The Brain Health Champion study: A health coaching intervention with mobile technology in older adults with mild cognitive impairment or risk factors for dementia

Abstract

Background There is growing evidence that adherence to brain‐healthy behaviors can reduce the rate of cognitive decline and risk of dementia. We previously demonstrated that a health coaching intervention, including weekly phone calls, facilitated adherence to these lifestyle recommendations in older adults with mild cognitive impairment (MCI) or mild dementia. The current study extends this research by including cognitively normal, at‐risk older adults and adding technologies, including a mobile health platform and wearable fitness trackers, to the health coaching intervention. Method Participants, age 60‐79, with MCI or dementia risk factors are being randomized to the Brain Health Champion (BHC) intervention or a counseling and education (CE) control. In BHC, with guidance from a health coach, participants set personalized goals, reinforced by weekly video calls, mobile messaging, one dietitian consult, and 30‐minute in‐person or virtual visits every six weeks. In CE, educational materials sent every six weeks supplement usual care. Changes in physical activity, diet, social/cognitive engagement, neuropsychological test scores, and metrics of behavioral health are being measured over a six‐month intervention period using validated questionnaires, wearable fitness trackers, and photographed food logs. Maintenance of behavior changes is also being assessed six months post‐intervention. Result Twenty participants have been enrolled in the study, with five BHC and six CE participants completing it to date. All participants successfully operated the mobile technology by themselves or with caregivers’ assistance. Data trends show that BHC participants had numerically increased scores on neuropsychological tests, cognitive activities, and photographed Mediterranean diet adherence compared to CE participants. Participation in the study, regardless of program, was associated with increased self‐reported Mediterranean diet adherence. Participants also reported enjoying their respective programs. Four of five BHC participants and four of six CE participants said that they would like if their program was implemented into their regular care. All but one participant reported foreseeing their program having a lasting impact on their health and wellbeing. Conclusion Older adults with MCI or dementia risk factors are able to manage the requirements of either the BHC or CE program. Trends in the data indicate that the BHC program is particularly well‐suited for promoting adherence to brain‐healthy behaviors.

Neurocognitive Effects of an Online Brain Health Program and Weekly Telehealth Support Group in Older Adults with Subjective Memory Loss: A Pilot Study

“…This innovative intervention led to improvements in global cognition, spatial planning, and visuospatial processing. These results, especially improvements in global cognition, are consistent with prior studies assessing the cognitive benefits of health coaching, including in those with cognitive impairments [ 14 , 16 , 27 ]. This format may be effective in promoting behavior change that slows cognitive decline and aligns with prior research that incorporates technology into health coaching interventions aimed at improving brain health outcomes [ 15 , 16 , 27 ].…”

“…It is also worth noting that our study was conducted successfully during the COVID-19 pandemic. Based on the result of this pilot study and previous research, online and mobile health coaching programs are feasible for individuals with cognitive complaints, and may lead to improvements in cognition, with the potential to be implemented into routine medical care [ 27 , 36 ].…”