March 2025
Online lifestyle trial shown to improve cognition in older adults
By Melanie Hinze
New research published in Nature Medicine calls for effective, scalable dementia prevention interventions to address modifiable risk factors for dementia.
The single-blind, randomised controlled trial assessed an online multidomain lifestyle intervention, called Maintain Your Brain (MYB), which was designed to target modifiable risk factors that may prevent cognitive decline.
It included 6104 dementia-free community-dwelling Australians, aged 55 to 77 years (64% female) who were found to have modifiable dementia risk factors.
Participants were randomised in a 1:1 ratio to a personalised schedule of online coaching in two to four modules. The modules targeted physical activity, nutrition, cognitive activity, and depression or anxiety, whereas the control group was provided with publicly available information only.
Over three years, the mean change in global cognitive composite (GCC) z-score from baseline was 0.28 in the intervention group compared with 0.10 in the control group. The study authors concluded that this internet-delivered lifestyle intervention resulted in significantly better cognition in older adults over three years.
The intervention group was shown to have greater improvement in physical activity levels (minutes of aerobic exercise and days of strength training), dietary habits (greater adherence to a Mediterranean-type diet) and lower psychological distress compared with controls. Greater impact was also seen in younger participants, suggesting early intervention may be ideal.
Although the relative contribution of the four intervention modules was not able to be determined, the authors suggested targeting a broad range of lifestyle factors for success.
Lead author, Professor Henry Brodaty, Co-Director of UNSW Sydney’s Centre for Healthy Brain Ageing, said, ‘This intervention is scalable with the potential for population-level roll out that may delay cognitive decline in the general community.’
‘We could essentially reduce worldwide dementia prevalence if this trial were implemented to the wider population.’
Professor Brodaty, who is also Scientia Professor of Ageing and Mental Health at UNSW Sydney and Director of the Dementia Centre for Research Collaboration, said that primary care had been highly successful in promoting cardiovascular health.
‘Brain health is the new frontier for GPs to master,’ he said, adding that ‘We have strong evidence to do this’.
In the future, developments could focus on cultural adaptation, particularly targeting groups from lower socioeconomic backgrounds and those with less education, he told Medicine Today.