Personalized Alzheimer’s Risk Reduction Software Improves Calculated Alzheimer’s Risk: A Digital, Decentralized, Randomized Controlled Trial
Richard Isaacson1, Jennifer Reschke2, Mark McInnis2, Tammie Elgammal2, Paula Spencer Scott2, Sandeep Chinthapatlab2, Nabeel Saif3, Jeff Welge4, Kellyann Niotis1, Robert Krikorian4
1The Institute for Neurodegenerative Diseases (IND) Florida, 2Retain Health Inc., 3State University of New York Upstate Medical University, 4Dept of Psychiatry & Behavioral Neuroscience, University of Cincinnati Academic Health Center
Objective:
To determine the efficacy of automated digital health risk reduction software compared to a time-neutral control in lowering calculated Alzheimer’s risk.
Background:
Over 300 million people worldwide have Alzheimer’s disease (AD) pathology starting silently in their brains decades before symptoms begin. Research shows that 45% of dementia cases may be preventable by addressing modifiable risk factors, and growing evidence supports the efficacy of multimodal risk reduction care for at-risk individuals. With AD prevalence nearly surpassing capacity of available specialists, a scalable solution is needed. Digital devices may serve as a mechanism for broad and cost-effective dissemination of risk reduction interventions.
Design/Methods:
RetainYourBrain is an interactive, evidence-based, online software application that identifies users’ risk factors, sets priorities for improvement, educates, provides automated, customized recommendations and support, and longitudinally monitors outcomes. We evaluated its effectiveness on calculated Alzheimer’s risk (Alzheimer’s National University-AD Risk Index [ANU-ADRI]) in a 6-month randomized controlled trial against a time-neutral control in people ≥53 years with a family history of AD (n=987). Analysis of covariance models, with treatment arm as the main factor and baseline risk score as the covariate, were used to evaluate treatment effects on the ANU-ADRI score.
Results:
There were no significant differences in baseline characteristics between the intervention and control arms. Participants were largely married/partnered, well-educated, and White (mean age 64.2 years; SD=6.9) and 75% of the sample completed final assessments (n=737 analyzable). This personalized digital health intervention significantly reduced ANU-ADRI total score after 6-months (ß=0.86, 95%CI=[0.02, 1.55], p=0.014) versus controls.
Conclusions:
RetainYourBrain effectively promotes behavior change in lifestyle domains linked to dementia risk. This innovative software offers a convenient, automated and cost-effective method for lowering AD risk that can be implemented more widely than otherwise possible in traditional, face-to-face health care encounters (ClinicalTrials.gov/NCT06027320).
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