On 1st August, 2022 Professor Henry Brodaty at UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA) presented a brief report by Zoom on the outcome of Maintain Your Brain (MYB) at the world’s largest dementia conference, the Alzheimer’s Association International Conference held in San Diego. In the ten-minute pre-recorded talk Professor Brodaty outlined the purpose, techniques, recruitment, results and implications of MYB.
MYB recruited participants aged 55-77 years old in 2018 through the 45 and Up Study to determine whether engagement in healthy lifestyle behaviours could delay or prevent cognitive decline associated with ageing and ultimately dementia.
Over 6,000 people volunteered to be involved in MYB, completed all baseline questions and had at least one of four risk factors for cognitive decline: low physical activity, sub optimal dietary intake, sub optimal cognitive activity and anxiety/ depression symptoms or history of either. The MYB team devised an online program broken down into modules to address each of these factors. Participants were eligible to receive up to four modules tailored to meet individual risk factors. After completing each module, participants received regular booster sessions until the end of year three.
Furthermore, participants were randomly divided into two groups. Participants in both groups received up to four ten-week modules over year one tailored to individual risk factors. One group received information for each module curated from publicly available, authoritative guidelines. The other group received coaching for each eligible module. Both groups received booster sessions until the end of year three.
Initial analysis demonstrated that both groups showed improvement in cognition generally and in specific domains of cognition. Those in the coaching group improved more than those receiving information.
The MYB team is now completing analysis of the data and preparing a paper for publication. “The implications of the findings from MYB are that larger population-based interventions to prevent cognitive decline with ageing are warranted,” says Professor Brodaty.
The Maintain Your Brain trial, led by CHeBA Co-Director Professor Henry Brodaty AO, was featured on ABC News. The groundbreaking trial assesses over 6,200 Australians in an attempt to prevent dementia and cognitive decline.
Article written by Heidi Mitchell, Marketing & Communications Officer, CHeBA
Research led by Professor Henry Brodaty at UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA) has been highlighted in a special issue of the Journal of Alzheimer’s Disease. The protocol paper showcases the significance of CHeBA’s Maintain Your Brain trial in relation to dementia risk reduction and translation into practice. Protocol papers standardly are used to help improve the standard of medical research.
Current estimates suggest that around the world there is a new case of dementia every 3 seconds. Unchanged, this will see the current number of 50 million people living with dementia triple by 2050.
Professor Henry Brodaty says that in the past 20 years there have been over 100 attempts at developing drug treatments for dementia but only four have been approved, all being symptomatic and not disease modifying. No new drug has been approved in almost 20 years.
“Given the scale of the issue and the challenging path to a cure, there is an increasing focus on prevention,” says Professor Brodaty.
“As much as 30% of all late-life dementia could be associated with preventable lifestyle factors,” he said.
Maintain Your Brain (MYB) is a randomised controlled trial of an online multi-modal lifestyle intervention targeting these modifiable dementia risk factors with the primary aim being to reduce cognitive decline in people aged 55-77 years.
“The people in our trial are young enough to be able to prevent the accumulation of more pathology in their brain, and old enough that we can study the outcomes to benefit future generations,” says Professor Brodaty.
The published paper details the protocol for this three-year trial which focuses on interventions built around four areas of physical activity, nutrition, cognitive training and mental health. Interventions are personalised so participants receive the most appropriate modules.
Lead author of the paper and Study Coordinator of Maintain Your Brain, Dr Megan Heffernan, says that the study finished recruitment in October 2018, with over 6,000 people volunteering to be involved.
“Our participants are currently completing their 12-month assessments.
“If successful, MYB will provide a model for not just effective intervention among older adults, but an intervention that is scalable for broad use internationally,” says Dr Heffernan.
Article written by Tiffany Chau, Research Assistant, Maintain Your Brain, CHeBA
Maintain Your Brain (MYB) is the largest trial in the world to attempt to prevent cognitive decline and potentially dementia through an online intervention program. Participants, aged 55 to 77, are screened for modifiable dementia risk factors related to four modules that comprise the Maintain Your Brain intervention: Physical Activity, Nutrition, Brain Training and Peace of Mind.
“Internet-based delivery of lifestyle interventions can prevent or delay cognitive decline, are cost-effective and allow scalability at a population level.”
A dress rehearsal of the main trial, the Pilot study, started in November 2017 and 425 participants consented to the study. Eligible participants went on to complete one of the four 10-week modules. The Pilot study concluded in February 2018. Based on challenges and feedback in Pilot, the Maintain Your Brain digital platform was modified in preparation for the main trial (e.g., extended recruitment period, clearer instructions and timeline for participants, ensured help was easily accessible on the platform).
The Maintain Your Brain main trial recruited between June - October 2018. Of a total of 14,064 participants who consented to the Maintain Your Brain trial, 6,236 participants were eligible and randomised into the trial. The first group started their first module in July 2018, while the second group commenced in October 2018. Recruitment has now closed, and all participants are currently completing their modules (up to 4 modules).
“Of course declining memory with age worries most of us. But together, we can search for the key to preventing memory and thinking problems!”
Maintain Your Brain will run for 3 years and if successful, it will provide a model for an intervention that is scalable for national and international use.
Article written by Heidi Mitchell, Marketing & Communications Officer, CHeBA
CHeBA Co-Directors Professors Henry Brodaty and Perminder Sachdev showcased CHeBA’s Maintain Your Brain trial at the 2017 Alzheimer’s Association International Conference (AAIC) held in London during 16-20 July. Two presentations about Maintain Your Brain were included in a session examining internet-based interventions to prevent cognitive decline, co-chaired by Professor Brodaty and Dr Edo Richard, Radboud University, Amsterdam.
Maintain Your Brain is the world’s largest clinical trial for people aged 55-75 testing online tools designed to reduce participants’ risk of dementia. Professor Brodaty said the study provides a critical contribution to the challenge of preventing dementia, which presents a rapidly rising economic and social burden particularly as there is no cure for the disease. Current estimates predict dementia costs will exceed $14 billion in Australia alone during 2017.
“Internet-based delivery of lifestyle interventions can prevent or delay cognitive decline, are cost-effective and allow scalability at a population level,” said Professor Brodaty. “The findings from Maintain Your Brain will provide crucial information for future clinical and policy guidelines, in line with CHeBA’s vision of achieving healthier brain ageing through research.”
Maintain Your Brain is a multimodal randomised-control trial, which is widely recognised as the gold-star standard for research methodology. The program will deliver exercise and cognitive training, nutritional advice, depression treatment and strategies for controlling cardiovascular health risks via the internet for 18,000 persons aged 55-75. Interventions will be conducted intensively for the first year, with boosters and follow-ups over four years.
Professor Sachdev presented an overview of the study’s methodology and aims, explaining that the project has important short and long term goals for dementia prevention.
“In the short-term, we are developing an innovative eHealth platform which is customised for participants and designed for sequential dementia risk factor reduction,” said Professor Sachdev. “In the medium term, we are determining its efficacy in reducing the rate of cognitive decline and in the longer term, its efficacy in delaying dementia onset, as well as the more practical consideration of cost-effectiveness.”
The use of next generation brain training technology in Maintain Your Brain was also presented by Professor Michael Valenzuela from the University of Sydney, a chief investigator on the trial. Previously, the effectiveness of brain training technology has been limited because it has only been effective when supervised in a group environment and gains wane if participants do not remain engaged. To counteract this, Maintain Your Brain is designed on gaming principles and includes innovations targeting the nature of delivery, supervision and the wider training context, rather than content alone.
“We aim to socialize the online brain training experience, connecting participants with like-minded peers, expert trainers and their own social network for long term engagement and sustained cognitive benefit,” explained Professor Valenzuela.
Led by Professor Brodaty, Maintain Your Brain involves twenty specialists from around Australia, including experts in exercise, cognitive training, diet, IT platform design, general practice, research design and prevention, hypertension and depression and consumer representation. Ita Buttrose is the patron for the study.
For more information about Maintain Your Brain, click here. If you would like to make a donation to support the research of the Centre of Healthy Brain Ageing (CHeBA), please click here and contact us.