An Online Shared Decision-making Intervention for Dementia Prevention: A Parallel-group Randomized Pilot Study.

Raymond L Ownby, Rosemary Davenport
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Abstract

Objectives: Evaluate the acceptability and efficacy of an online dementia prevention intervention based on a cognitive behavioral shared decision-making model.

Materials and methods: This was an unblinded pilot study in which participants were randomly assigned to one of two treatment groups. This study was carried out remotely via telephone, video conferencing, and online data collection. Eighteen English-speaking persons 40 years of age and older interested in developing more brain-healthy lifestyles. Both groups received 12 weekly sessions on lifestyle factors related to cognitive decline. The treatment-as-usual (TAU) group received the information and was encouraged to make lifestyle changes. The cognitive behavioral shared decision- making model (CBSDM) group received structured weekly sessions with support for evidence- informed personal goal choices and behavior change strategies. Primary outcome measures were the Alzheimer's Disease Risk Inventory and the Memory Self-Efficacy and Dementia Knowledge Assessment Scales. Participants reported brain health activities during the first, sixth, and 12th weeks of the study.

Results: No significant between-group changes were seen in the three primary outcome measures. The intervention was viewed positively by participants, who all said they would participate in it again. Participants in the CBSDM group showed increases in knowledge of dementia risk factors and exercise. Other outcomes were consistent with moderate to large effect sizes for both groups.

Conclusion: An online intervention providing psychoeducation and behavior change support was viewed positively by older adults. Results provide preliminary support for the CBSDM intervention's efficacy in promoting brain health in older adults.

Clinical trial registration number: NCT04822129.

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预防痴呆的在线共享决策干预:一项平行组随机先导研究。
目的:评估基于认知行为共享决策模型的在线痴呆预防干预的可接受性和有效性。材料和方法:这是一项非盲法先导研究,参与者被随机分配到两个治疗组之一。设置:本研究通过电话、视频会议和在线数据收集远程进行。参与者:18名40岁及以上的英语人士,他们对发展更健康的大脑生活方式感兴趣。干预:两组患者每周接受12次与认知能力下降有关的生活方式因素的治疗。照旧治疗组(TAU)收到了这些信息,并被鼓励改变生活方式。认知行为共享决策模型(CBSDM)组接受结构化的每周会议,支持证据知情的个人目标选择和行为改变策略。测量:主要结果测量是阿尔茨海默病风险量表和记忆自我效能和痴呆知识评估量表。参与者在研究的第一、第六和第十二周报告了大脑健康活动。结果:三个主要结局指标在组间无明显变化。参与者对干预的评价是积极的,他们都表示会再次参与。CBSDM组的参与者对痴呆症风险因素的认识和锻炼都有所增加。两组的其他结果均为中等到较大的效应值。结论:老年人对提供心理教育和行为改变支持的在线干预持积极态度。结果为CBSDM干预在促进老年人脑健康方面的有效性提供了初步支持。
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