A web‐based multidomain intervention improves modifiable risk factors for Alzheimer's disease
Bibliographic record
Abstract
BACKGROUND: The Canadian Therapeutics Platform for Multidomain Interventions to Prevent Dementia (CAN-THUMBS UP (CTU)) was developed to address modifiable lifestyle risk factors through its online program Brain Health PRO (BHPro), to enable Canadians to participate remotely across a broad geography, and at a significantly lower operational cost compared to in-person initiatives. This program self surveys multiple risk factors and provides personalized profiles to its participants. We report here on the results of the inception cohort's risk factor profiles and longitudinal outcomes following the BHPro intervention. METHOD: A twelve-month, prospective, multi-center, longitudinal study of BHPro was launched in March 2022. 353 participants throughout Canada were enrolled, including older adults with no cognitive impairment or those with mild cognitive impairment (MCI), and at least one dementia risk factor (first-degree family history of dementia, hypertension, hypercholesterolemia, body mass index >30 or physical inactivity). The intervention comprised of 181 online, interactive chapters covering dementia risk factors, delivered progressively over 10 months. The primary outcome was dementia literacy, and secondary outcomes included self-efficacy, both of which are reported separately. The exploratory outcomes included a change in a composite score of 7 self-reported, modifiable risk factors, including physical activity, nutrition, cognitive engagement, social/psychological function, vascular health, sleep, and vision/hearing, as well as change in individual risk factors. Lifestyle questionnaires were adapted from published literature. RESULT: A covariate-adjusted mixed linear model for the intention-to-treat sample (N = 353; mean age = 69.7) revealed a significant positive change in a composite lifestyle risk score at 6 months (standardized change = 0.162; p < 0.001), and 12 months (standardized change = 0.167; p < 0.001). Individually, physical activity, nutrition, cognitive engagement, and sleep showed statistically significant improvements at both 6 and 12 months. CONCLUSION: BHPro, a relatively inexpensive web-based multidomain intervention, improves key modifiable risk factors for Alzheimer's disease following a program duration of either 6 or 12 months. Future studies will assess efficacy in a larger and more diverse population at risk for Alzheimers disease, and prospectively determine how improving lifestyle may reduce the risk of developing dementia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".