The Brain Health Champion study: Health coaching changes behaviors in patients with cognitive impairment

Schwartz, Harry C.; Bay, Camden; McFeeley, Brittany; Krivanek, Taylor; Daffner, Kirk R.; Gale, Seth A

doi:10.1016/j.trci.2019.09.008

Cited by 14 publications

(12 citation statements)

References 53 publications

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“…Practical analyses for required sample size were conducted by examining related HC literature and the samples recruited to demonstrate efficacy therein. Studies examining the efficacy of HC on improving psychological and cognitive variables were conducted with sample sizes ranging from 40 to 45 total participants and demonstrated significant improvement in outcome measures [ 14 , 15 , 18 ]. Taken together, a sample size of at least 100 participants was pursued for this study.…”

Section: Methodsmentioning

confidence: 99%

“…Health coaching (HC) is a guided intervention wherein a health coach assists participants in achieving their desired health-related outcomes through goal-setting, education, motivation, re-assessment, and personalized, guided progression [ 13 ]. In previous studies, HC improved many of the lifestyle factors associated with ADRD [ 14 , 15 ] and may facilitate increased engagement in behaviors believed to benefit cognition [ 15 ]. However, HC’s efficacy for specifically decreasing ADRD risk and improving cognitive-related function among an at-risk sample has not, to our knowledge, yet been examined.…”

Section: Introductionmentioning

confidence: 99%

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The effect of a digital health coaching and health education protocol on cognition in adults at-risk for Alzheimer’s

et al. 2022

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Several modifiable lifestyle factors have been linked to cognitive ability and the risk of developing Alzheimer’s disease and related dementias (ADRD). Health coaching (HC) is an intervention that addresses lifestyle factors associated with cognition. The effectiveness of an HC protocol was evaluated and compared with a health education (HE) intervention, representing the current standard of care, in a sample of 216 adults between the ages of 45 and 75 years who were at-risk for developing ADRD. Outcomes examined were global cognition, neuropsychological cognition, and Alzheimer’s risk. HC participants received personalized coaching from a health coach focusing on nutrition, physical activity, sleep, stress, social engagement, and cognitive activity. HE participants received biweekly education materials focusing on the same modifiable lifestyle factors addressed by HC. Participants were assessed at baseline and again 4 months later. Self-reported global cognition scores improved only in the HC group (16.18 to 15.52, p = .03) and neuropsychological cognitive ability improved in the HE group (104.48 to 108.76, p < .001). When non-adherence in the HC group was accounted for, however, the mean change in neuropsychological score was similar between groups (p > .05), self-reported global cognition demonstrated an even larger mean improvement in the HC group (16.20 to 15.41, p = .01), and the HC group saw an improvement in ADRD protective risk score (− 10.39 to − 11.45, p = .007). These results indicate that HC and HE can both improve cognition, but HC may be more effective and may yield increased protection against ADRD risk.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of a digital health coaching and health education protocol on cognition in adults at-risk for Alzheimer’s

et al. 2022

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“…In the Brain Health Champion study, our team demonstrated the efficacy of a low-cost, health-coaching intervention in older adults with MCI or mild dementia. Using evidence-based BCTs, including MI and BA, the health-coaching intervention was associated with increased adherence to brain-healthy behaviors and improved self-reported quality of life [ 559 ]. The results of these studies demonstrate the promise of employing models of evidence-based BCTs to encourage the adoption of brain-healthy behaviors.…”

Section: Promoting Successful Cognitive Agingmentioning

confidence: 99%

Promoting Successful Cognitive Aging: A Ten-Year Update

Krivanek

Gale

McFeeley

et al. 2021

JAD

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A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Many of the suggestions made in 2010 have been supported by additional research. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors.

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“…These seminal findings warrant the search for methods to operationalize this knowledge to clinically promote brain health. The recent Brain Health Champion study demonstrated a motivational-interviewing intervention significantly improving physical activity, adherence to a Mediterranean diet, social/cognitive stimulation, and quality of life in patients with SCD or MCI [58]. Although the study lacked a formal calendar or organizational system, it highlighted the importance of goal setting, which was incorporated into the EMS component of our program.…”

Section: Discussionmentioning

confidence: 99%

Compensatory and Lifestyle-Based Brain Health Program for Subjective Cognitive Decline: Self-Implementation versus Coaching

et al. 2021

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Although recent studies have explored the potential of multidomain brain health programs, there is a dearth of literature on operationalizing this research to create a clinical treatment program specifically for subjective cognitive decline (SCD). Patients seen by geriatricians in primary care and by behavioral neurology services at our institution presenting with SCD were recruited via a patient-appropriate flyer. After all participants had a 1-h brain health consultation with a neuropsychologist and were provided with program materials, they were randomized to attend a 10-week intervention designed to support program implementation (N = 10) or the control group of implementing the program on their own (N = 11). The program included (1) a calendar-based executive and memory support system for compensatory training and (2) training in healthy lifestyle. There were no significant differences between groups for any outcomes. Participants across both groups showed significant improvements with moderate effect sizes in compensatory strategy use, anxiety symptoms, and daily functioning, which were sustained through 6-month follow-up. They also increased physical activity by the end of the intervention period but did not sustain this through 6-month follow-up. Our pilot study demonstrates preliminary feasibility of a cognitive compensatory and lifestyle-based brain health program. Additional research is recommended to further develop two potentially scalable implementation strategies—coaching and self-implementation after brief consultation.

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The Brain Health Champion study: Health coaching changes behaviors in patients with cognitive impairment

Cited by 14 publications

References 53 publications

The effect of a digital health coaching and health education protocol on cognition in adults at-risk for Alzheimer’s

The effect of a digital health coaching and health education protocol on cognition in adults at-risk for Alzheimer’s

Promoting Successful Cognitive Aging: A Ten-Year Update

Compensatory and Lifestyle-Based Brain Health Program for Subjective Cognitive Decline: Self-Implementation versus Coaching

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