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Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404:572-628. [PMID: 39096926 DOI: 10.1016/s0140-6736(24)01296-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/08/2024] [Accepted: 06/16/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - David Ames
- National Ageing Research Institute, Melbourne, VIC, Australia; University of Melbourne Academic Unit for Psychiatry of Old Age, Melbourne, VIC, Australia
| | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Nick C Fox
- The Dementia Research Centre, Department of Neurodegenerative Disease, University College London, London, UK
| | - Cleusa P Ferri
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Laura N Gitlin
- College of Nursing and Health Professions, AgeWell Collaboratory, Drexel University, Philadelphia, PA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Noeline Nakasujja
- Department of Psychiatry College of Health Sciences, Makerere University College of Health Sciences, Makerere University, Kampala City, Uganda
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Kokoro Shirai
- Graduate School of Social and Environmental Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK; Université Paris Cité, Inserm U1153, Paris, France
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Sebastian Walsh
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Yao Yao
- China Center for Health Development Studies, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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Firth J, Torous J, López-Gil JF, Linardon J, Milton A, Lambert J, Smith L, Jarić I, Fabian H, Vancampfort D, Onyeaka H, Schuch FB, Firth JA. From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions. World Psychiatry 2024; 23:176-190. [PMID: 38727074 PMCID: PMC11083903 DOI: 10.1002/wps.21188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.
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Affiliation(s)
- Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - John Torous
- Division of Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - José Francisco López-Gil
- One Health Research Group, Universidad de las Americas, Quito, Ecuador
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jake Linardon
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Alyssa Milton
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Australian Research Council, Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
| | | | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ivan Jarić
- Laboratoire Ecologie, Systématique et Evolution, Université Paris-Saclay, Gif-sur-Yvette, France
- Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Hannah Fabian
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Henry Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Health Sciences, Universidad Autônoma de Chile, Providência, Chile
| | - Josh A Firth
- Department of Biology, University of Oxford, Oxford, UK
- School of Biology, University of Leeds, Leeds, UK
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Glatt RM, Amos A, Merrill DA, Hodes JF, Wong CL, Miller KJ, Siddarth P. Neurocognitive Effects of an Online Brain Health Program and Weekly Telehealth Support Group in Older Adults with Subjective Memory Loss: A Pilot Study. Geriatrics (Basel) 2024; 9:37. [PMID: 38525754 PMCID: PMC10961747 DOI: 10.3390/geriatrics9020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/26/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION Adopting healthy lifestyle behaviors has the potential to slow cognitive decline in older adults by reducing risks associated with dementia. Curriculum-based group health coaching may aid in establishing behavior change centered for dementia risk factors. METHODS In this pilot clinical care patient group study (n = 6), we examined the effects of a six-month online Cognitive Health Program combined with a weekly telehealth support group led by the course creator, and personalized health optimization by a collaborating physician, in older adults with subjective cognitive decline. Cognition was assessed at baseline and post-intervention using a computerized battery. RESULTS Cognitive changes were estimated with nonparametric tests and effect sizes (Cohen's d). Results showed significant improvements in global cognition (p < 0.03, d = 1.6), spatial planning (p < 0.01, d = 2.3), and visuospatial processing (p < 0.05, d = 1.1) compared to baseline. Participants reported high levels of satisfaction with the virtual group format and online curriculum. CONCLUSIONS This small pilot study suggests that a virtual six-month personalized health coaching group with self-paced online health education is feasible and potentially efficacious for improving cognition in participants with subjective cognitive complaints. This format may facilitate behavior change to slow cognitive decline. Future studies should include a control group, a larger, more diverse sample as well as assessing mood and other subjective measures.
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Affiliation(s)
- Ryan M. Glatt
- Pacific Neuroscience Institute and Foundation, Santa Monica, CA 90404, USA; (R.M.G.); (D.A.M.); (K.J.M.)
| | | | - David A. Merrill
- Pacific Neuroscience Institute and Foundation, Santa Monica, CA 90404, USA; (R.M.G.); (D.A.M.); (K.J.M.)
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
- Providence Saint John’s Cancer Institute, Santa Monica, CA 90404, USA
| | - John F. Hodes
- College of Medicine, Drexel University, Philadelphia, PA 19104, USA;
| | - Claudia L. Wong
- Pacific Neuroscience Institute and Foundation, Santa Monica, CA 90404, USA; (R.M.G.); (D.A.M.); (K.J.M.)
| | - Karen J. Miller
- Pacific Neuroscience Institute and Foundation, Santa Monica, CA 90404, USA; (R.M.G.); (D.A.M.); (K.J.M.)
| | - Prabha Siddarth
- Pacific Neuroscience Institute and Foundation, Santa Monica, CA 90404, USA; (R.M.G.); (D.A.M.); (K.J.M.)
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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Chen Q, Ji H, Shang Q. The association between the diversity of online activities on smartphones and cognitive function among middle-aged and elderly Chinese adults. BMC Public Health 2024; 24:547. [PMID: 38383336 PMCID: PMC10882890 DOI: 10.1186/s12889-024-17932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Many studies have shown that using smartphones can improve cognitive function, but no studies have shown the effect of the diversity of online activities on cognitive function. Therefore, this study explores the association between the diversity of online activity on smartphones and cognitive function among middle-aged and elderly Chinese adults. METHODS A total of 13,347 Chinese middle-aged and elderly participants were used in the final analysis. Multivariate linear regression models were used to explore the relationships among the frequency of smartphone use, number of online activities, various activities, and cognitive function. RESULTS We found that 2,143 respondents (16.1%) used smartphones, and the top three online activities were watching news (80.3%), posting moments (72.4%), and chatting (68.0%) among all smartphone users to access the internet. After adjusting for all covariates, we found that the increase in the frequency of smartphone use and the number of online activities were correlated with a higher cognitive score. Moreover, some online activities, such as watching news (β:0.5, 95% CI:0.2-0.8), posting moments (β:0.4, 95% CI:0.2-0.7) playing games (β:0.3, 95% CI:0.03-0.6) and making mobile payments (β:0.3, 95% CI:0.1-0.5) were independently associated with good cognitive function. DISCUSSION In the middle-aged and elderly population, smartphone use plays an important role in cognitive function. Considering the increasing prevalence of smartphones among middle-aged and elderly individuals, this study can provide references and insights for health education and in-depth scientific research related to internet usage.
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Affiliation(s)
- Qian Chen
- College of Chinese Medicine, Shandong University of Traditional Chinese Medicine, 250300, Jinan, Shandong Province, China
| | - Haoqiang Ji
- School of Public Health, Shandong University, 250012, Jinan, Shandong Province, China.
- Shandong University, 44 West Wenhua Road, Lixia District, Jinan City, Shandong Province, China.
| | - Qingxin Shang
- College of Chinese Medicine, Shandong University of Traditional Chinese Medicine, 250300, Jinan, Shandong Province, China.
- Shandong University of Traditional Chinese Medicine, 4655 Daxue Road, Changqing District, Jinan City, Shandong Province, China.
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Wang T, Giunti G, Goossens R, Melles M. Timing, Indicators, and Approaches to Digital Patient Experience Evaluation: Umbrella Systematic Review. J Med Internet Res 2024; 26:e46308. [PMID: 38315545 PMCID: PMC10877490 DOI: 10.2196/46308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/05/2023] [Accepted: 11/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The increasing prevalence of DH applications has outpaced research and practice in digital health (DH) evaluations. Patient experience (PEx) was reported as one of the challenges facing the health system by the World Health Organization. To generate evidence on DH and promote the appropriate integration and use of technologies, a standard evaluation of PEx in DH is required. OBJECTIVE This study aims to systematically identify evaluation timing considerations (ie, when to measure), evaluation indicators (ie, what to measure), and evaluation approaches (ie, how to measure) with regard to digital PEx. The overall aim of this study is to generate an evaluation guide for further improving digital PEx evaluation. METHODS This is a 2-phase study parallel to our previous study. In phase 1, literature reviews related to PEx in DH were systematically searched from Scopus, PubMed, and Web of Science databases. Two independent raters conducted 2 rounds of paper screening, including title and abstract screening and full-text screening, and assessed the interrater reliability for 20% (round 1: 23/115 and round 2: 12/58) random samples using the Fleiss-Cohen coefficient (round 1: k1=0.88 and round 2: k2=0.80). When reaching interrater reliability (k>0.60), TW conducted the rest of the screening process, leaving any uncertainties for group discussions. Overall, 38% (45/119) of the articles were considered eligible for further thematic analysis. In phase 2, to check if there were any meaningful novel insights that would change our conclusions, we performed an updated literature search in which we collected 294 newly published reviews, of which 102 (34.7%) were identified as eligible articles. We considered them to have no important changes to our original results on the research objectives. Therefore, they were not integrated into the synthesis of this review and were used as supplementary materials. RESULTS Our review highlights 5 typical evaluation objectives that serve 5 stakeholder groups separately. We identified a set of key evaluation timing considerations and classified them into 3 categories: intervention maturity stages, timing of the evaluation, and timing of data collection. Information on evaluation indicators of digital PEx was identified and summarized into 3 categories (intervention outputs, patient outcomes, and health care system impact), 9 themes, and 22 subthemes. A set of evaluation theories, common study designs, data collection methods and instruments, and data analysis approaches was captured, which can be used or adapted to evaluate digital PEx. CONCLUSIONS Our findings enabled us to generate an evaluation guide to help DH intervention researchers, designers, developers, and program evaluators evaluate digital PEx. Finally, we propose 6 directions for encouraging further digital PEx evaluation research and practice to address the challenge of poor PEx.
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Affiliation(s)
- Tingting Wang
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Guido Giunti
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Clinical Medicine Neurology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Richard Goossens
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Marijke Melles
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Zülke AE, Luppa M, van Boxtel M, Deckers K, Heger I, Köhler S, Riedel-Heller SG. Older adults' awareness of modifiable risk and protective factors for dementia and interest in eHealth interventions for brain health: a comparison between the Netherlands and Germany. BMC Public Health 2023; 23:2321. [PMID: 37996822 PMCID: PMC10668348 DOI: 10.1186/s12889-023-17247-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Evidence on modifiable risk factors for dementia is accumulating rapidly, including e.g. smoking, hypertension, and diabetes. Comparing knowledge of risk factors for dementia and factors associated with knowledge and motivation to learn about dementia risk reduction in different countries may support the design of tailored public health campaigns. We investigated (1) differences in knowledge of risk and protective factors for dementia between the Netherlands and Germany, and interest in (2) information on brain health and (3) eHealth for brain health. MATERIALS AND METHODS Population-based telephone (Germany) or web-based surveys (Netherlands) were conducted among adults aged 60-75 (ntotal=614; Germany: n = 270; Netherlands: n = 344), assessing sociodemographic factors, knowledge of risk and protective factors for dementia, interest in information on brain health and respective eHealth-tools. Correlates of knowledge, interest in information on brain health and eHealth for brain health were analyzed using multivariable regression, by country and in pooled analyses. RESULTS In the total sample (Mage: 67.3 (SD: 4.3) years; %female: 48.6), knowledge of risk and protective factors (sum score assessing number of correctly identified factors) was higher among German participants (M (SD) = 7.6 (2.5) vs. 6.0 (4.3), p < .001). This was confirmed using linear regression analyses, controlling for sociodemographic covariates (b = 1.51; 95% CI: 1.00; 2.01). High education was linked to better knowledge of risk and protective factors (b = 1.61; 95% CI: 0.89; 2.34). Controlling for covariates, interest in information on brain health (OR: 0.05, 95% CI: 0.02; 0.09) and eHealth for brain health (OR: 0.40, 95% CI: 0.25; 0.65) was lower in German participants. Widowed participants were less interested in information on brain health, while widowed and single participants expressed less interest in eHealth for brain health in pooled analyses. Further associations between sociodemographic factors, interest in information on brain health and eHealth for brain health by country were detected. DISCUSSION Engaging older adults in the design of eHealth interventions and cooperation with trusted sources, e.g., general practitioners, might enhance appreciation of eHealth for brain health. Education on risk and protective factors for dementia is warranted in both countries. However, differences in recruitment and assessment need to be acknowledged.
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Affiliation(s)
- Andrea E Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Irene Heger
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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Wittich W, Kröger E, Aubin G, Fadhlaoui A, Anderson ND, Ben Gaied N, Itzhak I, Belleville S. Using co-creation focus groups to customise a remote multidomain programme designed to increase dementia literacy. BMJ Open 2023; 13:e074555. [PMID: 37709333 PMCID: PMC10921908 DOI: 10.1136/bmjopen-2023-074555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES To adapt the content and functionalities of Brain Health PRO, a web-based multidomain program designed to increase dementia literacy, to the context and needs of users, providers and community organisations across Québec, Canada. DESIGN Five consecutive qualitative co-creation focus group sessions 30-90 min in duration each, exploring potential barriers and facilitators to usability, accessibility, comprehensibility, participant recruitment and retention. SETTING Virtual meetings. PARTICIPANTS A 15-member team based in Québec and Ontario, Canada, consisting of 9 researchers (including a graduate student and the project coordinator), representing occupational therapy, sensory rehabilitation, neuropsychology, psychology, health science and research methods, 3 informal caregivers of older adults living with cognitive decline and 3 members of the Federation of Quebec Alzheimer Societies. DATA ANALYSIS Session recordings were summarised through both qualitative description and thematic analysis. RESULTS The synthesised recommendations included adjustments around diversity, the complexity and presentation styles of the materials, suggestions on refining the web interface and the measurement approaches; it influenced aspects of participant recruitment, retention efforts and engagement with the content of Brain Health PRO. CONCLUSIONS Co-creation in dementia prevention research is important because it involves collaboration between researchers, community support and service providers, and persons with lived experience as care providers, in the design and implementation of clinical studies. This approach helps to ensure that the content and presentation of educational material is relevant and meaningful to the target population and those involved in its delivery, and it leads to a greater understanding of their needs and perspectives.
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Affiliation(s)
- Walter Wittich
- School of Optometry, Universite de Montreal, Montreal, Québec, Canada
| | - Edeltraut Kröger
- Laval University Research Center on Primary Care and Services, Centre integre universitaire de sante et de services sociaux de la Capitale-Nationale, Quebec, Québec, Canada
| | - Gabrielle Aubin
- Department of Psychology, Universite de Montreal, Montreal, Québec, Canada
| | - Asma Fadhlaoui
- Institut Universitaire de Gériatrie de Montréal, Centre intégré universitairede santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
| | - Nicole D Anderson
- Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Academy of Research and Eduction, Toronto, Ontario, Canada
| | - Nouha Ben Gaied
- Fédération québécoise des Sociétés Alzheimer, Montreal, Québec, Canada
| | - Inbal Itzhak
- Lady Davis Institute, Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l'Île-de-Montréal, Montreal, Québec, Canada
| | - Sylvie Belleville
- Department of Psychology, Universite de Montreal, Montreal, Québec, Canada
- Institut Universitaire de Gériatrie de Montréal, Centre intégré universitairede santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Québec, Canada
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Kira IA, Alpay EH, Shuwiekh HAM, Türkeli A. A type
III
continuous trauma perspective on the effects of increased ongoing hostility, discrimination, community violence and poverty on refugees' mental health and cognitive functioning: A longitudinal study. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2023. [DOI: 10.1002/casp.2693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Heger I, Deckers K, de Vugt M, Verhey F, Oenema A, van Boxtel M, Köhler S. Using mHealth for Primary Prevention of Dementia: A Proof-of-Concept Study on Usage Patterns, Appreciation, and Beliefs and Attitudes Regarding Prevention. J Alzheimers Dis 2023; 94:935-948. [PMID: 37355903 PMCID: PMC10473134 DOI: 10.3233/jad-230225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Health- and lifestyle factors account for a substantial part of all dementia cases, which opens the opportunity for primary prevention. However, the required behavioral change is complex and involves targeting multiple risk factors. mHealth interventions can potentially contribute to improving motivation in a low-cost and scalable way. OBJECTIVE To explore usage patterns, appreciation, and beliefs and attitudes regarding dementia risk reduction during the use of the MyBraincoach mobile app. METHODS Participants were community-dwelling middle-aged adults from the Netherlands and used either the standard (education) or extended (education+motivational triggers) app version for three months. Two panel studies were combined in this paper. Chi-square tests, t-tests and linear mixed models were used, adjusted for age, sex, and education. RESULTS Of all participants (n = 299, 50.2% male), 167 (55.9%) had installed the app. The most reported reason for non-use was technical problems (47%). Those who used the app were at baseline already more positive about dementia risk reduction than those who did not use the app. Of all users who completed the evaluation (n = 102), 78.4% (n = 80) stated that the app provided a positive approach towards brain health and 80.4% (n = 82) felt better informed. Younger (<60y) and lower educated participants evaluated the app most positively. CONCLUSION Usage of the app was low, but users showed more positive beliefs and attitudes regarding dementia risk reduction. Most users evaluated the app positively and stated to have gained knowledge on the topic. Improving the use of the app must keep high priority in future studies.
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Affiliation(s)
- Irene Heger
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anke Oenema
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute Maastricht, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Andre L, Giulioli C, Piau A, Bongard V, Richard E, Moll van Charante EP, Coley N, Andrieu S. Telephone and Smartphone-Based Interventions for Cognitive and Cardio-Metabolic Health in Middle-Aged and Older Adults: A Systematic Review. Clin Interv Aging 2022; 17:1599-1624. [PMID: 36393902 PMCID: PMC9661915 DOI: 10.2147/cia.s352137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/10/2022] [Indexed: 11/01/2023] Open
Abstract
PURPOSE Dementia and cardio-metabolic diseases share many risk factors. Management of these risk factors could contribute to successful aging, including the prevention of cardio-metabolic disease and dementia. The increasing use of smartphones offers an opportunity for remote preventive interventions. We provided a systematic review of telephone and smartphone-based interventions targeting the prevention of cognitive decline, dementia cardio-metabolic diseases or their risk factors among adults aged over 50 years. PATIENTS AND METHODS We searched Pubmed and the International Clinical Trials Registry Platform for experimental studies. We used the Cochrane risk-of-bias tool (Version 2) for randomized trials or TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) checklists to assess study quality for completed studies. RESULTS We analyzed 21 completed (3 for cognition, 18 for cardio-metabolic outcomes) and 50 ongoing studies (23 for cognition, 27 for cardio-metabolic outcomes). Smartphone interventions were used in 26 studies (3 completed, 23 ongoing). Other interventions involved telephone vocal support and text messaging. Few studies were at low risk of bias. There were heterogeneous cognitive and cardio-metabolic outcomes. The highest quality studies found no significant effects on cognition, and inconsistent results for HbA1c, blood pressure or physical activity. The lower quality-studies found effects on global cognition, working memory, memory and language and inconsistent results for clinical, biological or behavioral cardio-metabolic outcomes. CONCLUSION AND IMPLICATIONS Despite the large number of commercially available mobile health applications, the magnitude of the scientific evidence base remains very limited. Based on published studies, the added value of telephone and smartphone tools for the prevention of cardio-metabolic diseases, cognitive decline or dementia is currently uncertain, but, there are several ongoing studies expected to be completed in the coming years.
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Affiliation(s)
- Laurine Andre
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France
- Pole de Geriatrie, University Hospital of Toulouse, UPS, Toulouse, F-31400, France
| | - Caroline Giulioli
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France
| | - Antoine Piau
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France
- Pole de Geriatrie, University Hospital of Toulouse, UPS, Toulouse, F-31400, France
| | - Vanina Bongard
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Edo Richard
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eric P Moll van Charante
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100DD, the Netherlands
| | - Nicola Coley
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Sandrine Andrieu
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - On behalf of the PRODEMOS consortium
- Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France
- Pole de Geriatrie, University Hospital of Toulouse, UPS, Toulouse, F-31400, France
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100DD, the Netherlands
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Knowledge of risk and protective factors for dementia in older German adults A population-based survey on risk and protective factors for dementia and internet-based brain health interventions. PLoS One 2022; 17:e0277037. [PMID: 36342935 PMCID: PMC9639821 DOI: 10.1371/journal.pone.0277037] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Background Evidence on potentially modifiable risk factors for dementia is accumulating rapidly, including e.g. physical inactivity, hypertension, or diabetes. It is unclear to what extent these risk factors are known among the general population in Germany. We investigated knowledge on risk and protective factors for dementia and openness to eHealth interventions for brain health in the older general population in Germany. Methods A population-based telephone survey among randomly selected community-dwelling adults aged ≥ 60 years was conducted. We assessed sociodemographic factors, knowledge on risk and protective factors for dementia, openness towards eHealth and psychosocial outcomes (health literacy, resilience). Factors associated with interest in information on brain health and openness towards eHealth interventions were assessed using multivariable logistic regression. Results Of n = 500 respondents (mean age: 74.8 years, % female: 62.8), 67.9% believed that dementia risk is modifiable. Participants mostly endorsed physical and cognitive activity as protective factors and social isolation as a risk factor. Knowledge on cardiovascular risk factors was low to moderate. 38.0% were interested in information on dementia risk reduction. Better knowledge of risk factors for dementia and higher age were linked to interest in information on brain health. Being widowed and higher levels of health literacy were associated with lower interest in information. Openness to eHealth interventions was moderate (46.2%). Younger age, better knowledge of risk and protective factors were linked to openness towards eHealth tools, as was knowing someone with dementia and interest in information on brain health. Conclusion Belief in preventability of dementia was higher in our sample than previously reported. However, knowledge on cardiovascular risk factors for disease was insufficient and more information and intervention approaches targeted at older adults are needed. Interest in information on dementia risk reduction and eHealth approaches was moderate, and further studies are warranted to assess needs and concerns of older adults regarding dementia prevention.
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Essery R, Pollet S, Bradbury K, Western MJ, Grey E, Denison-Day J, Smith KA, Hayter V, Kelly J, Somerville J, Stuart B, Becque T, Zhang J, Slodkowska-Barabasz J, Mowbray F, Ferrey A, Yao G, Zhu S, Kendrick T, Griffin S, Mutrie N, Robinson S, Brooker H, Griffiths G, Robinson L, Rossor M, Ballard C, Gallacher J, Rathod S, Gudgin B, Phillips R, Stokes T, Niven J, Little P, Yardley L. Parallel randomized controlled feasibility trials of the "Active Brains" digital intervention to protect cognitive health in adults aged 60-85. Front Public Health 2022; 10:962873. [PMID: 36203694 PMCID: PMC9530972 DOI: 10.3389/fpubh.2022.962873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/30/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Multidomain interventions to address modifiable risk factors for dementia are promising, but require more cost-effective, scalable delivery. This study investigated the feasibility of the "Active Brains" digital behavior change intervention and its trial procedures. Materials and methods Active Brains aims to reduce cognitive decline by promoting physical activity, healthy eating, and online cognitive training. We conducted 12-month parallel-design randomized controlled feasibility trials of "Active Brains" amongst "lower cognitive scoring" (n = 180) and "higher cognitive scoring" (n = 180) adults aged 60-85. Results We collected 67.2 and 76.1% of our 12-month primary outcome (Baddeley verbal reasoning task) data for the "lower cognitive score" and "higher cognitive score" groups, respectively. Usage of "Active Brains" indicated overall feasibility and satisfactory engagement with the physical activity intervention content (which did not require sustained online engagement), but engagement with online cognitive training was limited. Uptake of the additional brief telephone support appeared to be higher in the "lower cognitive score" trial. Preliminary descriptive trends in the primary outcome data might indicate a protective effect of Active Brains against cognitive decline, but further investigation in fully-powered trials is required to answer this definitively. Discussion Whilst initial uptake and engagement with the online intervention was modest, it was in line with typical usage of other digital behavior change interventions, and early indications from the descriptive analysis of the primary outcome and behavioral data suggest that further exploration of the potential protective benefits of Active Brains are warranted. The study also identified minor modifications to procedures, particularly to improve online primary-outcome completion. Further investigation of Active Brains will now seek to determine its efficacy in protecting cognitive performance amongst adults aged 60-85 with varied levels of existing cognitive performance.
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Affiliation(s)
- Rosie Essery
- University of Southampton, Southampton, United Kingdom,*Correspondence: Rosie Essery
| | | | - Katherine Bradbury
- University of Southampton, Southampton, United Kingdom,NIHR ARC Wessex, Southampton, United Kingdom
| | | | | | | | | | | | - Joanne Kelly
- University of Southampton, Southampton, United Kingdom
| | | | - Beth Stuart
- University of Southampton, Southampton, United Kingdom,Queen Mary University of London, London, United Kingdom
| | - Taeko Becque
- University of Southampton, Southampton, United Kingdom
| | - Jin Zhang
- University of Southampton, Southampton, United Kingdom
| | | | | | - Anne Ferrey
- University of Oxford, Oxford, United Kingdom
| | - Guiqing Yao
- University of Leicester, Leicester, United Kingdom
| | - Shihua Zhu
- University of Southampton, Southampton, United Kingdom
| | - Tony Kendrick
- University of Southampton, Southampton, United Kingdom
| | | | | | | | | | - Gareth Griffiths
- NIHR Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | | | | | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Southampton, United Kingdom
| | - Bernard Gudgin
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Rosemary Phillips
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Tom Stokes
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - John Niven
- Patient and Public Involvement Contributor, University of Southampton, Southampton, United Kingdom
| | - Paul Little
- University of Southampton, Southampton, United Kingdom
| | - Lucy Yardley
- University of Southampton, Southampton, United Kingdom,University of Bristol, Bristol, United Kingdom
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Cohn‐Schwartz E, Finlay JM, Kobayashi LC. Perceptions of societal ageism and declines in subjective memory during the COVID-19 pandemic: Longitudinal evidence from US adults aged ≥55 years. THE JOURNAL OF SOCIAL ISSUES 2022; 78:JOSI12544. [PMID: 36249550 PMCID: PMC9538955 DOI: 10.1111/josi.12544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 05/07/2023]
Abstract
The cognitive health of older adults since the COVID-19 pandemic onset is unclear, as is the potential impact of pandemic-associated societal ageism on perceived cognition. We investigated associations between perceptions of societal ageism and changes in subjective memory over a 10-month period during the COVID-19 pandemic. We collected longitudinal data from monthly online questionnaires in the nationwide COVID-19 Coping Study of US adults aged ≥55 from April 2020 to January 2021 (N = 4444). We analyzed the data using multivariable longitudinal multilevel models. We identified an overall decline in subjective memory, especially in the initial months of the pandemic. Adults who perceived that societal respect for older adults decreased during the pandemic experienced more rapid declines in their subjective memory. These findings suggest that aging adults perceived a decline in their memory, especially during the initial months of the COVID-19 pandemic. Societal interventions to combat ageism may help improve subjective memory and could decrease risk for cognitive decline among middle-aged and older adults.
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Affiliation(s)
- Ella Cohn‐Schwartz
- Epidemiology, Biostatistics, and Community Health SciencesFaculty of Health SciencesBen‐Gurion UniversityBeer‐ShevaIsrael
| | - Jessica M. Finlay
- Center for Social Epidemiology and Population HealthDepartment of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
- Social Environment and Health ProgramSurvey Research CenterUniversity of Michigan Institute for Social ResearchAnn ArborMichiganUSA
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population HealthDepartment of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
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Wang T, Giunti G, Melles M, Goossens R. Digital Patient Experience: Umbrella Systematic Review. J Med Internet Res 2022; 24:e37952. [PMID: 35925651 PMCID: PMC9389377 DOI: 10.2196/37952] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx). OBJECTIVE This study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health. METHODS We performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories. RESULTS The search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx-related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations. CONCLUSIONS We propose the following definition for digital PEx: "Digital patient experience is the sum of all interactions affected by a patient's behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health." In this study, we constructed a design and evaluation framework that contains 4 phases-define design, define evaluation, design ideation, and design evaluation-and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx-related research.
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Affiliation(s)
- Tingting Wang
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Guido Giunti
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Digital Health Design and Development, University of Oulu, Oulu, Finland
| | - Marijke Melles
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Richard Goossens
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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15
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Farrow M, Fair H, Klekociuk SZ, Vickers JC. Educating the masses to address a global public health priority: The Preventing Dementia Massive Open Online Course (MOOC). PLoS One 2022; 17:e0267205. [PMID: 35507576 PMCID: PMC9067672 DOI: 10.1371/journal.pone.0267205] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/04/2022] [Indexed: 02/03/2023] Open
Abstract
Dementia is a global public health priority and risk reduction is an important pillar of the public health response. While 40% of cases are estimated to be attributable to modifiable health and lifestyle risk factors, public awareness of the evidence is low, limiting peoples’ opportunity to adopt risk-reducing behaviours. To address this gap, we designed, implemented, and evaluated an educational intervention, the Preventing Dementia Massive Open Online Course (PDMOOC). This mixed-methods study examined the reach and impact of the free and globally available PDMOOC, to assess its potential to provide effective dementia risk reduction education to a broad international audience. Over 100,000 individuals participated in the PDMOOC across seven iterations from 2016 to 2020, with 55,739 of these consenting to participate in research. Their mean age was 49 years (SD = 15), they came from 167 different countries, and the majority were female (86%), had completed post-secondary education (77%), lived in high-income countries (93%) and worked in health care and social assistance (63%). This demographic profile changed across time, with more men, people with higher education and people from low- and middle-income countries participating in recent course iterations. Two-thirds of participants completed the PDMOOC; completion was associated with being aged 50 to 70 years, residing in a high-income country, having tertiary education, and working in the health sector. Participants reported high levels of satisfaction with the PDMOOC, improved dementia risk reduction understanding and self-efficacy, increased motivation to maintain healthy lifestyles, and, importantly, application of their learning to health behaviour change with the potential to reduce their dementia risk. The PDMOOC educated a large global audience about dementia risk reduction, which contributed to participants making risk-reducing behaviour changes. This suggests MOOCs can be a successful public health strategy to improve dementia risk reduction understanding.
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Affiliation(s)
- Maree Farrow
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
- * E-mail:
| | - Hannah Fair
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Shannon Z. Klekociuk
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - James C. Vickers
- Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Kępka A, Ochocińska A, Borzym-Kluczyk M, Chojnowska S, Skorupa E, Przychodzeń M, Waszkiewicz N. Healthy Food Pyramid as Well as Physical and Mental Activity in the Prevention of Alzheimer’s Disease. Nutrients 2022; 14:nu14081534. [PMID: 35458096 PMCID: PMC9028231 DOI: 10.3390/nu14081534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/05/2023] Open
Abstract
The ageing of the population is resulting in neurodegenerative diseases, including Alzheimer’s disease (AD), which are an increasing social, economic and medical problem. Diet and physical activity are now considered as important modifiable factors that help prevent or delay the development of AD and other dementia-related diseases. The pyramid of healthy nutrition and lifestyle is a way of presenting the principles, the implementation of which gives a chance for proper development and a long healthy life. The basis of the pyramid, in the first place, is physical activity. Our review of the literature in the PubMed database supports the hypothesis that complementary factors, such as proper diet, physical exercise and mental activity, have a positive impact on the prevention of neurodegenerative diseases. The nutritional recommendations for healthy adults primarily include the consumption of vegetables, fruits, cereals, legumes, vegetable oils and fishes. Therefore, the introduction of Mediterranean and Asian diets may reduce the risk of the neurodegenerative diseases associated with dementia, whereas dairy products and meat—the main sources of L-carnitine—should be consumed in moderate amounts. The aim of our work is to provide up-to-date knowledge about the appropriate dietary model and healthy lifestyle elements and their impact on good health and the long life of people.
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Affiliation(s)
- Alina Kępka
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute of Warsaw, 04-730 Warsaw, Poland;
- Correspondence: (A.K.); (A.O.); Tel.: +48-22-815-73-01 (A.O.)
| | - Agnieszka Ochocińska
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute of Warsaw, 04-730 Warsaw, Poland;
- Correspondence: (A.K.); (A.O.); Tel.: +48-22-815-73-01 (A.O.)
| | - Małgorzata Borzym-Kluczyk
- Department of Pharmaceutical Biochemistry, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Sylwia Chojnowska
- Faculty of Health Sciences, Lomza State University of Applied Sciences, 18-400 Lomza, Poland;
| | - Ewa Skorupa
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute of Warsaw, 04-730 Warsaw, Poland;
| | - Małgorzata Przychodzeń
- Department of Psychogeriatry, Independent Public Psychiatric Health Care Institution in Choroszcz, 16-070 Choroszcz, Poland;
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, 15-089 Bialystok, Poland;
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Fair H, Klekociuk S, Eccleston C, Doherty K, Farrow M. Interpersonal Communication May Improve Equity in Dementia Risk Education. Health Promot J Austr 2022; 34:561-569. [PMID: 35355355 DOI: 10.1002/hpja.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED Encouraging people to adopt life-long habits that reduce dementia risk is necessary to manage the growing global prevalence of this condition and is, therefore, a global health priority. Current initiatives promoting risk-reducing behaviour primarily attract participants from a limited range of backgrounds, even if widely available. This may inadvertently increase health inequities, as the people who are most likely to develop dementia are the people who are least involved in risk-reduction initiatives. Interpersonal communication can effectively disseminate health messages to demographically diverse populations and may therefore broaden the reach of dementia risk reduction information. METHODS Coding reliability thematic analysis was used to categorise reports of information sharing provided by participants from one global online dementia risk education initiative, the [course - name removed for blinding]. These reports of information sharing were provided in response to the feedback question: "If you have already applied your [course] learning, please tell us how". RESULTS Information was reportedly shared with a wide range of people, including those from demographic groups that are under-represented among [course] participants. Information about specific risk factors was shared, along with general information about the course and/or dementia risk reduction. Some participants also reported that the people they shared information with were initiating risk-reducing behaviours. CONCLUSION Interpersonal communication has the potential to disseminate dementia risk reduction information to, and promote behaviour change among, a broad group of people at risk of dementia, thereby increasing equity in dementia risk education.
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Affiliation(s)
- Hannah Fair
- Wicking Dementia Research and Education Centre, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, Australia, 7000
| | - Shannon Klekociuk
- Wicking Dementia Research and Education Centre, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, Australia, 7000
| | - Claire Eccleston
- Wicking Dementia Research and Education Centre, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, Australia, 7000
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, Australia, 7000
| | - Maree Farrow
- Wicking Dementia Research and Education Centre, University of Tasmania, 17 Liverpool St, Hobart, Tasmania, Australia, 7000
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Klaming L, Robbemond L, Lemmens P, Hart de Ruijter E. Digital Compensatory Cognitive Training for Older Adults with Memory Complaints. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2044989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Laura Klaming
- Philips Research Brain, Behavior & Cognition High Tech Campus 34, Eindhoven, Netherlands
| | - Lisanne Robbemond
- University of Groningen, University Center of Psychiatry, Groningen, The Netherlands
| | - Paul Lemmens
- Philips Research Brain, Behavior & Cognition High Tech Campus 34, Eindhoven, Netherlands
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Meng X, Fang S, Zhang S, Li H, Ma D, Ye Y, Su J, Sun J. Multidomain lifestyle interventions for cognition and the risk of dementia: A systematic review and meta-analysis. Int J Nurs Stud 2022; 130:104236. [DOI: 10.1016/j.ijnurstu.2022.104236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/12/2022] [Accepted: 03/14/2022] [Indexed: 11/15/2022]
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Castro R, Ribeiro-Alves M, Oliveira C, Romero CP, Perazzo H, Simjanoski M, Kapciznki F, Balanzá-Martínez V, De Boni RB. What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review. Front Public Health 2022; 9:735624. [PMID: 35047469 PMCID: PMC8761632 DOI: 10.3389/fpubh.2021.735624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/29/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change. Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites. Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention-but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.
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Affiliation(s)
- Rodolfo Castro
- Escola Nacional de Saúde Pública Sergio Arouca, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
- Instituto de Saúde Coletiva, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Cátia Oliveira
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Carmen Phang Romero
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Hugo Perazzo
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Mario Simjanoski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapciznki
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Raquel B. De Boni
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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21
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Coley N, Andre L, Hoevenaar-Blom M, Ngandu T, Beishuizen C, Barbera M, van Wanrooij L, Kivipelto M, Soininen H, van Gool WA, Brayne C, Moll van Charante E, Richard E, Andrieu S. Factors predicting engagement of older adults with a coach-supported eHealth intervention promoting lifestyle change, and associations between engagement and changes in cardiovascular and dementia risk: secondary analysis of an 18-month multinational randomized controlled trial. J Med Internet Res 2021; 24:e32006. [PMID: 35385395 PMCID: PMC9127655 DOI: 10.2196/32006] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/08/2021] [Accepted: 12/13/2021] [Indexed: 02/05/2023] Open
Abstract
Background Digital health interventions could help to prevent age-related diseases, but little is known about how older adults engage with such interventions, especially in the long term, or whether engagement is associated with changes in clinical, behavioral, or biological outcomes in this population. Disparities in engagement levels with digital health interventions may exist among older people and be associated with health inequalities. Objective This study aimed to describe older adults’ engagement with an eHealth intervention, identify factors associated with engagement, and examine associations between engagement and changes in cardiovascular and dementia risk factors (blood pressure, cholesterol, BMI, physical activity, diet, and cardiovascular and dementia risk scores). Methods This was a secondary analysis of the 18-month randomized controlled Healthy Ageing Through Internet Counselling in the Elderly trial of a tailored internet-based intervention encouraging behavior changes, with remote support from a lifestyle coach, to reduce cardiovascular and cognitive decline risk in 2724 individuals aged ≥65 years, recruited offline in the Netherlands, Finland, and France. Engagement was assessed via log-in frequency, number of lifestyle goals set, measurements entered and messages sent to coaches, and percentage of education materials read. Clinical and biological data were collected during in-person visits at baseline and 18 months. Lifestyle data were self-reported on a web-based platform. Results Of the 1389 intervention group participants, 1194 (85.96%) sent at least one message. They logged in a median of 29 times, and set a median of 1 goal. Higher engagement was associated with significantly greater improvement in biological and behavioral risk factors, with evidence of a dose-response effect. Compared with the control group, the adjusted mean difference (95% CI) in 18-month change in the primary outcome, a composite z-score comprising blood pressure, BMI, and cholesterol, was −0.08 (−0.12 to −0.03), −0.04 (−0.08 to 0.00), and 0.00 (−0.08 to 0.08) in the high, moderate, and low engagement groups, respectively. Low engagers showed no improvement in any outcome measures compared with the control group. Participants not using a computer regularly before the study engaged much less with the intervention than those using a computer up to 7 (adjusted odds ratio 5.39, 95% CI 2.66-10.95) or ≥7 hours per week (adjusted odds ratio 6.58, 95% CI 3.21-13.49). Those already working on or with short-term plans for lifestyle improvement at baseline, and with better cognition, engaged more. Conclusions Greater engagement with an eHealth lifestyle intervention was associated with greater improvement in risk factors in older adults. However, those with limited computer experience, who tended to have a lower level of education, or who had poorer cognition engaged less. Additional support or forms of intervention delivery for such individuals could help minimize potential health inequalities associated with the use of digital health interventions in older people.
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Affiliation(s)
- Nicola Coley
- Center for Epidemiology and Research in Population health (CERPOP), University of Toulouse UPS, INSERM UMR1295, 37 allées Jules Guesde, Toulouse, FR.,Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, FR
| | - Laurine Andre
- Center for Epidemiology and Research in Population health (CERPOP), University of Toulouse UPS, INSERM UMR1295, 37 allées Jules Guesde, Toulouse, FR
| | - Marieke Hoevenaar-Blom
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, NL.,Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, NL.,Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, NL
| | - Tiia Ngandu
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, FI.,Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, SE
| | - Cathrien Beishuizen
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, NL
| | - Mariagnese Barbera
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, Kuopio, FI.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, GB
| | - Lennard van Wanrooij
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, NL
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, SE.,Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, Kuopio, FI.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, GB.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, FI
| | - Hilkka Soininen
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, Kuopio, FI.,Neurocenter, Neurology, Kuopio University Hospital, Kuopio, FI
| | - Willem A van Gool
- Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, NL
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, GB
| | - Eric Moll van Charante
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, NL.,Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, NL
| | - Edo Richard
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, NL.,Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, NL
| | - Sandrine Andrieu
- Center for Epidemiology and Research in Population health (CERPOP), University of Toulouse UPS, INSERM UMR1295, 37 allées Jules Guesde, Toulouse, FR.,Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, FR
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22
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Essery R, Pollet S, Smith KA, Mowbray F, Slodkowska-Barabasz J, Denison-Day J, Hayter V, Bradbury K, Grey E, Western MJ, Milton A, Hunter C, Ferrey AE, Müller AM, Stuart B, Mutrie N, Griffin S, Kendrick T, Brooker H, Gudgin B, Phillips R, Stokes T, Niven J, Little P, Yardley L. Planning and optimising a digital intervention to protect older adults' cognitive health. Pilot Feasibility Stud 2021; 7:158. [PMID: 34407886 PMCID: PMC8371874 DOI: 10.1186/s40814-021-00884-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND By 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of 'Active Brains': a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults. METHODS During the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional 'guiding principles' and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content. RESULTS Scoping reviews and qualitative interviews suggested that the same intervention content may be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of intervention content and functionality that appeared highly acceptable amongst a sample of target users. CONCLUSIONS A digitally delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.
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Affiliation(s)
- Rosie Essery
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK.
| | - Sebastien Pollet
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Kirsten A Smith
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Fiona Mowbray
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Joanna Slodkowska-Barabasz
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - James Denison-Day
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Victoria Hayter
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | | | | | - Alexander Milton
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Cheryl Hunter
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Anne E Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore.,Centre for Sport & Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Beth Stuart
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Simon Griffin
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tony Kendrick
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Bernard Gudgin
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Rosemary Phillips
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Tom Stokes
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - John Niven
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Paul Little
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK. .,School of Psychological Science, University of Bristol, Bristol, UK.
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23
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Effects of Smartphone-Based Compensatory Cognitive Training and Physical Activity on Cognition, Depression, and Self-Esteem in Women with Subjective Cognitive Decline. Brain Sci 2021; 11:brainsci11081029. [PMID: 34439648 PMCID: PMC8392206 DOI: 10.3390/brainsci11081029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022] Open
Abstract
Subjective cognitive decline is a symptom that may appear in the early stages of Alzheimer’s disease. This study examined the effects of smartphone-based calendar training and walking exercise regimen on postmenopausal women experiencing subjective cognitive decline. Experimental group 1 participated in both calendar training and walking exercise, group 2 participated in calendar training only, and the control group did not receive either intervention. Forty-two participants completed a cognitive function test and questionnaire upon entering the study and 12 weeks later. The controlled oral word association score increased in experimental groups 1 and 2 and decreased in the control group. Memory contentment increased in experimental group 1, maintained in experimental group 2, and decreased in the control group. Smartphone-based calendar training and a walking exercise regimen improved executive function and memory contentment in everyday life, but the effects on depressive symptoms and self-esteem were not significant. Our findings demonstrate that smartphone-based calendar training and walking exercise improved cognitive function and have potential as nonpharmacologic interventions to strengthen cognitive function in women experiencing subjective cognitive decline.
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24
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Drijver AJ, Reijneveld JC, Wesselman LMP, Klein M. A Web-Based Lifestyle Intervention Aimed at Improving Cognition in Patients With Cancer Returning to Work in an Outpatient Setting: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e22670. [PMID: 33900201 PMCID: PMC8111506 DOI: 10.2196/22670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/20/2021] [Accepted: 02/16/2021] [Indexed: 01/19/2023] Open
Abstract
Background A high percentage of patients with cancer experience cognitive impairment after cancer treatment, resulting in a decreased health-related quality of life and difficulty returning to work. Consequently, there is a need for effective treatment options to improve cognitive functioning in these patients. In a healthy aging population, multidomain web-based lifestyle interventions have been found to be effective in preventing cognitive decline and improving cognitive functioning. Objective This study aims to investigate the feasibility and effectiveness of the web-based lifestyle intervention Mijn Fitte Brein (My Fit Brain [MFB]) on cognitive functioning in patients with cancer returning to work. Methods The study consists of a feasibility study (N=10), followed by a randomized controlled trial (RCT; N=220). Patients will be recruited by their occupational physicians after their return to work following cancer treatment. Mijn Fitte Brein is organized into 4-week cycles in which patients set a lifestyle goal using the Goal Attainment Scale, receive weekly tips and support, and finally evaluate whether they succeeded in achieving this goal. Lifestyle goals are based on 6 domains: physical exercise, diet, sleep, stress, alcohol use, and smoking. In the feasibility study, data on user experience (structured interview) and usability, assessed with the Post-Study System Usability Scale, will be collected and used to optimize Mijn Fitte Brein. In the RCT, patients will be randomized 1:1 between an intervention group and a control group. Patients will be assessed at baseline, 3 months, and 6 months. The primary outcome measure is subjective cognitive functioning, assessed with the Functional Assessment of Cancer Therapy–Cognitive Function (FACT-Cog). Secondary outcome measures are lifestyle, objective cognitive functioning, and work and psychosocial factors. Results Recruitment for the feasibility study has started in February 2020. As of July 2020, however, no patients have been enrolled (due to COVID-19 restrictions). The findings of the feasibility study will be used to optimize the Mijn Fitte Brein intervention. Enrollment for the RCT will continue when possible. The feasibility study will take 6 months (including making adjustments to the intervention), and the RCT will take 2 years. The final results are expected in 2024. The results of the feasibility study and the RCT will be published in peer-reviewed journals. Conclusions This is the first time the feasibility and efficacy of a multidomain web-based lifestyle intervention will be studied in patients with cancer. If Mijn Fitte Brein is found to be effective in decreasing cognitive complaints in these patients returning to work, it will be a promising treatment option because of being both affordable and accessible. Trial Registration Netherlands Trial Register NL8407; https://www.trialregister.nl/trial/8407 International Registered Report Identifier (IRRID) DERR1-10.2196/22670
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Affiliation(s)
- A Josephine Drijver
- Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jaap C Reijneveld
- Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
| | - Linda M P Wesselman
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Martin Klein
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Medical Psychology, Amsterdam UMC, Amsterdam, Netherlands
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25
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Friedman BB, Suri S, Solé-Padullés C, Düzel S, Drevon CA, Baaré WFC, Bartrés-Faz D, Fjell AM, Johansen-Berg H, Madsen KS, Nyberg L, Penninx BWJH, Sexton C, Walhovd KB, Zsoldos E, Budin-Ljøsne I. Are People Ready for Personalized Brain Health? Perspectives of Research Participants in the Lifebrain Consortium. THE GERONTOLOGIST 2021; 60:1050-1059. [PMID: 31682729 PMCID: PMC7427479 DOI: 10.1093/geront/gnz155] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives A healthy brain is central to physical and mental well-being. In this multi-site, qualitative study, we investigated views and attitudes of adult participants in brain research studies on the brain and personalized brain health as well as interest in maintaining a healthy brain. Design and Methods We conducted individual interviews with 44 adult participants in brain research cohorts of the Lifebrain consortium in Spain, Norway, Germany, and the United Kingdom. The interviews were audio recorded, transcribed, and coded using a cross-country codebook. The interview data were analyzed using qualitative content analysis. Results Most participants did not focus on their own brain health and expressed uncertainty regarding how to maintain it. Those actively focusing on brain health often picked one specific strategy like diet or memory training. The participants were interested in taking brain health tests to learn about their individual risk of developing brain diseases, and were willing to take measures to maintain their brain health if personalized follow-up was provided and the measures had proven impact. The participants were interested in more information on brain health. No differences in responses were identified between age groups, sex, or countries. Discussion and Implications Concise, practical, personalized, and evidence-based information about the brain may promote brain health. Based on our findings, we have launched an ongoing global brain health survey to acquire more extensive, quantitative, and representative data on public perception of personalized brain health.
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Affiliation(s)
- Barbara Bodorkos Friedman
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway
| | - Sana Suri
- Department of Psychiatry and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Cristina Solé-Padullés
- Department of Medicine, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - Sandra Düzel
- Max Planck Institute for Human Development, Berlin, Germany
| | - Christian A Drevon
- Vitas AS, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre,Denmark
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences and Neuroscience Institute, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway
| | | | - Kathrine S Madsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Lars Nyberg
- Centre for Functional Brain Imaging, Umeå Universitet, Sweden
| | | | - Claire Sexton
- Department of Psychiatry and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK.,Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, Oslo, Norway
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway
| | - Enikő Zsoldos
- Department of Psychiatry and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Isabelle Budin-Ljøsne
- Center for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway.,Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
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26
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Neal DP, Kerkhof YJF, Ettema TP, Muller M, Bosmans J, Finnema E, Graff M, Dijkstra K, Stek ML, Dröes RM. Evaluation of FindMyApps: protocol for a randomized controlled trial of the effectiveness and cost-effectiveness of a tablet-based intervention to improve self-management and social participation of community-dwelling people with mild dementia, compared to usual tablet use. BMC Geriatr 2021; 21:138. [PMID: 33627069 PMCID: PMC7903400 DOI: 10.1186/s12877-021-02038-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 01/19/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND For the rising number of people living with dementia, cost-effective community-based interventions to support psychosocial care are needed. The FindMyApps intervention has been developed with and for people with dementia and their caregivers, to help them use tablets to facilitate self-management and engagement in meaningful social activities. A feasibility study and exploratory pilot trial evaluating FindMyApps have been carried out. This definitive trial further evaluates the effectiveness of the intervention and, for the first time, the cost-effectiveness. METHODS A randomized controlled non-blinded single-center two-arm superiority trial will be conducted. Community-dwelling people with Mild Cognitive Impairment (MCI), or dementia with a Mini Mental-State Examination (MMSE) of > 17 and < 26, or Global Deterioration Scale 3 or 4, with an informal caregiver and access to a wireless internet connection will be included. In total, 150 patient-caregiver dyads will be randomly allocated to receive either usual care (control arm - tablet computer; n = 75 dyads) or usual care and the FindMyApps intervention (experimental arm - tablet computer and FindMyApps; n = 75 dyads). The primary outcomes are: for people with dementia, self-management and social participation; for caregivers, sense of competence. In addition to a main effect analysis, a cost-effectiveness analysis will be performed. In line with MRC guidance for evaluation of complex interventions a process evaluation will also be undertaken. DISCUSSION Results of the trial are expected to be available in 2023 and will be submitted for publication in international peer-reviewed scientific journals, in addition to conference presentations and reporting via the EU Marie Sklodowska-Curie DISTINCT ITN network. By providing evidence for or against the effectiveness and cost-effectiveness of the FindMyApps intervention, the results of the trial will influence national implementation of FindMyApps. We hope that the results of the trial will further stimulate research and development at the intersection of technology and psycho-social care in dementia. We hope to further demonstrate that the randomized controlled trial is a valuable and feasible means of evaluating new digital technologies, to stimulate further high-quality research in this growing field. TRIAL REGISTRATION NUMBER Netherlands Trial Register: NL8157 ; registered 15th November 2019.
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Affiliation(s)
- David Peter Neal
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
| | | | - Teake P Ettema
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
| | - Majon Muller
- Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Judith Bosmans
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Evelyn Finnema
- University Medical Centre Groningen, Groningen, Netherlands
| | - Maud Graff
- Radboud University Medical Centre, Nijmegen, Netherlands
| | - Karin Dijkstra
- Saxion University of Applied Sciences, Deventer, Netherlands
| | - Max L Stek
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands
- Department of Old Age Psychiatry, GGZ inGeest, Amsterdam, Netherlands
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Centers, location VUmc, Amsterdam, Netherlands.
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27
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de Souto Barreto P, Pothier K, Soriano G, Lussier M, Bherer L, Guyonnet S, Piau A, Ousset PJ, Vellas B. A Web-Based Multidomain Lifestyle Intervention for Older Adults: The eMIND Randomized Controlled Trial. J Prev Alzheimers Dis 2021; 8:142-150. [PMID: 33569560 PMCID: PMC7754697 DOI: 10.14283/jpad.2020.70] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Importance/Objective: To describe the feasibility and acceptability of a 6-month web-based multidomain lifestyle training intervention for community-dwelling older people and to test the effects of the intervention on both function- and lifestyle-related outcomes. DESIGN 6-month, parallel-group, randomized controlled trial (RCT). SETTING Toulouse area, South-West, France. PARTICIPANTS Community-dwelling men and women, ≥ 65 years-old, presenting subjective memory complaint, without dementia. INTERVENTION The web-based multidomain intervention group (MIG) received a tablet to access the multidomain platform and a wrist-worn accelerometer measuring step counts; the control group (CG) received only the wrist-worn accelerometer. The multidomain platform was composed of nutritional advices, personalized exercise training, and cognitive training. Main outcomes and measures: Feasibility, defined as the proportion of people connecting to ≥75% of the prescribed sessions, and acceptability, investigated through content analysis from recorded semi-structured interviews. Secondary outcomes included clinical (eg, cognitive function, mobility, health-related quality of life (HRQOL)) and lifestyle (eg, step count, food intake) measurements. RESULTS Among the 120 subjects (74.2 ±5.6 years-old; 57.5% women), 109 completed the study (n=54, MIG; n=55, CG). 58 MIG subjects connected to the multidomain platform at least once; among them, adherers of ≥75% of sessions varied across multidomain components: 37 people (63.8% of 58 participants) for cognitive training, 35 (60.3%) for nutrition, and three (5.2%) for exercise; these three persons adhered to all multidomain components. Participants considered study procedures and multidomain content in a positive way; the most cited weaknesses were related to exercise: too easy, repetitive, and slow progression. Compared to controls, the intervention had a positive effect on HRQOL; no significant effects were observed across the other clinical and lifestyle outcomes. CONCLUSIONS AND RELEVANCE Providing multidomain lifestyle training through a web-platform is feasible and well-accepted, but the training should be challenging enough and adequately progress according to participants' capabilities to increase adherence. Recommendations for a larger on-line multidomain lifestyle training RCT are provided.
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Affiliation(s)
- P de Souto Barreto
- Professor Philipe de Souto Barreto, Gérontopôle de Toulouse, Institut du Vieillissement, 37 Allées Jules Guesde, F-31000 Toulouse, France, Phone: (+33) 561 145 668, Fax: (+33) 561 145 640, e-mail:
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28
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Salmoirago-Blotcher E, Trivedi D, Dunsiger S, Harris K, Breault C, Yang Santos C, Walaska K, Snyder P, Cohen R. Exploring Effects of Aerobic Exercise and Mindfulness Training on Cognitive Function in Older Adults at Risk of Dementia: A Feasibility, Proof-of-Concept Study. Am J Alzheimers Dis Other Demen 2021; 36:15333175211039094. [PMID: 34797188 PMCID: PMC10581144 DOI: 10.1177/15333175211039094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study sought to explore feasibility, acceptability, and preliminary effects of aerobic training (AT), mindfulness training (MT), or both (MT + AT) on cognitive function in older individuals at risk of dementia. METHOD Participants were randomized to AT, MT, both, or usual care (UC). Z-scores of attention, verbal fluency, and episodic memory for non-demented adults (ZAVEN) were computed at baseline, end of treatment (EOT), and 6 months since baseline. RESULTS Of the 36 enrolled participants (12 M, 24 F, mean age = 70.1 years), 97% were retained in the study at 6 months. At EOT, MT had higher ZAVEN scores than UC (b = .43, P =.03) and AT (b = .26, P = .10), while no differences were seen with MT + AT. A similar pattern was observed at a 6 month follow-up (all P values = .10). DISCUSSION MT may improve cognitive function in older individuals at risk of dementia. These preliminary findings need to be confirmed in a fully powered RCT.
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Affiliation(s)
- Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Dyuti Trivedi
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Shira Dunsiger
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, RI, USA
| | - Kristie Harris
- Department of Internal Medicine, Yale School of Medicine, West Haven, CT, USA
| | - Christopher Breault
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Cláudia Yang Santos
- Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI, USA
| | - Kristen Walaska
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Peter Snyder
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, RI, USA
| | - Ronald Cohen
- Cognitive Aging and Memory Program, McKnight Institute on Aging, University of Florida, Gainesville, FL, USA
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29
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Belleville S, Cuesta M, Bieler-Aeschlimann M, Giacomino K, Widmer A, Mittaz Hager AG, Perez-Marcos D, Cardin S, Boller B, Bier N, Aubertin-Leheudre M, Bherer L, Berryman N, Agrigoroaei S, Demonet JF. Rationale and protocol of the StayFitLonger study: a multicentre trial to measure efficacy and adherence of a home-based computerised multidomain intervention in healthy older adults. BMC Geriatr 2020; 20:315. [PMID: 32859156 PMCID: PMC7453698 DOI: 10.1186/s12877-020-01709-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/16/2020] [Indexed: 11/22/2022] Open
Abstract
Background In older adults, multidomain training that includes physical and cognitive activities has been associated with improvement of physical and cognitive health. The goal of the multisite StayFitLonger study is to assess a home-based computerised training programme, which combines physical exercises, stimulating cognitive activities and virtual coaching. Methods One hundred twenty-eight cognitively healthy older adults will be recruited from the community in Switzerland, Canada and Belgium. The study will comprise (1) a 26-week double-blind randomized controlled efficacy trial and (2) a 22-week pragmatic adherence sub-study. In the efficacy trial, participants will be randomly assigned to an experimental or an active control intervention. In the experimental intervention, participants will use the StayFitLonger programme, which is computerised on a tablet and provides content that combines physical activities with a focus on strength and balance, as well as divided attention, problem solving and memory training. Outcomes will be measured before and after 26 weeks of training. The primary efficacy outcome will be performance on the “Timed-Up & Go” test. Secondary outcomes will include measures of frailty, cognition, mood, fear of falling, quality of life, and activities of daily living. Age, sex, education, baseline cognition, expectation, and adherence will be used as moderators of efficacy. Following the 26-week efficacy trial, all participants will use the experimental programme meaning that participants in the control group will ‘cross over’ to receive the StayFitLonger programme for 22 weeks. Adherence will be measured in both groups based on dose, volume and frequency of use. In addition, participants’ perception of the programme and its functionalities will be characterised through usability, acceptability and user experience. Discussion This study will determine the efficacy, adherence and participants’ perception of a home-based multidomain intervention programme and its functionalities. This will allow for further development and possible commercialization of a scientifically validated training programme. Trial registration ClinicalTrials.gov, NCT04237519 Registered on January 22, 2020 - Retrospectively registered.
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Affiliation(s)
- S Belleville
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada. .,Université de Montréal, Montréal, Canada.
| | - M Cuesta
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada
| | - M Bieler-Aeschlimann
- Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland.,MindMaze SA, Lausanne, Switzerland
| | - K Giacomino
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | - A Widmer
- HES-SO Valais-Wallis, School of Managment, Sierre, Switzerland
| | - A G Mittaz Hager
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | | | - S Cardin
- MindMaze SA, Lausanne, Switzerland
| | - B Boller
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - N Bier
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université de Montréal, Montréal, Canada
| | - M Aubertin-Leheudre
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Montréal, Montréal, Canada
| | - L Bherer
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université de Montréal, Montréal, Canada.,Montréal Heart Institute, Montréal, Canada
| | - N Berryman
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Montréal, Montréal, Canada
| | - S Agrigoroaei
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - J F Demonet
- Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland
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30
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Frisoni GB, Molinuevo JL, Altomare D, Carrera E, Barkhof F, Berkhof J, Delrieu J, Dubois B, Kivipelto M, Nordberg A, Schott JM, van der Flier WM, Vellas B, Jessen F, Scheltens P, Ritchie C. Precision prevention of Alzheimer's and other dementias: Anticipating future needs in the control of risk factors and implementation of disease-modifying therapies. Alzheimers Dement 2020; 16:1457-1468. [PMID: 32815289 DOI: 10.1002/alz.12132] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 05/02/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022]
Abstract
Empirical evidence suggests that a fair proportion of dementia cases are preventable, that some preventive actions can be taken immediately, and others may soon be implemented. Primary prevention may target cognitively normal persons with modifiable risk factors through lifestyle and multiple domain interventions (including general cardiovascular health). While the effect on individuals may be modest, it might have a large societal impact by decreasing overall dementia incidence by up to 35%. Secondary prevention will target cognitively normal persons at high risk of dementia due to Alzheimer's disease pathology with future anti-amyloid, anti-tau, or other drugs. This approach is likely to have major benefits to both individuals and society. Memory clinics will need structural and functional changes to adapt to novel technologies and increased patients' demands, and brand-new services may need to be developed with specific skills on risk profiling, risk communication, and personalized risk reduction plans.
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Affiliation(s)
- Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.,Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.,Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuel Carrera
- Stroke Center, Department of Neurology, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.,Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Johannes Berkhof
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Julien Delrieu
- Gérontopole of Toulouse, University Hospital of Toulouse (CHU-Toulouse), Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer, IM2A, INSERM, Institut du Cerveau et de la Moelle Épinière, UMR-S975, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Miia Kivipelto
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Aging Theme, Karolinska University Hospital, Stockholm, Sweden.,Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland.,School of Public Health, Imperial College, London, UK
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Aging Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Jonathan M Schott
- Queen Square Institute of Neurology at University College London, London, UK
| | - Wiesje M van der Flier
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Bruno Vellas
- Gérontopole of Toulouse, University Hospital of Toulouse (CHU-Toulouse), Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Craig Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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31
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Ternes K, Iyengar V, Lavretsky H, Dawson WD, Booi L, Ibanez A, Vahia I, Reynolds C, DeKosky S, Cummings J, Miller B, Perissinotto C, Kaye J, Eyre HA. Brain health INnovation Diplomacy: a model binding diverse disciplines to manage the promise and perils of technological innovation. Int Psychogeriatr 2020; 32:955-979. [PMID: 32019621 PMCID: PMC7423685 DOI: 10.1017/s1041610219002266] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Brain health diplomacy aims to influence the global policy environment for brain health (i.e. dementia, depression, and other mind/brain disorders) and bridges the disciplines of global brain health, international affairs, management, law, and economics. Determinants of brain health include educational attainment, diet, access to health care, physical activity, social support, and environmental exposures, as well as chronic brain disorders and treatment. Global challenges associated with these determinants include large-scale conflicts and consequent mass migration, chemical contaminants, air quality, socioeconomic status, climate change, and global population aging. Given the rapidly advancing technological innovations impacting brain health, it is paramount to optimize the benefits and mitigate the drawbacks of such technologies. OBJECTIVE We propose a working model of Brain health INnovation Diplomacy (BIND). METHODS We prepared a selective review using literature searches of studies pertaining to brain health technological innovation and diplomacy. RESULTS BIND aims to improve global brain health outcomes by leveraging technological innovation, entrepreneurship, and innovation diplomacy. It acknowledges the key role that technology, entrepreneurship, and digitization play and will increasingly play in the future of brain health for individuals and societies alike. It strengthens the positive role of novel solutions, recognizes and works to manage both real and potential risks of digital platforms. It is recognition of the political, ethical, cultural, and economic influences that brain health technological innovation and entrepreneurship can have. CONCLUSIONS By creating a framework for BIND, we can use this to ensure a systematic model for the use of technology to optimize brain health.
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Affiliation(s)
- Kylie Ternes
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Vijeth Iyengar
- U.S. Administration on Aging/Administration for Community Living, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, California, USA
| | - Walter D Dawson
- Memory and Aging Center, School of Medicine, UCSF, San Francisco, California, USA
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
- School of Medicine, Oregon Health and Science University, Portland, Oregon, USA
- Institute on Aging, School of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
| | - Laura Booi
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
| | - Agustin Ibanez
- Memory and Aging Center, School of Medicine, UCSF, San Francisco, California, USA
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Center for Social and Cognitive Neuroscience (CSCN), Universidad Adolfo Ibanez, Santiago, Chile
- Universidad Autónoma del Caribe, Barranquilla, Colombia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Ipsit Vahia
- McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Cambridge, Massachusetts, USA
| | - Charles Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Steven DeKosky
- McKnight Brain Institute and Department of Neurology, College of Medicine, University of Florida, Miami, Florida, USA
| | - Jeffrey Cummings
- Department of Brain Health, School of Integrated Health Sciences, Cleveland Clinic Lou Ruvo Center for Brain Health, UNLV, Las Vegas, Nevada, USA
| | - Bruce Miller
- Memory and Aging Center, School of Medicine, UCSF, San Francisco, California, USA
- Global Brain Health Institute, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
| | - Carla Perissinotto
- Division of Geriatrics, School of Medicine, UCSF, San Francisco, California, USA
| | - Jeffrey Kaye
- School of Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Harris A Eyre
- Innovation Institute, Texas Medical Center, Houston, Texas, USA
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
- IMPACT SRC, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Brainstorm Laboratory for Mental Health Innovation, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, California, USA
- Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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