Abstract
BackgroundBy 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults.MethodsDuring the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional ‘guiding principles’ and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content.ResultsScoping reviews and qualitative interviews suggested that the same intervention content may be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of intervention content and functionality that appeared highly acceptable amongst a sample of target users.ConclusionsA digitally delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.
Highlights
By 2050, worldwide dementia prevalence is expected to triple
There is very limited evidence about whether digital delivery of multi-domain behaviour change interventions is feasible, engaging and acceptable in the context of protecting cognitive health. It is unclear whether the same intervention content, structure and functionality is suitable for both those with and without existing cognitive impairment
Around 10% of mild cognitive impairment (MCI) and associated cognitive decline (AACD) cases convert to dementia each year [4]
Summary
By 2050, worldwide dementia prevalence is expected to triple. This paper outlines the theory-, evidence- and person-based development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults. Fifty-million people worldwide currently have dementia [1]. Cognitive impairment is even more common; mild cognitive impairment (MCI) and age-associated cognitive decline (AACD) are estimated to affect nearly 20% of adults aged 60 and over [2, 3]. The annual global cost of dementia is nearly US$1 trillion with dementia prevalence expected to rise to 152 million by 2050 [5]. Dementia and cognitive decline place unsustainable demand on health and social care systems worldwide, and pose substantial threat to individuals’ independence and quality of life [6]. Prevention and management of dementia are public health priorities [7]
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