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Public Health.

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An online intervention significantly reduced cognitive decline in older adults by improving cognition, mental well-being, and lowering dementia risk. This scalable approach shows promise for widespread public health.

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Area of Science:

  • Gerontology
  • Public Health
  • Digital Health

Background:

  • Multimodal interventions show promise for preventing cognitive decline, but in-person approaches are limited in scalability.
  • Online interventions offer a scalable and feasible solution for population-level delivery, yet efficacy remains unproven.
  • The Maintain Your Brain (MYB) intervention was developed to address cognitive decline in aging adults through an online multimodal approach.

Purpose of the Study:

  • To evaluate the efficacy of the online multimodal intervention, Maintain Your Brain (MYB), in reducing cognitive decline over three years.
  • To assess the impact of MYB on cognitive domains, mental well-being, and dementia risk.
  • To determine the cost-effectiveness of the online intervention for older adults.

Main Methods:

  • Recruitment of 14,064 participants aged 55-77 from the 45 and Up study in Australia.
  • Randomized allocation to either personalized coaching modules (intervention) or static information modules (control) based on risk factors.
  • Primary outcome: change in an online global cognitive score; secondary outcomes: specific cognitive domains, module outcomes, dementia risk, and cost.

Main Results:

  • The intervention group showed significant improvement in the global composite cognition z-score (ES=0.18, p <0.001) over three years.
  • Significant improvements were observed in complex attention, executive function, learning and memory, physical activity, nutrition, and depression (all p <0.001).
  • Dementia risk was significantly reduced (p=0.007), and the intervention was found to be cost-effective with balanced health savings.

Conclusions:

  • The online MYB platform, tailored to individual risk profiles, effectively reduced cognitive decline in older adults over three years.
  • The intervention is effective, scalable, and potentially delays dementia onset while being cost-effective.
  • Despite proven efficacy, challenges remain in securing broader commercial or governmental interest for wider implementation of the MYB intervention.