Protocol for the Brain Health Support Program Study of the Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia (CAN-THUMBS UP): A Prospective 12-Month Intervention Study

Feldman, Howard; Belleville, Sylvie; Montero‐Odasso, Manuel; Durant, J.; Lupo, Jody-Lynn; Revta, Carolyn; Chan, S.; Cuesta, Marc; Slack, Penelope J.; Winer, Shawn; Brewster, Paul; Lim, Aaron G.; Centen, Andrew; Jacobs, Diane M.; Anderson, Nicole; Walker, Judy; Speechley, Mark; Zou, Guang Yong; Chertkow, Howard

doi:10.14283/jpad.2023.65

Cited by 5 publications

(7 citation statements)

References 20 publications

(23 reference statements)

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“…From age 45-54 to 75-85 years, prevalence increased from 13.4% to 81.2% for hearing loss, 8.5% to 37.0% for less education, 16.5% to 21.9% for hypertension, 71.5% to 87.8% for physical inactivity, and 4.2% to 12.0% for diabetes. The highest prevalence of traumatic brain injury (15.4%) and smoking (13.7%) was observed at age 45…”

Section: By Sex and Age Groupsmentioning

confidence: 99%

“…5,6 Given the number of intervention trials delivering sleep and diet interventions to improve cognition, it is timely to quantify their population impact. [14][15][16] Estimating the population impact of diet is challenging due to the difficulty in measuring the diet pattern. For sleep, a recent study estimated that 5.7% of dementia cases are attributable to unhealthy sleep duration, using UK Biobank data.…”

Section: Introduction 4193/5500 Wordsmentioning

confidence: 99%

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Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison

Son,

Speechley,

Zou

et al. 2024

Preprint

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BACKGROUND Previous estimates suggested that up to 40% of dementia cases worldwide are associated with modifiable risk factors, however, these estimates are not known in Canada. Furthermore, sleep disturbance, an emerging factor, has not been incorporated into the life-course model of dementia prevention. Objective To estimate the population impact of 12 modifiable risk factors in Canadian adults including sleep disturbance, by sex and age groups, and to compare with other countries. Design Cross-sectional analysis of Canadian Longitudinal Study on Aging Baseline data Setting Community Participants 30,097 adults aged 45 years and older. Measurements Prevalence and Population Attributable Fraction (PAF) of less education, hearing loss, traumatic brain injury, hypertension, excessive alcohol, obesity, smoking, depression, social isolation, physical inactivity, diabetes, and sleep disturbance. Results The risk factors with the largest PAF were later life physical inactivity (10.2%; 95% CI, 6.8% to 13%), midlife hearing loss (6.5%; 3.7% to 9.3%), midlife obesity (6.4; 4.1% to 7.7%), and midlife hypertension (6.2%; 2.7% to 9.3%). The PAF of later life sleep disturbance was 3.0% (95% CI, 1.8% to 3.8%). The 12 risk factors accounted for 51.9% (32.2% to 68.0%) of dementia among men and 52.4% (32.5% to 68.7%) among women. Overall, the combined PAF of all risk factors was 49.2% (31.1% to 64.9%), and it increased with age. Conclusion Nearly up to 50% of dementia cases in Canada could be prevented by modifying the 12 risk factors across the lifespan. Canadian risk reduction strategies should prioritize targeting physical inactivity, hearing loss, obesity, and hypertension.

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Section: By Sex and Age Groupsmentioning

confidence: 99%

Section: Introduction 4193/5500 Wordsmentioning

confidence: 99%

Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison

Son,

Speechley,

Zou

et al. 2024

Preprint

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“…addition, participatory research is the ethically correct way of project planning, involving the people for whom the project is intended, right from its design: as they have a stake in it, they should have a say in it as well. 23 Brain Health PRO Over the last 2 years, our team has used a collaborative co-creation research process [24][25][26] to develop Brain Health PRO, 27 a user-friendly evidence-based online risk reduction programme tailored to Canadians. 28 The Brain Health PRO programme, currently ongoing and available in English and French, is educational, interactive and designed for older adults at risk of cognitive decline.…”

Section: Open Accessmentioning

confidence: 99%

Using co-creation focus groups to customise a remote multidomain programme designed to increase dementia literacy

Wittich,

Kröger,

Aubin

et al. 2023

BMJ Open

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ObjectivesTo adapt the content and functionalities ofBrain Health PRO,a web-based multidomain program designed to increase dementia literacy, to the context and needs of users, providers and community organisations across Québec, Canada.DesignFive consecutive qualitative co-creation focus group sessions 30–90 min in duration each, exploring potential barriers and facilitators to usability, accessibility, comprehensibility, participant recruitment and retention.SettingVirtual meetings.ParticipantsA 15-member team based in Québec and Ontario, Canada, consisting of 9 researchers (including a graduate student and the project coordinator), representing occupational therapy, sensory rehabilitation, neuropsychology, psychology, health science and research methods, 3 informal caregivers of older adults living with cognitive decline and 3 members of the Federation of Quebec Alzheimer Societies.Data analysisSession recordings were summarised through both qualitative description and thematic analysis.ResultsThe synthesised recommendations included adjustments around diversity, the complexity and presentation styles of the materials, suggestions on refining the web interface and the measurement approaches; it influenced aspects of participant recruitment, retention efforts and engagement with the content ofBrain Health PRO.ConclusionsCo-creation in dementia prevention research is important because it involves collaboration between researchers, community support and service providers, and persons with lived experience as care providers, in the design and implementation of clinical studies. This approach helps to ensure that the content and presentation of educational material is relevant and meaningful to the target population and those involved in its delivery, and it leads to a greater understanding of their needs and perspectives.

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“…Educational interventions have been shown to improve knowledge and belief in the importance of health behaviors for dementia among healthy adults, adults at‐risk of dementia, and among dementia patient caregivers 15–17 . However, there is limited availability for evidence‐informed tool(s) that deliver quality education about dementia risk reduction and that incorporate other aspects such as increasing self‐efficacy and goal setting to support positive behavior change 18–22 . These tools would be particularly helpful in primary care and geriatric health clinics where fast‐paced health care delivery and limited resources often limit effective education and support for behavioral modification 23 .…”

Section: Introductionmentioning

confidence: 99%

“… 15 , 16 , 17 However, there is limited availability for evidence‐informed tool(s) that deliver quality education about dementia risk reduction and that incorporate other aspects such as increasing self‐efficacy and goal setting to support positive behavior change. 18 , 19 , 20 , 21 , 22 These tools would be particularly helpful in primary care and geriatric health clinics where fast‐paced health care delivery and limited resources often limit effective education and support for behavioral modification. 23 Equally important would be offering these tools to the public to complement awareness campaigns and further galvanize the public's interest in and commitment toward dementia prevention.…”

Section: Introductionmentioning

confidence: 99%

Developing the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia program

Moukarzel,

Zlatar,

Hartman

et al. 2024

A&D Transl Res & Clin Interv

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INTRODUCTIONWith Alzheimer's disease and related dementias (ADRD) representing an enormous public health challenge, there is a need to support individuals in learning about and addressing their modifiable risk factors (e.g., diet, sleep, and physical activity) to prevent or delay dementia onset. However, there is limited availability for evidence‐informed tools that deliver both quality education and support for positive behavior change such as by increasing self‐efficacy and personalizing goal setting. Tools that address the needs of Latino/a, at higher risk for ADRD, are even more scarce.METHODSWe established a multidisciplinary team to develop the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia (HALT‐AD) program, a bilingual online personalized platform to educate and motivate participants to modify their risk factors for dementia. Grounded in social cognitive theory and following a cultural adaptation framework with guidance from a community advisory board, we developed HALT‐AD iteratively through several cycles of rapid prototype development, user‐centered evaluation through pilot testing and community feedback, and refinement.RESULTSUsing this iterative approach allowed for more than 100 improvements in the content, features, and design of HALT‐AD to improve the program's usability and alignment with the interests and educational/behavior change support needs of its target audience. Illustrative examples of how pilot data and community feedback informed improvements are provided.DISCUSSIONDeveloping HALT‐AD iteratively required learning through trial and error and flexibility in workflows, contrary to traditional program development methods that rely on rigid, pre‐set requirements. In addition to efficacy trials, studies are needed to identify mechanisms for effective behavior change, which might be culturally specific. Flexible and personalized educational offerings are likely to be important in modifying risk trajectories in ADRD.

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Protocol for the Brain Health Support Program Study of the Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia (CAN-THUMBS UP): A Prospective 12-Month Intervention Study

Cited by 5 publications

References 20 publications

Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison

Potentially Modifiable Dementia Risk Factors in Canada: An Analysis of Canadian Longitudinal Study on Aging with a Multi-Country Comparison

Using co-creation focus groups to customise a remote multidomain programme designed to increase dementia literacy

Developing the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia program

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