My Healthy Brain: Rationale and Case Report of a Virtual Group Lifestyle Program Targeting Modifiable Risk Factors for Dementia

Ryan A Mace, Sarah W Hopkins, Gretchen O Reynolds, Ana-Maria Vranceanu, Ryan A Mace, Sarah W Hopkins, Gretchen O Reynolds, Ana-Maria Vranceanu

Abstract

Nearly half of dementia cases may be explained by modifiable lifestyle risk factors. Multidomain interventions are needed to bypass cognitive decline (CD) and aging-related barriers to sustained healthy lifestyles in at-risk older adults. We iteratively developed My Healthy Brain, a group-based lifestyle program (8 weeks, 90 min sessions) delivered via live video that applies behavioral principles to target multiple risk factors for dementia. We describe the program structure, virtual delivery, and outcomes for a group of older adults with subjective CD or mild cognitive impairment and lifestyle risk factors (e.g., sedentary, poor sleep or diet). We also conducted a group exit interview to qualitatively assess participant experiences and elicit feedback to improve My Healthy Brain. This case report demonstrates that delivering evidence-based brain health education and behavior change skills in a group setting via live video is feasible, acceptable, and has the potential to improve lifestyle, cognitive, and psychosocial outcomes in older adults with CD.

Keywords: Case study; Cognitive impairment; Dementia; Lifestyle; Telehealth.

Conflict of interest statement

All authors declare that they have no conflicts of interest.

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Figures

Fig. 1
Fig. 1
Conceptual model of multidomain intervention targeting modifiable risk factors of brain disease and optimizing cognitive function with aging

References

    1. Advocat J, Enticott J, Vandenberg B, Hassed C, Hester J, Russell G. The effects of a mindfulness-based lifestyle program for adults with Parkinson’s disease: A mixed methods, wait list controlled randomised control study. BMC Neurology. 2016;16:166. doi: 10.1186/s12883-016-0685-1.
    1. Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic Proceedings. 2011;86:876–884. doi: 10.4065/mcp.2011.0252.
    1. Allan CL, Behrman S, Ebmeier KP, Valkanova V. Diagnosing early cognitive decline—When, how and for whom? Maturitas. 2017;96:103–108. doi: 10.1016/j.maturitas.2016.11.018.
    1. Amireault S, Godin G. The Godin-Shephard leisure-time physical activity questionnaire: Validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories. Perceptual and Motor Skills. 2015;120:604–622. doi: 10.2466/03.27.PMS.120v19x7.
    1. Andel R, Crowe M, Pedersen NL, Fratiglioni L, Johansson B, Gatz M. Physical exercise at midlife and risk of dementia three decades later: A population-based study of Swedish twins. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2008;63:62–66. doi: 10.1093/gerona/63.1.62.
    1. Andrieu, S., Guyonnet, S., Coley, N., Cantet, C., Bonnefoy, M., Bordes, S., Bories, L., Cufi, M.-N., Dantoine, T., Dartigues, J.-F., Desclaux, F., Gabelle, A., Gasnier, Y., Pesce, A., Sudres, K., Touchon, J., Robert, P., Rouaud, O., Legrand, P., … Olivier-Abbal, P Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): A randomised, placebo-controlled trial. The Lancet Neurology. 2017;16:377–389. doi: 10.1016/S1474-4422(17)30040-6.
    1. Ashford JW, Mortimer JA. Non-familial Alzheimer’s disease is mainly due to genetic factors. Journal of Alzheimer’s Disease: JAD. 2002;4:169–177. doi: 10.3233/JAD-2002-4307.
    1. Attkisson, C.C. (1987). Client satisfaction questionnaire (CSQ-8). In K. Corcoran & K. Fischer (Eds.), Measures for clinical practice: A sourcebook (Vol. 2, 3rd Ed.). New York: Free Press.
    1. Barnard Y, Bradley MD, Hodgson F, Lloyd AD. Learning to use new technologies by older adults: Perceived difficulties, experimentation behaviour and usability. Computers in Human Behavior. 2013;29:1715–1724. doi: 10.1016/j.chb.2013.02.006.
    1. Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. The Lancet Neurology. 2011;10:819–828. doi: 10.1016/S1474-4422(11)70072-2.
    1. Barrett S, Begg S, O’Halloran P, Kingsley M. Integrated motivational interviewing and cognitive behaviour therapy for lifestyle mediators of overweight and obesity in community-dwelling adults: A systematic review and meta-analyses. BMC Public Health. 2018;18:1160. doi: 10.1186/s12889-018-6062-9.
    1. Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2015;11:718–726. doi: 10.1016/j.jalz.2015.05.016.
    1. Belleville, S., Nygaard, H. B., Bherer, L., Camicioli, R., Carrier, J., Anderson, N. D., Dang‐Vu, T. T., Dwosh, E., Ferland, G., Harris, E., Laurin, D., Liu‐Ambrose, T., Madlensky, L., Miller, L., Montero‐Odasso, M., Phillips, N., Pichora‐Fuller, M. K., Robillard, J., Smith, E. E., … Feldman, H. H The Brain Health Support Program: A web-based interactive platform to increase dementia literacy and awareness regarding lifestyle factors in at-risk individuals. Alzheimer’s & Dementia. 2020;16:e042603. doi: 10.1002/alz.042603.
    1. Brawley LR, Rejeski WJ, King AC. Promoting physical activity for older adults: The challenges for changing behavior. American Journal of Preventive Medicine. 2003;25:172–183. doi: 10.1016/s0749-3797(03)00182-x.
    1. Brookmeyer R, Johnson E, Ziegler-Graham K, Arrighi HM. Forecasting the global burden of Alzheimer’s disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2007;3:186–191. doi: 10.1016/j.jalz.2007.04.381.
    1. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol use disorders identification test. Archives of Internal Medicine. 1998;158:1789–1795. doi: 10.1001/archinte.158.16.1789.
    1. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research. 1989;28:193–213. doi: 10.1016/0165-1781(89)90047-4.
    1. Cadar D, Pikhart H, Mishra G, Stephen A, Kuh D, Richards M. The role of lifestyle behaviors on 20-year cognitive decline. Journal of Aging Research. 2012;2012:1–13. doi: 10.1155/2012/304014.
    1. Cations M, Radisic G, Crotty M, Laver KE. What does the general public understand about prevention and treatment of dementia? A systematic review of population-based surveys. PLoS ONE. 2018;13:e0196085. doi: 10.1371/journal.pone.0196085.
    1. Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., Amtmann, D., Bode, R., Buysse, D., Choi, S., Cook, K., Devellis, R., DeWalt, D., Fries, J. F., Gershon, R., Hahn, E. A., Lai, J.-S., Pilkonis, P., Revicki, D., … PROMIS Cooperative Group The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. Journal of Clinical Epidemiology. 2010;63:1179–1194. doi: 10.1016/j.jclinepi.2010.04.011.
    1. Cerwinske LA, Rasmussen HE, Lipson S, Volgman AS, Tangney CC. Evaluation of a dietary screener: The Mediterranean Eating Pattern for Americans tool. Journal of Human Nutrition and Dietetics: The Official Journal of the British Dietetic Association. 2017;30:596–603. doi: 10.1111/jhn.12451.
    1. Chaffin AJ, Harlow SD. Cognitive learning applied to older adult learners and technology. Educational Gerontology. 2005;31:301–329. doi: 10.1080/03601270590916803.
    1. Clark F, Jackson J, Carlson M, Chou C-P, Cherry BJ, Jordan-Marsh M, Knight BG, Mandel D, Blanchard J, Granger DA, Wilcox RR, Lai MY, White B, Hay J, Lam C, Marterella A, Azen SP. Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: Results of the well elderly 2 randomised controlled trial. Journal of Epidemiology and Community Health. 2012;66:782–790. doi: 10.1136/jech.2009.099754.
    1. Claudia C, Aguirre E, Barber JA, Bass N, Brodaty H, Burton A, Higgs P, Abrams R, Huntley J, Lang I, Kales HC, Marchant NL, Minihane AM, Ritchie K, Morgan-Trimmer S, Arvanitakis Z, Walters K, Wenborn J, Rapaport P. APPLE-Tree (Active Prevention in People at risk of dementia: Lifestyle, bEhaviour change and Technology to REducE cognitive and functional decline) programme: Protocol. International Journal of Geriatric Psychiatry. 2020;35:811–819. doi: 10.1002/gps.5249.
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior. 1983;24:385–396. doi: 10.2307/2136404.
    1. Constantino MJ, Arnkoff DB, Glass CR, Ametrano RM, Smith JZ. Expectations. Journal of Clinical Psychology. 2011;67:184–192. doi: 10.1002/jclp.20754.
    1. Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry. 2000;31:73–86. doi: 10.1016/S0005-7916(00)00012-4.
    1. Doorley, J. D., Mace, R. A., Popok, P. J., Grunberg, V. A., Ragnhildstveit, A., & Vranceanu, A. M. (2021). Feasibility randomized controlled trial of a mind-body activity program for older adults with chronic pain and cognitive decline: The virtual "Active Brains" study. Gerontologist, 6, gnab135. 10.1093/geront/gnab135
    1. Dutton G. The role of mindfulness in health behavior change. ACSM’S Health & Fitness Journal. 2008;12:7–12. doi: 10.1249/FIT.0b013e31817bf5db.
    1. Eaton, K., Stritzke, W., & Ohan, J. (2019). Using scribes in qualitative research as an alternative to transcription. The Qualitative Report, 24, 586–605. 10.46743/2160-3715/2019.3473
    1. Ewers M, Sperling RA, Klunk WE, Weiner MW, Hampel H. Neuroimaging markers for the prediction and early diagnosis of Alzheimer’s disease dementia. Trends in Neurosciences. 2011;34:430–442. doi: 10.1016/j.tins.2011.05.005.
    1. Gale RC, Wu J, Erhardt T, Bounthavong M, Reardon CM, Damschroder LJ, Midboe AM. Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration. Implementation Science. 2019;14:11. doi: 10.1186/s13012-019-0853-y.
    1. Geda YE, Roberts RO, Knopman DS, Christianson TJH, Pankratz VS, Ivnik RJ, Boeve BF, Tangalos EG, Petersen RC, Rocca WA. Physical exercise, aging, and mild cognitive impairment: A population-based study. Archives of Neurology. 2010 doi: 10.1001/archneurol.2009.297.
    1. Geiger PJ, Boggero IA, Brake CA, Caldera CA, Combs HL, Peters JR, Baer RA. Mindfulness-based interventions for older adults: A review of the effects on physical and emotional well-being. Mindfulness. 2016;7:296–307. doi: 10.1007/s12671-015-0444-1.
    1. Greenberg, J., Lin, A., Zale, E. L., Kulich, R. J., James, P., Millstein, R. A., Shapiro, H., Schatman, M. E., Edwards, R. R., & Vranceanu, A.-M. (2019). Development and early feasibility testing of a mind-body physical activity program for patients with heterogeneous chronic pain; the getactive study. Journal of Pain Research, 12, 3279–3297. 10.2147/JPR.S222448
    1. Hahn, E. A., DeWalt, D. A., Bode, R. K., Garcia, S. F., DeVellis, R. F., Correia, H., Cella, D., & PROMIS Cooperative Group New English and Spanish social health measures will facilitate evaluating health determinants. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association. 2014;33:490–499. doi: 10.1037/hea0000055.
    1. Hamer M, Chida Y. Physical activity and risk of neurodegenerative disease: A systematic review of prospective evidence. Psychological Medicine. 2009;39:3–11. doi: 10.1017/S0033291708003681.
    1. Hamilton AB, Finley EP. Qualitative methods in implementation research: An introduction. Psychiatry Research. 2019;280:112516. doi: 10.1016/j.psychres.2019.112516.
    1. Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis. Archives of Physical Medicine and Rehabilitation. 2004;85:1694–1704. doi: 10.1016/j.apmr.2004.03.019.
    1. Jacobson NS, Truax P. Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology. 1991;59:12–19. doi: 10.1037/0022-006X.59.1.12.
    1. Jansen, W. J., Ossenkoppele, R., Knol, D. L., Tijms, B. M., Scheltens, P., Verhey, F. R. J., Visser, P. J., Aalten, P., Aarsland, D., Alcolea, D., Alexander, M., Almdahl, I. S., Arnold, S. E., Baldeiras, I., Barthel, H., Berckel, B. N. M. van, Bibeau, K., Blennow, K., Brooks, D. J., … Zetterberg, H Prevalence of cerebral amyloid pathology in persons without dementia: A meta-analysis. JAMA. 2015;313:1924–1938. doi: 10.1001/jama.2015.4668.
    1. Janssen V, De Gucht V, Dusseldorp E, Maes S. Lifestyle modification programmes for patients with coronary heart disease: A systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology. 2013;20:620–640. doi: 10.1177/2047487312462824.
    1. Jessen F. Subjective and objective cognitive decline at the pre-dementia stage of Alzheimer’s disease. European Archives of Psychiatry and Clinical Neuroscience. 2014;264:S3–7. doi: 10.1007/s00406-014-0539-z.
    1. Jessen, F., Amariglio, R. E., van Boxtel, M., Breteler, M., Ceccaldi, M., Chételat, G., Dubois, B., Dufouil, C., Ellis, K. A., van der Flier, W. M., Glodzik, L., van Harten, A. C., de Leon, M. J., McHugh, P., Mielke, M. M., Molinuevo, J. L., Mosconi, L., Osorio, R. S., Perrotin, A., … Subjective Cognitive Decline Initiative (SCD-I) Working Group A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2014;10:844–852. doi: 10.1016/j.jalz.2014.01.001.
    1. Lam LC-W, Chan WC, Leung T, Fung AW-T, Leung EM-F. Would older adults with mild cognitive impairment adhere to and benefit from a structured lifestyle activity intervention to enhance cognition?: A cluster randomized controlled trial. PLoS ONE. 2015;10:e0118173. doi: 10.1371/journal.pone.0118173.
    1. Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: A clinical review. JAMA. 2014;312:2551–2561. doi: 10.1001/jama.2014.13806.
    1. Larson EB, Yaffe K, Langa KM. New insights into the dementia epidemic. New England Journal of Medicine. 2013;369:2275–2277. doi: 10.1056/NEJMp1311405.
    1. Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet. 2020;396:413–446. doi: 10.1016/S0140-6736(20)30367-6.
    1. Lourida I, Hannon E, Littlejohns TJ, Langa KM, Hyppönen E, Kuźma E, Llewellyn DJ. Association of lifestyle and genetic risk with incidence of dementia. JAMA. 2019;322:430–437. doi: 10.1001/jama.2019.9879.
    1. Ludwig DS, Kabat-Zinn J. Mindfulness in medicine. JAMA. 2008;300:1350–1352. doi: 10.1001/jama.300.11.1350.
    1. Mace, R. A., Doorley, J. D., Popok, P. J., & Vranceanu, A.-M. (2020). Live video adaptations to a mind-body activity program for chronic pain and cognitive decline: Protocol for the “Virtual Active Brains” study. JMIR Research Protocols. 10.2196/25351
    1. Mace, R. A., Gates, M. V., Bullard, B., Lester, E. G., Silverman, I. H., Quiroz, Y. T., & Vranceanu, A.-M. (2020). Development of a novel mind-body activity and pain management program for older adults with cognitive decline. Gerontologist. 10.1093/geront/gnaa084
    1. Mace, R. A., Gates, M. V., Popok, P. J., Kulich, R., Quiroz, Y. T., & Vranceanu, A.-M. (2020). Feasibility trial of a mind-body activity pain management program for older adults with cognitive decline. Gerontologist. 10.1093/geront/gnaa179
    1. Mace, R., Greenberg, J., Stauder, M., Reynolds, G., & Vranceanu, A. (2021). My Healthy Brain: A multimodal lifestyle program to promote brain health. Aging & Mental Health. 10.1080/13607863.2021.1904828
    1. Mahaffey BL, Mackin DM, Vranceanu A-M, Lofaro L, Bromet EJ, Luft BJ, Gonzalez A. The Stony Brook Health Enhancement Program: The development of an active control condition for mind-body interventions. Journal of Health Psychology. 2020;25(13–14):2129–2140. doi: 10.1177/1359105318787024.
    1. McMaster, M., Kim, S., Clare, L., Torres, S. J., Cherbuin, N., DʼEste, C., & Anstey, K. J Lifestyle risk factors and cognitive outcomes from the multidomain dementia risk reduction randomized controlled trial, body brain life for cognitive decline (BBL-CD) Journal of the American Geriatrics Society. 2020;68:2629–2637. doi: 10.1111/jgs.16762.
    1. Mehta D, Jackson R, Paul G, Shi J, Sabbagh M. Why do trials for Alzheimer’s disease drugs keep failing? A discontinued drug perspective for 2010–2015. Expert Opinion on Investigational Drugs. 2017;26:735–739. doi: 10.1080/13543784.2017.1323868.
    1. Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., Bäckman, L., Hänninen, T., Jula, A., Laatikainen, T., Lindström, J., Mangialasche, F., Paajanen, T., Pajala, S., Peltonen, M., Rauramaa, R., Stigsdotter-Neely, A., Strandberg, T., Tuomilehto, J., … Kivipelto, M A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial. Lancet (London, England) 2015;385:2255–2263. doi: 10.1016/S0140-6736(15)60461-5.
    1. Nissen T, Wynn R. The clinical case report: A review of its merits and limitations. BMC Research Notes. 2014;7:264. doi: 10.1186/1756-0500-7-264.
    1. Onken LS, Carroll KM, Shoham V, Cuthbert BN, Riddle M. Reenvisioning clinical science: Unifying the discipline to improve the public health. Clinical Psychological Science: A Journal of the Association for Psychological Science. 2014;2:22–34. doi: 10.1177/2167702613497932.
    1. Pilkonis PA, Choi SW, Reise SP, Stover AM, Riley WT, Cella D. Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS®): Depression, anxiety, and anger. Assessment. 2011;18:263–283. doi: 10.1177/1073191111411667.
    1. Pilkonis PA, Yu L, Dodds NE, Johnston KL, Maihoefer CC, Lawrence SM. Validation of the depression item bank from the Patient-Reported Outcomes Measurement Information System (PROMIS) in a three-month observational study. Journal of Psychiatric Research. 2014;56:112–119. doi: 10.1016/j.jpsychires.2014.05.010.
    1. Rabin JS, Klein H, Kirn DR, Schultz AP, Yang H-S, Hampton O, Jiang S, Buckley RF, Viswanathan A, Hedden T, Pruzin J, Yau W-YW, Guzmán-Vélez E, Quiroz YT, Properzi M, Marshall GA, Rentz DM, Johnson KA, Sperling RA, Chhatwal JP. Associations of physical activity and β-amyloid with longitudinal cognition and neurodegeneration in clinically normal older adults. JAMA Neurology. 2019;76:1203–1210. doi: 10.1001/jamaneurol.2019.1879.
    1. Raina P, Santaguida P, Ismaila A, Patterson C, Cowan D, Levine M, Booker L, Oremus M. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: Evidence review for a clinical practice guideline. Annals of Internal Medicine. 2008;148:379–397. doi: 10.7326/0003-4819-148-5-200803040-00009.
    1. Renfro CP, Rome Z, Gatwood J, Hohmeier KC. Use of rapid assessment procedures when analyzing qualitative data in pharmacy research. Research in Social and Administrative Pharmacy. 2021 doi: 10.1016/j.sapharm.2021.05.013.
    1. Reuter-Lorenz PA, Park DC. How does it STAC up? Revisiting the scaffolding theory of aging and cognition. Neuropsychology Review. 2014;24:355–370. doi: 10.1007/s11065-014-9270-9.
    1. Rose M, Bjorner JB, Becker J, Fries JF, Ware JE. Evaluation of a preliminary physical function item bank supported the expected advantages of the Patient-Reported Outcomes Measurement Information System (PROMIS) Journal of Clinical Epidemiology. 2008;61:17–33. doi: 10.1016/j.jclinepi.2006.06.025.
    1. Sabayan B, Sorond F. Reducing risk of dementia in older age. JAMA. 2017;317:2028–2028. doi: 10.1001/jama.2017.2247.
    1. Schulte D. Patients’ outcome expectancies and their impression of suitability as predictors of treatment outcome. Psychotherapy Research: Journal of the Society for Psychotherapy Research. 2008;18:481–494. doi: 10.1080/10503300801932505.
    1. Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. Mindfulness and behavior change. Harvard Review of Psychiatry. 2020;28:371–394. doi: 10.1097/HRP.0000000000000277.
    1. Shaha M, Wenzel J, Hill EE. Planning and conducting focus group research with nurses. Nurse Researcher. 2011;18:77–87. doi: 10.7748/nr2011.01.18.2.77.c8286.
    1. Sink KM, Holden KF, Yaffe K. Pharmacological treatment of neuropsychiatric symptoms of dementia: A review of the evidence. JAMA. 2005;293:596. doi: 10.1001/jama.293.5.596.
    1. Slooter AJ, Cruts M, Kalmijn S, Hofman A, Breteler MM, Van Broeckhoven C, van Duijn CM. Risk estimates of dementia by apolipoprotein E genotypes from a population-based incidence study: The Rotterdam Study. Archives of Neurology. 1998;55:964–968. doi: 10.1001/archneur.55.7.964.
    1. SPRINT MIND Investigators for the SPRINT Research Group, Williamson, J. D., Pajewski, N. M., Auchus, A. P., Bryan, R. N., Chelune, G., Cheung, A. K., Cleveland, M. L., Coker, L. H., Crowe, M. G., Cushman, W. C., Cutler, J. A., Davatzikos, C., Desiderio, L., Erus, G., Fine, L. J., Gaussoin, S. A., Harris, D., Hsieh, M.-K., … Wright, C. B Effect of intensive vs standard blood pressure control on probable dementia: A randomized clinical trial. JAMA. 2019;321:553–561. doi: 10.1001/jama.2018.21442.
    1. Sullivan AN, Lachman ME. Behavior change with fitness technology in sedentary adults: A review of the evidence for increasing physical activity. Frontiers in Public Health. 2017 doi: 10.3389/fpubh.2016.00289.
    1. Tomaszewski Farias S, Mungas D, Harvey DJ, Simmons A, Reed BR, Decarli C. The measurement of everyday cognition: Development and validation of a short form of the Everyday Cognition scales. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2011;7:593–601. doi: 10.1016/j.jalz.2011.02.007.
    1. Tsai H-YS, Shillair R, Cotten SR. Social support and “playing around”: An examination of how older adults acquire digital literacy with tablet computers. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society. 2017;36:29–55. doi: 10.1177/0733464815609440.
    1. Tuso P. Strategies to increase physical activity. The Permanente Journal. 2015;19:84–88. doi: 10.7812/TPP/14-242.
    1. Verlinden VJA, van der Geest JN, de Bruijn RFAG, Hofman A, Koudstaal PJ, Ikram MA. Trajectories of decline in cognition and daily functioning in preclinical dementia. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. 2016;12:144–153. doi: 10.1016/j.jalz.2015.08.001.
    1. White ND, Lenz TL, Smith K. Tool guide for lifestyle behavior change in a cardiovascular risk reduction program. Psychology Research and Behavior Management. 2013;6:55–63. doi: 10.2147/PRBM.S40490.
    1. Whitmer RA, Sidney S, Selby J, Johnston SC, Yaffe K. Midlife cardiovascular risk factors and risk of dementia in late life. Neurology. 2005;64:277–281. doi: 10.1212/01.WNL.0000149519.47454.F2.
    1. Xu W, Tan L, Wang H-F, Jiang T, Tan M-S, Tan L, Zhao Q-F, Li J-Q, Wang J, Yu J-T. Meta-analysis of modifiable risk factors for Alzheimer’s disease. Journal of Neurology, Neurosurgery & Psychiatry. 2015 doi: 10.1136/jnnp-2015-310548.
    1. Goossens, M. E. J. B., Vlaeyen, J. W. S., Hidding, A., Kole-Snijders, A., & Evers, S. M. A. A. (2005). Treatment expectancy affects the outcome of cognitive-behavioral interventions in chronic pain. The Clinical Journal of Pain, 21, 18–26; discussion 69–72. 10.1097/00002508-200501000-00003
    1. Merriam, S. B., Caffarella, R. S., & Baumgartner, L. (2012). Learning in adulthood: A comprehensive guide. Wiley.
    1. Rosenbloom, M., Borson, S., Barclay, T., Hanson, L. R., Werner, A., Stuck, L., & McCarten, J. (2016). Routine cognitive screening in a neurology practice. Neurology: Clinical Practice, 6, 16–21. 10.1212/CPJ.0000000000000186
    1. Rubin, H. J., & Rubin, I. S. (2005). Qualitative interviewing (2nd ed.): The art of hearing data (2nd ed.). SAGE Publications, Inc. 10.4135/9781452226651
    1. Taylor, B., Henshall, C., Kenyon, S., Litchfield, I., & Greenfield, S. (2018). Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis. BMJ Open. 10.1136/bmjopen-2017-019993
    1. Vranceanu, A.-M., Zale, E. L., Funes, C. J., Macklin, E. A., McCurley, J., Park, E. R., Jordan, J. T., Lin, A., & Plotkin, S. R. (2018). Mind-body treatment for international english-speaking adults with neurofibromatosis via live videoconferencing: Protocol for a single-blind randomized controlled trial. JMIR Research Protocols, 7(10), e11008. 10.2196/11008
    1. World Health Organization. (2017). Global action plan on the public health response to dementia 2017–2025 (p. 44).

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