Digital multidomain lifestyle intervention to address cognitive health and modifiable risk factors for Alzheimer's disease

PROJECT SUMMARY Alzheimer s DiseaseADis expected to affectmillion people worldwide bybut as many as one third of these cases may be prevented by targeting modifiable risk factors such as dietphysical activitycognitive engagementand smokingNeurotrack TechnologiesInchas developed a digital multi domain lifestyle intervention for cognitive health designed to change behaviors associated with increased risk for ADIn a pilot studythis intervention supported significant behavior changes in multiple lifestyle domainsreduced depressive and anxiety symptomsand improved performance on a composite measure of cognitionThis digital intervention addresses the challenge of scaling effective multidomain lifestyle interventions for cognitive health and has the potential to improve risk behaviors and delay or reduce cognitive decline in older adults at risk for ADRobust trials of multi domain risk reduction interventions have demonstrated an ability to reduce the rate of cognitive declinemultimorbidityand cognitive impairmentHoweverscalability is limited by costintensity of the interventionnumber and diversity of healthcare professionals requiredand participant inconvenienceThusa lower costeasier to disseminate version would have the potential for high impact on public healthand digital interventions hold great promise for addressing this needNeurotrack s digital cognitive health program modeled on the landmark FINGER protocol provides structuredsemi tailored support for behavioral change across multiple domains through a mobile app and on demand health coachingThis Fast Track SBIR is designed to refine the digital platformPhase Iand conduct a randomized controlled trialPhase IIPHASE IAimRefine Neurotrack s digital multi domain lifestyle intervention interface and content delivery to optimize adoptionengagementand adherenceUser testing will provide information to improve design and deliveryof testers achieveTask Success Rateand the app will be replicated for delivery on Android devicesAndroid app passesof functionalitybug checksPHASE IIAimDetermine the effect of a two year digital multi domain AD risk reduction intervention on composite risk for AD in older adults at risk of developing ADAimDetermine the effect on the rate of cognitive declineAimDetermine the effect on change in general health outcomesThe Digital Cognitive Multi domain Alzheimer s Risk VelocityDC MARVELtrial will includeat risk adults agerandomized to a two year Memory Health ProgramMHPor digital health education protocol controlEndpoints will be assessed at baselineandmonthsMilestonesAtmonthsbetween groups difference ofpt on ANU ADRI andpt on RBANSandchangethe minimal clinically important difference on biomarkersfunctional measuresand behavioralquality of life measures for MHP from baseline tomonthsThis Fast Track SBIR has the potential for high impact by determining whether a broadly disseminable digital program can slow cognitive decline in at risk participants to ultimately delay or prevent AD onset PROJECT NARRATIVEAs many as one third of Alzheimer s Disease diagnoses may be prevented by targeting risk factors such as physical activitynutritioncognitive engagementand smokingBuilding on the success of in person lifestyle interventions to address these and other risk factorsthis study is designed to further develop and test a digital therapy that uses health education and coaching to reduce risk and potentially delay or prevent cognitive decline in adults at risk for the diseaseIf successfulthis digital therapy would expand the availability of effective lifestyle interventions to a much larger proportion of the population and may substantially reduce the number of people diagnosed with Alzheimer s Disease in the coming decades