A Novel BrainHealth Index Prototype Improved by Telehealth-Delivered Training During COVID-19

Introduction: Brain health is neglected in public health, receiving attention after something goes wrong. Neuroplasticity research illustrates that preventive steps strengthen the brain's component systems; however, this information is not widely known. Actionable steps are needed to scale proven population-level interventions. Objectives: This pilot tested two main objectives: (1) the feasibility/ease of use of an online platform to measure brain health, deliver training, and offer virtual coaching to healthy adults and (2) to develop a data driven index of brain health. Methods: 180 participants, ages 18-87, enrolled in this 12-week pilot. Participants took a BrainHealth Index™ (BHI), a composite of assessments encompassing cognition, well-being, daily-life and social, pre-post training. Participants engaged in online training with three coaching sessions. We assessed changes in BHI, effects of training utilization and demographics, contributions of sub-domain measures to the BHI and development of a factor analytic structure of latent BrainHealth constructs. Results: The results indicated that 75% of participants showed at least a 5-point gain on their BHI which did not depend on age, education, or gender. The contribution to these gains were from all sub-domains, including stress, anxiety and resilience, even though training focused largely on cognition. Some individuals improved due to increased resilience and decreased anxiety, whereas others improved due to increased innovation and social engagement. Larger gains depended on module utilization, especially strategy training. An exploratory factor analytic solution to the correlation matrix of online assessments identified three latent constructs. Discussion/Conclusion: This pilot study demonstrated the efficacy of an online platform to assess changes on a composite BrainHealth Index and efficacy in delivering training modules and coaching. We found that adults, college age to late life, were motivated to learn about their brain and engage in virtual-training with coaching to improve their brain health. This effort intends to scale up to thousands, thus the pilot data, tested by an impending imaging pilot, will be utilized in ongoing machine learning (ML) algorithms to develop a precision brain health model. This pilot is a first step in scaling evidence-based brain health protocols to reach individuals and positively affect public health globally.