The Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT) intervention: A personalized approach to dementia risk reduction.

Autor:	Barnes DE; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA., Balderson BH; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Shulman L; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Rosenberg DE; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Matson TE; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.; School of Public Health, University of Washington, Seattle, WA, USA., Mettert KD; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Delaney K; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., King D; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Adams K; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Fleckenstein L; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Peltz CB; Northern California Institute for Research and Education, San Francisco, CA, USA., Idu A; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA., Larson EB; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.; School of Public Health, University of Washington, Seattle, WA, USA., Yaffe K; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.; Department of Neurology, University of California, San Francisco, San Francisco, CA, USA., Dublin S; Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.; Epidemiology Department, University of Washington, Seattle, WA, USA.; Department of Health Systems Science, Kaiser Permanente Bernard Tyson School of Medicine, Pasadena, CA, USA.
Jazyk:	angličtina
Zdroj:	Journal of Alzheimer's disease : JAD [J Alzheimers Dis] 2024 Dec 03, pp. 13872877241296161. Date of Electronic Publication: 2024 Dec 03.
DOI:	10.1177/13872877241296161
Abstrakt:	Background: Addressing modifiable risk factors such as physical inactivity and social isolation could reduce risk of Alzheimer's disease and all-cause dementia, but little is known about which factors individuals are most willing to address or how they prefer to address them. Objective: To examine and describe behavior change goals set by participants during the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT). Methods: In SMARRT, older adults worked with a health coach and nurse over 2 years to set incremental, personalized goals to reduce dementia risk. We performed quantitative analyses to summarize the numbers of goals per risk factor and qualitative content analyses of health coach and nurse notes to describe types of goals and useful strategies. Results: 82 dementia-free adults (70 to 89 years) with at least two dementia risk factors participated in the SMARRT intervention arm (mean age, 76 ± 5 years; 72% women; 11% Black/African American, 4% Asian, 3% Hispanic, 7% another non-White race). Participants set a median of 12 health coach goals and 1 nurse goals. The risk factors participants chose to work on most frequently were physical activity (95%), hypertension (72%), and cognitive activity (60%). Participants reported that the most useful strategies included support and accountability from the health coach/nurse, setting small goals, and learning to manage setbacks. Conclusions: When given support, older adults at increased risk for dementia set a wide range of goals to reduce dementia risk. A flexible, personalized approach that focuses on setting feasible goals and managing setbacks provides a useful framework for dementia risk reduction. Competing Interests: Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Barnes is co-founder, Chief Science Advisor, and holds stock in Together Senior Health, Inc., which has created an online program for older adults with subjective cognitive decline that includes brain health education and coaching. The Conflict of Interest Advisory Committee at the University of California, San Francisco, reviewed this relationship and determined that there is no conflict with the SMARRT intervention. Dr Dublin has received grant funding from GSK and Syneos Health for work unrelated to this study. Other authors have no conflicts of interest.
Databáze:	MEDLINE
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