Dementia-prevention program could be rolled out nationally: Aus study

Australian researchers have shown that delivering lifestyle intervention programs to older people remotely, results in "significantly better cognition."
The Maintain Your Brain study, by UNSW's Centre for Healthy Brain Ageing (CHeBA) performed a clinical trial targeting modifiable risk factors for dementia and Alzheimer's disease, recruiting over 6,000 participants aged between 55 and 77 who possessed at least two risk factors, as dictated by last year's Lancet report.
Participants were split into two groups; one received personalised online coaching from a team of academics that aligned with their individual risk factors, the other received publicly available information.
The trial was led by CHeBA co-director Professor Henry Brodaty AO, who said the trial's evidence demonstrates that improving lifestyle behaviours can slow cognitive decline.
“The outcome was a resounding yes – we can improve cognition over three years and therefore, likely enhance resilience to dementia,” Professor Brodaty said.
“Both groups improved but the intervention group demonstrated the greatest benefit to date in a randomised control trial to prevent cognitive decline.”
The online "intervention modules" used throughout the study were based on four key lifestyle factors:
- Physical activity - consistent moderate to intense physical activity, strength training and balance training
- Nutrition - Mediterranean diet, reduced intake of meat, dairy, eggs and animal fats
- Brain training - targeted activities based on seven cognitive domains: verbal executive, verbal memory, visual executive, visual memory, visual attention, speed and working memory
- Mental health - cognitive behavioural therapy aimed at reducing or preventing depression and anxiety

Modifiable risk factors account for approximately 45 per cent of a person's risk of developing dementia, that is why the Maintain Your Brain researchers have said their findings have "international significance."
“This intervention is scalable with the potential for population-level roll out that may delay cognitive decline in the general community,” Professor Brodaty said.
“We could essentially reduce worldwide dementia prevalence if this trial were implemented to the wider population.”
Key findings
The trial's results show that just a deeper understanding of dementia, can improve cognition for those most at risk. However, through specified coaching programs, overall health factors such as aerobic fitness, strength, nutrition and mental health can also be significantly improved.
Notably, the study found that younger participants were more responsive to the program.
“Participants aged 55-65 showed greater benefit than those aged 66-77, suggesting we should consider starting prevention programs earlier,” Professor Brodaty said.
“Previous trials have largely not tailored interventions to match dementia risk factors of individual participants.
“Our findings suggest personalising interventions and targeting a broad range of lifestyle factors are important for success.”
CHeBA Advisory Committee chair Ita Buttrose AC OBE took the opportunity to celebrate the work of CHeBA academics.
“We now have clear evidence to support a national dementia prevention program,” she said.
“Previously Australia has been a leader in prevention, particularly with smoking, skin cancer and HIV minimisation, but we have dropped the ball. Dementia is a prime example of where we can and must act now.
“This evidence demonstrates significant benefits to improving cognition and potentially delaying the onset of dementia.
“It is now time for Australia to think seriously about long term goals, to acknowledge the evidence and embrace the need for investment in prevention.”
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