Mace Ryan A, Greenberg Jonathan, Stauder Matthew, Reynolds Gretchen, Vranceanu Ana-Maria
Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Aging Ment Health. 2022 May;26(5):980-991. doi: 10.1080/13607863.2021.1904828. Epub 2021 Mar 30.
Promoting brain health depends on sustaining healthy behaviors across the lifespan. Yet, public adoption of lifestyle behaviors and knowledge of cognitive decline (CD) prevention remains poor. Our multidisciplinary team developed (MHB) to promote a healthy lifestyle (e.g. diet, exercise, alcohol, sleep) and build cognitive reserve (e.g. memory compensatory strategies). Our objective was to demonstrate early proof-of-concept for MHB by exploring the feasibility, acceptability, and improvement in primary lifestyle outcomes as well as secondary outcomes of self-determination and subjective wellbeing.
Older adults with subjective (self-report only) or objective (confirmed by cognitive testing) CD, referred by neurologists to modify lifestyle risk factors (e.g. sedentary), participated in a non-randomized open pilot of MHB ( = 24). Participants completed the 8-week MHB group (90 min each) and pre-post outcome measures.
MHB met all a-priori set benchmarks, including good feasibility of (71% of patients screened) and (75% completed baseline), and good (75% completed 6 of 8 sessions and post-testing). Program satisfaction was excellent (100% of participants) and no adverse events were reported. We also observed improvements in primary lifestyle outcomes as well as secondary outcomes of self-determination and subjective well-being.
While MHB demonstrated preliminary feasibility and the potential to modify lifestyle risk factors for CD, the program can be improved. Future work will explore the integration of mindfulness skills with behavioral principles to bolster multidomain lifestyle change, and the live video delivery format to bypass barriers to participation.
促进大脑健康依赖于在整个生命周期中维持健康行为。然而，公众对生活方式行为的采用以及对认知衰退（CD）预防的了解仍然很差。我们的多学科团队开发了“促进大脑健康计划”（MHB），以促进健康的生活方式（如饮食、运动、饮酒、睡眠）并建立认知储备（如记忆补偿策略）。我们的目标是通过探索MHB在主要生活方式结果以及自我决定和主观幸福感等次要结果方面的可行性、可接受性和改善情况，来展示其早期概念验证。
由神经科医生转介来改变生活方式风险因素（如久坐不动）的主观（仅自我报告）或客观（通过认知测试确认）患有CD的老年人，参与了MHB的非随机开放试点（n = 24）。参与者完成了为期8周的MHB小组课程（每次90分钟）以及前后结果测量。
MHB达到了所有预先设定的基准，包括良好的筛查可行性（71%的患者接受了筛查）和入组率（75%完成了基线评估），以及良好的留存率（75%完成了8次课程中的6次并进行了测试后评估）。项目满意度极佳（100%的参与者），且未报告不良事件。我们还观察到主要生活方式结果以及自我决定和主观幸福感等次要结果有所改善。
虽然MHB展示了初步的可行性以及改变CD生活方式风险因素的潜力，但该项目仍可改进。未来的工作将探索将正念技能与行为原则相结合，以加强多领域生活方式改变，以及采用直播视频授课形式以消除参与障碍。
