindful awareness and selfcompassion presented lower levels of pain intensity and depressive symptoms, and higher levels of AE. PW did not significantly correlate with any variable in study. The mediation analysis showed that AE mediated the relationship between selfcompassion and depressive symptoms, independently from pain intensity. CONCLUSIONS: These findings seem to corroborate the hypothesis that selfcompassion is rooted in a motivational system, as it seems to correlate with less depressive symptoms through increasing the engagement with valued actions despite experiencing pain.

Symptom experiences in metastatic breast cancer patients: relationships to activity engagement, value-based living, and psychological inflexibility.

OBJECTIVE: This study examined symptom-based subgroups of metastatic breast cancer (MBC) patients and the extent to which they differed across key constructs of acceptance and commitment therapy (ACT). METHODS: Eighty women with MBC completed self-report surveys assessing 10 common symptoms and several ACT variables (ie, activity engagement, psychological inflexibility, value obstruction, and value progress) during a single time point. RESULTS: A cluster analysis yielded 3 patient subgroups: low symptoms, low-moderate symptoms, and moderate-high symptoms. Relative to the subgroup with low symptoms, the other subgroups reported less activity engagement. In addition, compared with patients with low symptoms, the subgroup with moderate-high symptoms reported greater psychological inflexibility (ie, avoidance of unwanted internal experiences) and greater difficulty living consistently with their values. CONCLUSIONS: Women with MBC show heterogeneity in their symptom profiles, and those with higher symptom burden are more likely to disengage from valued activities and avoid unwanted experiences (eg, thoughts, feelings, and bodily sensations). Findings are largely consistent with the ACT model and provide strong justification for testing ACT to address symptom interference in MBC patients.

The Role of Leisure Activities in Mediating the Relationship between Physical Health and Well-Being: Differential Patterns in Old and Very Old Age.

BACKGROUND: Recently, Paggi et al. [Gerontology 2016;62:450-458] for the very first time showed in a cross-sectional sample of 259 adults aged 18-81 years that the relation of physical health to psychological well-being was mediated via frequency of leisure activity participation. OBJECTIVE: To extend this framework, we followed theories on successful aging and vulnerability to propose to add a differential perspective predicting that certain individuals may be more vulnerable than others and therefore may show differences in the mediation pattern. Specifically, we examined whether mediation patterns were differential in certain populations, such as in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities. METHODS: We analyzed data from 3,080 individuals on physical health (number of chronic diseases, subjective health status, and subjective evaluation of change in health over the last 10 years), frequency of participation in 18 leisure activities, and physical and psychological well-being using moderated mediation models with a path model approach that allowed the simultaneous estimation of all model paths, including their significance. RESULTS: We found that the relation of physical health to physical and psychological well-being was mediated via frequency of activity participation. For physical (but not for psychological) well-being, this mediation was more pronounced in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities. These moderated mediations were attributable to differential relations of physical health to frequency of activity participation and to differential relations of frequency of activity participation to physical well-being between the investigated moderator levels. CONCLUSION: Present data suggest that participation in leisure activities may play a key role in mediating the relationship between physical health and well-being, particularly in very old age. Findings are discussed with respect to theories of successful aging and differences between physical and psychological well-being.

The association of educational attainment, cognitive level of job, and leisure activities during the course of adulthood with cognitive performance in old age: the role of openness to experience.

BACKGROUND: The relevance of mental health for everyday life functioning and well-being is crucial. In this context, higher educational attainment, higher cognitive level of one's occupation, and more engaging in stimulating leisure activities have been found to be associated with better cognitive functioning in old age. Yet, the detailed pattern of the potential interplay of such a cognitively engaged lifestyle with personality dimensions, such as openness to experience, in their relations to cognitive functioning remains unclear. METHODS: Two thousand eight hundred and twelve older adults served as sample for the present study. Psychometric tests on verbal abilities and processing speed were administered. In addition, individuals were retrospectively interviewed on their educational attainment, occupation, and regarding 18 leisure activities that had been carried out in mid-life. Moreover, openness to experience was assessed. RESULTS: We found that the effect of openness to experience on cognitive functioning was mediated by educational attainment, cognitive level of job, and engaging in different leisure activities. Data were not better described by alternative moderation models testing for interactive (i.e. dependent) effects of openness to experience and cognitively stimulating engagement. CONCLUSIONS: To explain interindividual differences in cognitive functioning in old age, present data are in line with a mechanism in which individuals with high openness to experience may have been more engaged in stimulating activities in early and mid-life. Possibly by increasing their cognitive reserve throughout adulthood, this may finally enhance their cognitive performance level later in old age.

The association of timing of retirement with cognitive performance in old age: the role of leisure activities after retirement.

BACKGROUND: The role of timing of retirement on cognitive functioning in old age is inconclusive so far. Therefore, the present study set out to investigate the association of timing of retirement with cognitive performance and its interplay with key correlates of cognitive reserve in a large sample of older adults. METHODS: Two thousand two hundred and sixty three older adults served as sample for the present study. Different psychometric tests (Trail Making Test part A (TMT A), Trail Making Test part B (TMT B), Mill Hill) were administered. In addition, individuals were interviewed on their retirement, occupation, educational attainment, and regarding 18 leisure activities that have been carried out after retirement. RESULTS: Earlier retirement (compared to retirement at legal age) was significantly associated with better performance in the TMT A, the TMT B, and the Mill Hill vocabulary test. Moderation analyses showed that in individuals with a moderate number of leisure activities in old age, earlier retirement was related to better cognitive performance, but not in those with a relatively large number of leisure activities. Hierarchical regression analyses revealed that entering leisure activities as additional predictor significantly increased explained variance in the cognitive measures over and above all other investigated markers of cognitive reserve (i.e. occupation and education). CONCLUSIONS: Present data further corroborate the view that leisure activities even in old age may lead to further enrichment effects and thereby may be related to better cognitive functioning. The role of engaging in activities in the context of major life events such as retirement is discussed.

Activity engagement of aging retirees in South Korea.

[Purpose] The purpose of this study was to analyze the activity engagement of the retiree population in South Korea. [Methods] The Korean-Activity Card Sort (K-ACS) was used to collect research data. A One-way ANOVA and post-hoc comparisons showed significant group effects among three age groups. The independent t-tests was used to analyze the differences in mean retained level of activity (MRA) between men and women. [Results] The one-way ANOVA showed statistically significant differences in MRA among different age groups. Scheffé's test revealed a statistically significant decrease in MRA in Group A, aged more than 75 years, as compared to the other two age groups. When participants were divided by gender, MRA of instrumental activities showed a statistically significant difference between the 65-74 years group and the 55-65 years group, but no difference in females of the leisure activities among the age groups. The independent t-tests demonstrated significant gender differences in MRA of activity of the 55-64 years group. [Conclusion] These findings suggest that health professionals should monitor the changes in retained level of activity after age 75, to maintain their engagement, and the importance of age-, gender- and activity-specific analyses in order to identifying patterns of activity engagement.

Deploying Robot-Led Activities for People with Dementia at Aged Care Facilities: A Feasibility Study.

OBJECTIVES: To explore the feasibility of deploying robot-led activities for people with dementia living in aged care facilities. DESIGN: Embedded mixed-methods design. SETTING AND PARTICIPANTS: Eleven residents (aged ≥65 years) with mild to moderate cognitive impairment were recruited from 2 aged care facilities in Brisbane, Australia. METHODS: We implemented a novel control logic, "Adam Program," for a human-like robot to provide proactive robot activities for people with dementia. Participants individually participated in a nonfacilitated robot intervention thrice a week for 5 weeks from November to December 2022. We video-recorded each intervention session and quantified participants' visual, behavioral, and verbal engagement. A semi-structured interview was conducted at the end of the 5-week intervention. The treatment fidelity strategies and finances were reported and evaluated. The Bowen Feasibility Framework guided data analysis into 6 focus areas: acceptability, demand, implementation, efficacy, integration, and practicality. RESULTS: Based on participants' perceptions, findings demonstrated adequate acceptability and demand for robot-led activities. Findings reported a high level of visual engagement (98.54%) and an increased trend of behavior engagement over 5 weeks. Participants independently communicated with Adam, with most (97.02%) verbal engagements free of human facilitation. The treatment fidelity strategies regarding the activity delivery, intervention received, and intervention skills are provided alongside the equipment expenses, revealing the feasibility of integrating robot-led activities for people with dementia in aged care facilities. CONCLUSIONS AND IMPLICATIONS: Using human-like robots to independently lead interactive activities for people with dementia at aged care facilities is feasible and acceptable. Although robot-led activities require further improvement, this study explored a practical-driven solution that provided guidelines for developing and implementing robot-led activities in aged care settings. Future studies could replicate similar robot-led activities for further investigation and evaluation. Strategies for multilevel determinants of Adam's implementation based on a context assessment are recommended for future research.