Online tool helps lower dementia risk

An online lifestyle intervention tool shown to improve cognition in older adults could be delivered in primary care to tackle growing dementia cases, a leading expert suggests.
 
Co-director of the University of New South Wales Centre for Healthy Brain Ageing, Professor Henry Brodaty, has led a clinical trial targeting modifiable risk factors for dementia, and Alzheimer’s disease in particular. He says GPs would be vital in any moves to scale-up the project.
 
More than 6000 participants aged 55–77, who were dementia-free but carried at least two of the major risk factors, were recruited to take part in the ‘Maintain your Brain’ trial over three years.
 
One group received an active intervention, including personalised coaching in between two and four modules (physical activity, brain training, nutrition or depression/anxiety) depending on their risk factors, while the control group received publicly available information.
 
Results published in Nature Medicine showed the intervention improved participants’ global cognition score which was determined from online tests measuring memory, reasoning and speed of information processing.
 
Professor Brodaty said the intervention group demonstrated the greatest benefit to date in a randomised control trial to prevent cognitive decline, and he would like to see this initiative widely rolled out.
 
‘Working with GPs was essential in implementing this work,’ he told newsGP.
 
‘We see this as the slip, slap, slop of brain health. We need a national program that gets people energised and keen to do something about their brains like we did for skin health.’
 
Professor Dimity Pond, a GP with a special interest in aged care, said the findings were important for general practice.
 
‘The 2024 Lancet Commission on Dementia prevention, intervention and care found 14 modifiable risk factors which could potentially prevent 45% of dementia, based on studies from around the world,’ she told newsGP.
 
‘Now we have a study which shows Australians can also take simple lifestyle steps to improve their cognitive function and prevent dementia.’
 
‘GPs are well placed to facilitate this, and indeed have been doing so for a long time. That we now have evidence that it reduces dementia risk is an added incentive for our patients to engage with these lifestyle changes.’
 
GP Dr Stephanie Daly, RACGP Specific Interests Dementia Chair, said boosting patient education was a vital step in addressing rising dementia cases in Australia.
 
‘Many people in the population have low levels of understanding and knowledge about dementia, so there are also low levels of knowledge around risk reduction strategies,’ she told newsGP.
 
‘I don’t think a single tool is the answer – it’s widespread education in the public domain and health professional community to ensure everyone is aware of how to reduce risk.’
 
Dr Daly added that we now know of the 14 modifiable risk factors, which suggests that primary prevention or delaying the date at onset may be possible.
 
‘We also know that improving cognitive reserve is protective,’ she said.  
 
‘Many of the risk factors are overlapping with other health complaints such as obesity, diabetes and heart disease, so utilising motivational interviewing and information delivery to patients to explain that acting on these areas can reduce dementia risk is important.’
 
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