Table_1_Parallel randomized controlled feasibility trials of the “Active Brains” digital intervention to protect cognitive health in adults aged 60–85.DOCX

IntroductionMultidomain interventions to address modifiable risk factors for dementia are promising, but require more cost-effective, scalable delivery. This study investigated the feasibility of the “Active Brains” digital behavior change intervention and its trial procedures.Materials and methodsActive Brains aims to reduce cognitive decline by promoting physical activity, healthy eating, and online cognitive training. We conducted 12-month parallel-design randomized controlled feasibility trials of “Active Brains” amongst “lower cognitive scoring” (n = 180) and “higher cognitive scoring” (n = 180) adults aged 60–85.ResultsWe collected 67.2 and 76.1% of our 12-month primary outcome (Baddeley verbal reasoning task) data for the “lower cognitive score” and “higher cognitive score” groups, respectively. Usage of “Active Brains” indicated overall feasibility and satisfactory engagement with the physical activity intervention content (which did not require sustained online engagement), but engagement with online cognitive training was limited. Uptake of the additional brief telephone support appeared to be higher in the “lower cognitive score” trial. Preliminary descriptive trends in the primary outcome data might indicate a protective effect of Active Brains against cognitive decline, but further investigation in fully-powered trials is required to answer this definitively.DiscussionWhilst initial uptake and engagement with the online intervention was modest, it was in line with typical usage of other digital behavior change interventions, and early indications from the descriptive analysis of the primary outcome and behavioral data suggest that further exploration of the potential protective benefits of Active Brains are warranted. The study also identified minor modifications to procedures, particularly to improve online primary-outcome completion. Further investigation of Active Brains will now seek to determine its efficacy in protecting cognitive performance amongst adults aged 60–85 with varied levels of existing cognitive performance.

针对痴呆症的可修改风险因素的跨领域干预措施虽具潜力，但仍需寻求更具成本效益和可扩展性的实施方式。本研究旨在探讨“活跃大脑”数字行为改变干预措施及其试验程序的可行性。材料与方法：“活跃大脑”旨在通过促进体育活动、健康饮食和在线认知训练来降低认知衰退。我们对180名“认知评分较低”的成年人（n = 180）和180名“认知评分较高”的成年人（n = 180）进行了为期12个月的平行设计随机对照可行性试验。结果：我们收集了“认知评分较低”组和“认知评分较高”组12个月主要结果（Baddeley言语推理任务）数据的67.2%和76.1%。使用“活跃大脑”表明了整体可行性，并对体育活动干预内容（无需持续的在线参与）的参与度令人满意，但在线认知训练的参与度有限。额外简短电话支持的采用在“认知评分较低”试验中似乎更高。初步描述性趋势分析显示，Active Brains可能对认知衰退具有保护作用，但需要进一步在完全随机化试验中调查以确定这一点。讨论：尽管在线干预措施的首批采用和参与度相对有限，但与其它数字行为改变干预措施的典型使用情况相符。对主要结果和行为数据的描述性分析早期迹象表明，进一步探索Active Brains潜在的保护益处是必要的。该研究还确定了程序上的微小修改，尤其是为了改善在线主要结果完成情况。现在，对Active Brains的进一步研究将寻求确定其在保护60-85岁成年人认知表现方面的有效性，这些成年人的现有认知表现水平各异。