Reducing dementia risk by targeting modifiable risk factors in mid-life: study protocol for the Innovative Midlife Intervention for Dementia Deterrence (In-MINDD) randomised controlled feasibility trial.

Catherine A O’Donnell,Alex Mcconnachie,Frans R J Verhey,Kevin Power,Susan Browne,Marjan Van Den Akker,Kay Deckers,Kate Irving,Sebastian Köhler,Valeria Manera,Martin P J Van Boxtel,Muriel Redmond,Maria Pierce

doi:10.1186/s40814-015-0035-x

Catherine A O’Donnell, Alex Mcconnachie + Show 11 more

Open Access

https://doi.org/10.1186/s40814-015-0035-x

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Abstract

BackgroundDementia prevalence is increasing as populations live longer, with no cure and the costs of caring exceeding many other conditions. There is increasing evidence for modifiable risk factors which, if addressed in mid-life, can reduce the risk of developing dementia in later life. These include physical inactivity, low cognitive activity, mid-life obesity, high blood pressure, and high cholesterol. This study aims to assess the acceptability and feasibility and impact of giving those in mid-life, aged between 40 and 60 years, an individualised dementia risk modification score and profile and access to personalised on-line health information and goal setting in order to support the behaviour change required to reduce such dementia risk. A secondary aim is to understand participants’ and practitioners’ views of dementia prevention and explore the acceptability and integration of the Innovative Midlife Intervention for Dementia Deterrence (In-MINDD) intervention into daily life and routine practice.Methods/designIn-MINDD is a multi-centre, primary care-based, single-blinded randomised controlled feasibility trial currently being conducted in four European countries (France, Ireland, the Netherlands and the UK). Participants are being recruited from participating general practices. Inclusion criteria will include age between 40 and 60 years; at least one modifiable risk factor for dementia risk (including diabetes, hypertension, obesity, renal dysfunction, current smoker, raised cholesterol, coronary heart disease, current or previous history of depression, self-reported sedentary lifestyle, and self-reported low cognitive activity) access to the Internet. Primary outcome measure will be a change in dementia risk modification score over the timescale of the trial (6 months). A qualitative process evaluation will interview a sample of participants and practitioners about their views on the acceptability and feasibility of the trial and the links between modifiable risk factors and dementia prevention. This work will be underpinned by Normalisation Process Theory.DiscussionThis study will explore the feasibility and acceptability of a risk profiler and on-line support environment to help individuals in mid-life assess their risk of developing dementia in later life and to take steps to alleviate that risk by tackling health-related behaviour change. Testing the intervention in a robust and theoretically informed manner will inform the development of a future, full-scale randomised controlled trial.Trial registrationISRCTN Registry: ISRCTN 98553005 (DOI: 10.1186/ISRCTN98553005).Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-015-0035-x) contains supplementary material, which is available to authorized users.

Highlights

Dementia prevalence is increasing as populations live longer, with no cure and the costs of caring exceeding many other conditions
Dementia is a serious loss of cognitive ability beyond what might be expected from normal ageing, with Alzheimer’s disease and vascular dementia, the commonest types [1]
Research has demonstrated high levels of anxiety amongst middle-aged and young-old individuals about their memory. This is compounded by the debilitation that can be associated with late-stage dementia, making it one of the most feared conditions in relation to ageing [5, 6]

Summary

Introduction

Dementia prevalence is increasing as populations live longer, with no cure and the costs of caring exceeding many other conditions. There is increasing evidence for modifiable risk factors which, if addressed in mid-life, can reduce the risk of developing dementia in later life. Research has demonstrated high levels of anxiety amongst middle-aged and young-old individuals about their memory This is compounded by the debilitation that can be associated with late-stage dementia, making it one of the most feared conditions in relation to ageing [5, 6]. There is a clear need to develop treatments for those with dementia, but to develop our understanding of the ways in which dementia risk might addressed and reduced in those still in mid-life, well before the onset of dementia This is the aim of Innovative Midlife Intervention for Dementia Deterrence (In-MINDD)

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