Personalized health coaching may improve cognition, lower dementia risk in high-risk older adults

Personalized dementia risk reduction intervention plans improved cognition and reduced dementia risk among high-risk older adults in a study detailed recently in JAMA Internal Medicine.

Researchers from the University of California, San Francisco; the University of Washington, Seattle; and Kaiser Permanente Washington Health Research Institute in Seattle conducted a two-year, randomized clinical trial in 172 adults aged 75 or more years to see whether a customized dementia intervention plan could improve cognition and lower their risk for developing the disease.

The Systematic Multi-Domain Alzheimer Risk Reduction Trial, or SMART, randomly assigned participants to a customized intervention group or a health education group. Dementia risk factors targeted in the study included physical inactivity, uncontrolled high blood pressure, poor sleep, risky medications, depression, uncontrolled diabetes, social isolation and smoking.

Members of the intervention group worked with a health coach and nurse in person or by telephone, with health coaching sessions offered every four to six weeks. Meanwhile, participants in the health education group received mailed educational material every three months about Alzheimer’s disease and related dementia as well as risk reduction.

For both groups, the investigators assessed changes in cognition, quality of life and dementia risk factors throughout the two-year study. Although cognition, dementia risk factors and quality of life improved for both groups, it improved slightly more for the intervention group participants receiving personalized plans.

Study participants in both groups reported satisfaction with the study and the ability to improve their health.

The researchers concluded that the trial showed a “promising strategy” that could be used in future larger trials to determine whether the two-year gains seen in the study translate into a reduced risk or delayed onset of Alzheimer’s disease and related dementias.

“Given their low cost, excellent safety profile, and benefit on health and quality of life overall, risk reduction strategies may be used in combination with medications or offered as primary prevention for those at risk for ADRD,” the authors noted. “Hopefully, in the future, treatment of ADRD will be like cardiovascular disease management, with a combination of risk reduction and specific drugs targeted for disease mechanisms.”