An NIA-funded study found that a tailored dementia risk reduction intervention slightly improved cognitive performance and reduced dementia risk factors in older adults at high risk of dementia. JAMA Internal MedicineIt supports the idea that a tailored health coaching approach to reduce dementia risk factors such as high blood pressure and reduced physical activity may be beneficial for older adults at high risk of dementia.
A research team from the University of California, San Francisco, Kaiser Permanente Washington Health Institute, and other collaborators led a two-year study to investigate the effectiveness of various intervention approaches to prevent dementia. The 172 participants were 70 years of age or older and did not have dementia at the start of the study. Participants had at least two of the following dementia risk factors: lack of physical activity, poorly controlled high blood pressure, poor sleep, unsafe medication use, depression, poorly controlled diabetes, social isolation, and smoking.
Participants were randomly assigned to receive personalized strategies (82 people) or non-customized health education (90 people). Participants in the personalized group met with a health coach or nurse to review their risk factor profile and discuss which factors they wanted to reduce. The health education control group received educational materials by mail every three months about dementia risk reduction for all eight risk factors.
The most common risk factors observed in both groups were lack of physical activity, poorly controlled high blood pressure, and poor sleep. Participants in the personalized group most frequently chose to address the same three factors. Researchers assessed changes in cognition, quality of life, and dementia risk factors over the two-year study period for both groups.
The researchers found that cognitive performance improved in both groups over the course of the study, but the gains in cognitive performance were slightly greater for the personalized participants. The personalized group reduced risk factors slightly more than the control group. Participants in both groups reported being satisfied with the study and the effects of their health improvements.
Overall, this pilot study supports previous findings suggesting that a personalized approach to dementia risk reduction may offer some benefit to older adults at risk of dementia. It also suggests the possibility of testing this approach in larger studies.
This research was supported by NIA grant R01AG057508.
reference: Yaffe K, et al. Effects of individualized risk reduction strategies on cognitive function and dementia risk profile in older adults: the SMARRT randomized clinical trial. JAMA Internal Medicine2024;184(1):54-62. doi: 10.1001/jamainternmed.2023.6279.
