None listed
Conditions
Brief summary
While there is currently no cure for dementia, there is evidence that some health conditions and lifestyles may increase the risk of developing dementia. Some of these risk factors for dementia can exist in mid-life, well before a person may start to show signs or symptoms of dementia. HAPPI MIND is a multi-domain intervention that brings together the expertise of different health professional groups to help reduce dementia risk factors and subsequent development of dementia in at-risk middle-aged adults. This primary care based model involves dementia risk assessment led by the practice nurse and GP, motivational interviewing to drive behavioural change, multidisciplinary management of dementia risk factors and a smart-phone app supported self-management of dementia risk factors. The study aims to evaluate the effectiveness and cost-effectiveness of the HAPPI MIND program for assessing dementia risk and reducing dementia risk factors in middle-aged adults in the primary care setting. It is hypothesised that primary care-based dementia risk assessment will lead to increased awareness and detection of dementia risk factors, and the tailored interdisciplinary GP/nurse-coordinated health promotion program (HAPPI MIND) will lead to reduced dementia risk, compared usual care and dementia risk assessment alone (minimal intervention).
Interventions
The main intervention will include;
• an individualised report (based on participants ANU-ADRI score) outlining risk factors known to be linked with increased risk of developing dementia in later-life.
• an educational booklet on dementia risk reduction prepared by Dementia Australia (available at https://www.dementia.org.au/sites/default/files/2020-07/20081_DA_HealthyBrainHealthyLife_A5_BOOKLET_FA_WEB.pdf).
• six individualised dementia risk reduction motivational interview sessions with a tra
The main intervention will include; • an individualised report (based on participants ANU-ADRI score) outlining risk factors known to be linked with increased risk of developing dementia in later-life. • an educational booklet on dementia risk reduction prepared by Dementia Australia (available at https://www.dementia.org.au/sites/default/files/2020-07/20081_DA_HealthyBrainHealthyLife_A5_BOOKLET_FA_WEB.pdf). • six individualised dementia risk reduction motivational interview sessions with a trained nurse. These sessions will occur face-to-face or via telephone or video telehealth. They will occur every 3 months for the first year then annually for a further 2 years. The first session will take 30-60minutes, with follow-up sessions likely being shorter (15-30minutes). The sessions will involve a review of the participant's dementia risk profile (and progress to date for follow-up sessions); identification of risk factors to target; discussion of capability, opportunity and motivation for behaviour change; and setting SMART (specific, measurable, attainable, realistic and timely) goals. Fidelity of the intervention will be measured using an intervention checklist completed by nurse at each session, and audio-recording at least one session at each time-point. • a purpose-built HAPPI MIND smart phone app to support self-management of dementia risk factors at home and to track progress against risk reduction goals. Participant's will be encouraged to monitor their risk factors in accordance with their SMART goals - daily, weekly or less frequently as appropriate. Participants will be encouraged to use the app for the full three year trial. Engagement with the app (duration and frequency of use) will be evaluated using app analytics from CSIRO.
Sponsors
Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
45 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Community-dwelling adults, aged 45-65years, with two or more modifiable risk factors for dementia who have access to, and are able to use, a smartphone, and who have had at least one visit to the practice/clinic in the previous 12 months, will be eligible. One or more visits will indicate patient engagement with the practice/clinic. Modifiable risk factors include: high blood pressure, hyperlipidaemia, type 2 diabetes, obesity, current smoking, physical inactivity, poor diet, excessive drinking of alcohol, depression, social isolation and lack of cognitive stimulation.
Exclusion criteria
Patients who are unable to provide informed consent, those unable to communicate in English, those with a terminal illness (anticipated survival <36 months) or those with other conditions preventing participation in the study as judged by the GP or their nominee will be excluded. Patients with a history of existing dementia, cognitive impairment or other significant neurologic disease (e.g. Parkinson’s disease, Huntington’s disease, multiple sclerosis, normal pressure hydrocephalus, progressive supranuclear palsy, seizure disorder, subdural hematoma, or history of significant head trauma with persistent neurologic sequelae or known structural brain abnormalities) will be excluded. Patients who are involved in other clinical trials targeting any of the modifiable risk factors for dementia listed above will be excluded.
Outcome results
None listed