Feasibility of a health coaching intervention with mobile health technology in older adults with mild cognitive impairment or risk factors for dementia

Abstract

AbstractBackgroundThere is growing evidence that adherence to brain‐healthy behaviors can reduce the risk of dementia and rate of decline. Current standard of care, however, does not systematically promote or monitor adherence to brain health guidelines. We recently demonstrated that a health coaching intervention, which included weekly phone calls, facilitated greater adherence to lifestyle recommendations and improved quality of life. The current study is investigating the impact of supplementing health coaching with digital health technology, including a mobile platform and wearable fitness trackers.MethodIn an ongoing six‐month trial, we are measuring the effect of a clinic‐embedded, technology‐augmented health coaching program on adherence to brain health recommendations. Forty patients with mild cognitive impairment (MCI) or risk factors for dementia are being randomized to the Brain Health Champion (BHC) intervention or a counseling and education (CE) control. In BHC, participants work with a health coach to set personalized goals, reinforced by weekly video calls, mobile messaging, and in‐person visits every six weeks. In CE, usual clinical care is supplemented with educational materials mailed every six weeks. Using validated questionnaires, wearable fitness trackers, and photographed food logs, changes in physical activity, diet, and social/cognitive engagement are being determined.ResultOf the 12 participants enrolled to date, 83% have been adherent to use of mobile technology and fitness trackers. In BHC, 93% of weekly video calls have been completed, and coaches and participants have exchanged an average of 7 text messages per week. BHC participants have been more likely to continue wearing and monitoring their fitness trackers after the required assessment period (75% BHC vs. 40% CE). 66% of all participants report that they would like their doctors to have access to data from mobile health applications, and 56% report that they would like to incorporate mobile health into their regular medical care.ConclusionA health coaching intervention for MCI patients and at‐risk older adults using digital health technology is feasible and shows promise for use in wider health care settings. The intervention’s impact on the adoption of brain‐healthy behaviors is being measured and an interim report will be provided.