• Posted November 28, 2023

Could a 'Brain Coach' Help Folks at Higher Risk for Alzheimer's?

Personal trainers can help people increase their strength and their fitness.

Could a “brain coach” be just as useful in preventing Alzheimer's' disease?

A new study suggests that personalized health and lifestyle changes can delay or even prevent memory loss for older adults at high risk of Alzheimer's or dementia.

People who received personal coaching experienced a 74% boost in their thinking and memory tests compared with those who didn't receive such attention.

“This is the first personalized intervention, focusing on multiple areas of cognition, in which risk factor targets are based on a participant's risk profile, preferences and priorities, which we think may be more effective than a one-size-fits-all approach,” said co-lead researcher Dr. Kristine Yaffe, vice chair of research in psychiatry at the University of California, San Francisco (UCSF).

For the study, researchers recruited 172 participants and assigned half to receive personal training in health and lifestyle areas believed to increase Alzheimer's risk.

The participants were between the ages of 70 and 89, and all had at least two of eight risk factors for dementia -- physical inactivity, high blood pressure, uncontrolled diabetes, poor sleep, use of prescription medications associated with risk of cognitive decline, high depressive symptoms, social isolation and smoking.

Patients met with a nurse and health coach and selected specific risk factors they wanted to address. They set personal goals like upping their number of daily steps or tracking their high blood pressure, and received coaching sessions every few months to review their progress.

Along with the boost in cognitive scores, participants also experienced a 145% improvement in their risk factors compared to those who didn't get coaching, as well as an 8% improvement in their quality of life.

The meetings started in person and switched to phone calls during the pandemic, but that didn't seem to affect the effectiveness of the coaching.

“We were pleasantly surprised that the positive results of the trial were not offset by the impact of the pandemic,” said co-lead researcher Dr. Eric Larson, a professor of medicine at University of Washington.

“We know that isolation from social distancing took a heavy toll on cognition, social lives, and mental and physical health in some older adults,” Larson added. “But participants in the intervention group fared better cognitively and had fewer risk factors after the trial, during the pandemic, than they did before.”

Such risk-reduction programs are a lot less expensive than pricey new Alzheimer's drugs like Aduhelm and Leqembi, Yaffe said. They also don't have strict eligibility criteria, and don't require extensive monitoring for potential side effects like brain bleeding.

“Hopefully in the future, treatment of Alzheimer's and related dementias will be like cardiovascular disease management, with a combination of risk-reduction and specific drugs targeted for disease mechanisms,” Yaffe said in a UCSF news release.

The study was published Nov. 27 in the journal JAMA Internal Medicine.

More information

The Alzheimer's Association has more on risk factors for Alzheimer's.

SOURCE: University of California, San Francisco, news release, Nov. 27, 2023