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'Small Steps' towards improving 24-hour time-use behaviours to decrease the risk of dementia: protocol for a
Maddison L Mellow1, Henry T Blake1, Ty Ferguson1
1Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, University of South Australia, Adelaide, South Australia, Australia.
BMJ Open
|November 5, 2025
Summary
This study tested a personalized 24-hour lifestyle intervention for older adults to improve brain health. The Small Steps trial assessed feasibility and preliminary effectiveness of tailored goals for physical activity, sleep, and sedentary behavior.
Area of Science:
- Gerontology
- Public Health
- Behavioral Science
Background:
- Physical inactivity is a modifiable dementia risk factor, impacting brain health.
- Previous interventions often neglect the interplay of physical activity with sleep and sedentary behavior across the 24-hour day.
- Personalized interventions considering individual needs are crucial for behavior change in older adults.
Purpose of the Study:
- To investigate the feasibility and acceptability of a personalized 24-hour time-use intervention for older adults.
- To assess the preliminary effectiveness of the intervention on lifestyle and cognitive health.
- To explore the impact of tailored goals on physical activity, sleep, and sedentary behavior.
Main Methods:
- Phase I randomized controlled trial (Small Steps) involving participants aged ≥65 years.
- Two groups: Extended (tailored website, personalized goals, weekly check-ins/calls) and Condensed (website resources only).
- Outcomes (feasibility, acceptability, time use, cognitive function, behavior change) assessed at 12, 24, and 36 weeks.
Main Results:
- Feasibility and acceptability of the personalized 24-hour intervention are currently under investigation.
- Preliminary data will inform the effectiveness of tailored lifestyle goals on brain health indicators.
- The study aims to provide insights into optimizing 24-hour behavior patterns for cognitive health in aging.
Conclusions:
- A personalized 24-hour time-use intervention shows promise for improving lifestyle and cognitive health in older adults.
- Tailoring interventions to individual needs is essential for addressing physical inactivity and promoting brain health.
- Further research is warranted to confirm the long-term effectiveness of this approach in dementia risk reduction.
