Abstract
BackgroundDementia is the leading cause of disability worldwide, and interventions aimed at reducing the prevalence and burden of the disease are urgently needed. Maintain Your Brain (MYB) is a randomized controlled trial of a multimodal digital health intervention targeting modifiable dementia risk factors to combat cognitive decline and potentially prevent dementia. In addition to behavioral modules targeting mood, nutrition, and physical exercise, a new Brain Training System (BTS) will deliver computerized cognitive training (CCT) throughout the trial to provide systematic, challenging, and personally adaptive cognitive activity.ObjectiveThis paper aimed to describe the design and development of BTS.MethodsBTS has been designed with a central focus on the end user. Raw training content is provided by our partner NeuroNation and delivered in several innovative ways. A baseline cognitive profile directs selection and sequencing of exercises within and between sessions and is updated during the 10-week 30-session module. Online trainers are available to provide supervision at different levels of engagement, including face-to-face share-screen coaching, a key implementation resource that is triaged by a “red flag” system for automatic tracking of user adherence and engagement, or through user-initiated help requests. Individualized and comparative feedback is provided to aid motivation and, for the first time, establish a social support network for the user based on their real-world circle of friends and family.ResultsThe MYB pilot was performed from November 2017 to March 2018. We are currently analyzing data from this pilot trial (n=100), which will make up a separate research paper. The main trial was launched in June 2018. Process and implementation data from the first training module (September to November 2018) are expected to be reported in 2019 and final trial outcomes are anticipated in 2022.ConclusionsThe BTS implemented in MYB is focused on maximizing adherence and engagement with CCT over the short and long term in the setting of a fully digital trial, which, if successful, could be delivered economically at scale.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12618000851268; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=370631&isReview=true
Highlights
BackgroundLate-life engagement in cognitively stimulating activities is associated with reduced risk for incident dementia [1]
The Maintain Your Brain (MYB) pilot was performed from November 2017 to March 2018
The Brain Training System (BTS) implemented in MYB is focused on maximizing adherence and engagement with computerized cognitive training (CCT) over the short and long term in the setting of a fully digital trial, which, if successful, could be delivered economically at scale
Summary
BackgroundLate-life engagement in cognitively stimulating activities is associated with reduced risk for incident dementia [1]. There are no established standards for planning and delivering CCT [9] Design factors such as the content of the training program, training schedules, delivery methods, and combinations with other interventions (eg, physical exercise) vary substantially within and across studies. Literature in this regard suggests that several key design factors may be important for treatment outcomes and fidelity and are briefly reviewed in this paper. In addition to behavioral modules targeting mood, nutrition, and physical exercise, a new Brain Training System (BTS) will deliver computerized cognitive training (CCT) throughout the trial to provide systematic, challenging, and personally adaptive cognitive activity
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