Barnes Deborah E, Balderson Benjamin H, Shulman Lisa, Rosenberg Dori E, Matson Theresa E, Mettert Kayne D, Delaney Kristin, King Deborah, Adams Kristin, Fleckenstein Lynn, Peltz Carrie B, Idu Abisola, Larson Eric B, Yaffe Kristine, Dublin Sascha
Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
J Alzheimers Dis. 2024 Dec;102(4):1121-1132. doi: 10.1177/13872877241296161. Epub 2024 Dec 3.
Addressing modifiable risk factors such as physical inactivity and social isolation could reduce risk of Alzheimer's disease and all-cause dementia, but little is known about which factors individuals are most willing to address or how they prefer to address them.
To examine and describe behavior change goals set by participants during the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT).
In SMARRT, older adults worked with a health coach and nurse over 2 years to set incremental, personalized goals to reduce dementia risk. We performed quantitative analyses to summarize the numbers of goals per risk factor and qualitative content analyses of health coach and nurse notes to describe types of goals and useful strategies.
82 dementia-free adults (70 to 89 years) with at least two dementia risk factors participated in the SMARRT intervention arm (mean age, 76 ± 5 years; 72% women; 11% Black/African American, 4% Asian, 3% Hispanic, 7% another non-White race). Participants set a median of 12 health coach goals and 1 nurse goals. The risk factors participants chose to work on most frequently were physical activity (95%), hypertension (72%), and cognitive activity (60%). Participants reported that the most useful strategies included support and accountability from the health coach/nurse, setting small goals, and learning to manage setbacks.
When given support, older adults at increased risk for dementia set a wide range of goals to reduce dementia risk. A flexible, personalized approach that focuses on setting feasible goals and managing setbacks provides a useful framework for dementia risk reduction.
解决诸如缺乏身体活动和社交孤立等可改变的风险因素可能会降低患阿尔茨海默病和全因性痴呆的风险，但对于个体最愿意解决哪些因素以及他们更喜欢如何解决这些因素，我们知之甚少。
研究并描述参与者在系统性多领域阿尔茨海默病风险降低试验（SMARRT）中设定的行为改变目标。
在SMARRT中，老年人与健康教练和护士合作两年，设定逐步推进的个性化目标以降低痴呆风险。我们进行了定量分析以总结每个风险因素的目标数量，并对健康教练和护士的记录进行定性内容分析，以描述目标类型和有用策略。
82名无痴呆的成年人（70至89岁），至少有两个痴呆风险因素，参与了SMARRT干预组（平均年龄76±5岁；72%为女性；11%为黑人/非裔美国人，4%为亚洲人，3%为西班牙裔，7%为其他非白人种族）。参与者设定的健康教练目标中位数为12个，护士目标中位数为1个。参与者选择最常处理的风险因素是身体活动（95%）、高血压（72%）和认知活动（60%）。参与者报告说，最有用的策略包括健康教练/护士的支持和问责、设定小目标以及学习应对挫折。
在获得支持的情况下，痴呆风险增加的老年人会设定广泛的目标以降低痴呆风险。一种灵活的、个性化的方法，专注于设定可行的目标和应对挫折，为降低痴呆风险提供了一个有用的框架。
