Abstract Details

Title The Brain Health Champion Study: Promoting Non-Pharmacological Interventions in Cognitive Disorders

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S9 - Aging and Dementia: Clinical Trials and Novel Therapies (3:52 PM-4:03 PM)

Poster/Presentation
Number 003

Objective To investigate novel ways to augment brain-healthy behaviors in patients with MCI and mild dementia.

Background

There is growing consensus among major medical organizations that adoption of certain healthy behaviors (e.g., physical exercise, Mediterranean diet, cognitively/socially stimulating activities) is essential to mitigate age-related brain and vascular disease. A wide gap remains between these consensus recommendations for lifestyle changes and their implementation in clinical practice, which does not systematically promote or monitor brain-healthy behaviors. Although neurologists often advise patients to adopt healthy lifestyles, more immediate medical issues commonly become the focus during follow-up visits. A health coaching model, utilizing relatively low-cost college graduates, may be an effective way to bridge this gap.

Design/Methods

We piloted a six-month, randomized, controlled investigation of 40 patients from the Alzheimer Center at Brigham and Women’s Hospital with dementia, MCI, or subjective cognitive decline. In the active intervention arm, patients and caregivers worked with an additional clinical team member, a “brain health champion” (BHC), participating in weekly motivational interviewing phone calls and additional in-person visits every six weeks. During encounters, BHCs and patients/caregivers worked together to establish and update personalized, attainable goals. Using validated questionnaires, changes in physical activity, dietary pattern, and cognitive/social engagement were measured. Secondary outcomes included quality of life (QOL), cognitive function, and neuropsychiatric status.

Results Compared to the standard-of-care control group, BHC participants had statistically significant and clinically meaningful increases in brain-healthy behavior scores and QOL. Cohen’s-d effect sizes were in the large to very large range for physical activity (d=1.37, p<0.001), Mediterranean diet (d=0.87, p=0.016), cognitive and social activity (d=1.09, p=0.003), and QOL (d=1.54, p<0.001). BHCs helped participants access existing, cost-effective, community-based resources to achieve goals.

Conclusions Our pilot results strongly demonstrate the potential efficacy of the BHC program, an inexpensive, interactive, multi-modal health coaching approach, in helping patients adopt consensus-based brain health recommendations.

Authors/Disclosures
Seth Gale, MD (Brigham and Womens Hospital) PRESENTER	Dr. Gale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cowen. The institution of Dr. Gale has received research support from Brigham And Women's Hospital.
	No disclosure on file
Kirk R. Daffner, MD, FAAN (Brigham & Women's Hospital - Harvard Medical School)	The institution of Dr. Daffner has received research support from Azheimer's Association.

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