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Prevention of Dementia using Mobile phone Applications

Periodic Reporting for period 4 - PRODEMOS (Prevention of Dementia using Mobile phone Applications)

Okres sprawozdawczy: 2022-07-01 do 2023-06-30

We have previously shown that dementia may be prevented through risk factor modification, and that people who are at risk of dementia are willing and able to use an internet intervention to reduce their risk of cognitive decline and dementia. In PRODEMOS we further investigated how to adapt, implement and upscale self-management of risk factors to prevent dementia and particularly how to make prevention of dementia accessible on a global scale using mobile Health. Using an implementation study design in the EU and China we assessed acceptability, feasibility, adoption, costs, sustainability and effectiveness of delivery of this dementia prevention strategy via mobile health.
All the objectives were achieved. However, due to COVID19 related restrictions, the trial is completed with 1488 instead of the anticipated 2400 participants. The intervention duration was on average 15 months in the UK and 17 months in China instead of the anticipated 18 months. We will take this into account when disseminating the results.
Currently, the trial is being evaluated for the efficacy on health outcomes and implementation success by focusing specifically on sustainability, acceptability, adoption and feasibility in the target population. Also, we performed a health-economic evaluation from a societal perspective. These results will be presented at international conferences and in media outings.
In total 8 manuscripts were already published from the PRODEMOS project in international peer reviewed journals [1-8]. Besides this, 1 television performance, 17 social media outings, 1 popularized lecture to general public and 18 website contributions. Partners went to meetings to disseminate PRODEMOS: 58 times people presented on PRODEMOS at a conference, 16 times a workshop was organized and 12 times people participated in a workshop bringing in PRODEMOS next to a few other events. Each specific activity is described in the appendix.Mainly thanks to a TV performance in China, over 1.16 billion people from the general public were reached – when leaving this performance out, still over 25 thousand people were reached. Almost a million people from the scientific community were reached, almost 16 thousand policy makers. Please note that the reported numbers needed to be estimated by the partners, so are not very exact.


References
1. Andre L, Giulioli C, Piau A, et al. Telephone and Smartphone-Based Interventions for Cognitive and Cardio-Metabolic Health in Middle-Aged and Older Adults: A Systematic Review. Clin Interv Aging. 2022 Nov 10;17:1599-1624.
2. Coley N, Hoevenaar-Blom MP, van Dalen JW, et al. Dementia risk scores as surrogate outcomes for lifestyle-based multidomain prevention trials-rationale, preliminary evidence and challenges. Alzheimers Dement. 2020 Aug 16.
3. Coley N, Andre L, Hoevenaar-Blom MP, et al. Factors Predicting Engagement of Older Adults With a Coach-Supported eHealth Intervention Promoting Lifestyle Change and Associations Between Engagement and Changes in Cardiovascular and Dementia Risk: Secondary Analysis of an 18-Month Multinational Randomized Controlled Trial. J Med Internet Res. 2022 May 9;24(5):e32006.
4. Coley N, Giulioli C, Aisen PS, et al. Randomised controlled trials for the prevention of cognitive decline or dementia: A systematic review. Ageing Res Rev. 2022 Dec;82:101777.
5. Eggink E, Hafdi M, Hoevenaar-Blom MP, et al. Attitudes and views on healthy lifestyle interventions for the prevention of dementia and cardiovascular disease among older people with low socioeconomic status: a qualitative study in the Netherlands. BMJ Open 2022;12:e055984 D
6. Eggink E, Hafdi M, Hoevenaar-Blom MP, et al. Prevention of dementia using mobile phone applications (PRODEMOS): protocol for an international randomised controlled trial. BMJ Open. 2021 Jun 9;11(6):e049762.
7. Hafdi M, Eggink E, Hoevenaar-Blom MP, et al. (2021) Design and Development of a Mobile Health (mHealth) Platform for Dementia Prevention in the Prevention of Dementia by Mobile Phone Applications (PRODEMOS) Project. Front. Neurol. 12:733878.
8. Zhang J, Eggink E, Zhang X, et al. Needs and views on healthy lifestyles for the prevention of dementia and the potential role for mobile health (mHealth) interventions in China: a qualitative study. PRODEMOS consortium.BMJ Open. 2022 Nov 22;12(11):e061111.
• The concepts from PRODEMOS are directly exploitable in new projects, including our own MIND-PRO project. With the experiences in and the results of the PRODEMOS project we started the MIND-PRO study, funded by The Netherlands Organisation for Healthcare Research in which we further develop the mHealth intervention to the needs of people of low literacy and/or with an immigration background. We will assess the potential for implementation and the efficacy in this hard to reach groups in a hybrid implementation-efficacy trial.
• The collaboration with our Chinese partners has been extremely rewarding, and we will visit China in January again to prepare new collaborative funding for new projects in the realm of prevention of dementia and cardiovascular disease, with a focus on blood pressure treatment optimization.
• The experiences with intercontinental mHealth and all challenges encountered will directly contribute to the design of future projects, since we now better know what the main bottlenecks are.
• Generic concepts about coach-supported mHealth across the UK and Chinese populations can be used by other researchers in different countries in the world.
• Our trial results contribute to the knowledge base with regards to the efficacy of mHealth interventions as well as to the barriers and facilitators across a broad spectrum of implementation outcomes, enhancing the design of future interventions and preventive strategies.
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