Login Register Cart 0
Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Commentary

Cogstim: A Shared Decision-making Model to Support Older Adults’ Brain Health

Author(s): Raymond L. Ownby* and Drenna Waldrop

Volume 20, Issue 3, 2023

Published on: 29 May, 2023

Page: [202 - 208] Pages: 7

DOI: 10.2174/1567205020666230525110814

Price: $65

Abstract

The lack of effective treatments for cognitive decline in older adults has led to an interest in the possibility that lifestyle interventions can help to prevent changes in mental functioning and reduce the risk for dementia. Multiple lifestyle factors have been related to risk for decline, and multicomponent intervention studies suggest that changing older adults’ behaviors can have a positive impact on their cognition. How to translate these findings into a practical model for clinical use with older adults, however, is not clear. In this Commentary, we propose a shared decision-making model to support clinicians’ efforts to promote brain health in older persons. The model organizes risk and protective factors into three broad groups based on their mechanism of action and provides older persons with basic information to allow them to make evidence- and preference-based choices in choosing goals for effective brain health programs. A final component includes basic instruction in behavior change strategies such as goal setting, self-monitoring, and problem-solving. The implementation of the model will support older persons’ efforts to develop a personally relevant and effective brainhealthy lifestyle that may help to reduce their risk for cognitive decline.

« Previous
[1]
Alzheimer’s Association. 2021 Alzheimer’s disease facts and figures. Alzheimers Dement 2021; 17(3): 327-406.
[http://dx.doi.org/10.1002/alz.12328] [PMID: 33756057]
[2]
Olivari BS, French ME, McGuire LC. The public health road map to respond to the growing dementia crisis. Innov Aging 2020; 4(1): igz043.
[http://dx.doi.org/10.1093/geroni/igz043] [PMID: 32405541]
[3]
Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396(10248): 413-46.
[http://dx.doi.org/10.1016/S0140-6736(20)30367-6] [PMID: 32738937]
[4]
National Academies of Sciences E, and Medicine, Preventing cognitive decline and dementia: A way forward Washington, DC: The National Academies Press. Washington, DC: The National Academies Press 2017.
[http://dx.doi.org/10.17226/24782]
[5]
World Health Organization. Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: World Health Organization 2019.
[6]
Nyberg L, Lövdén M, Riklund K, Lindenberger U, Bäckman L. Memory aging and brain maintenance. Trends Cogn Sci 2012; 16(5): 292-305.
[http://dx.doi.org/10.1016/j.tics.2012.04.005] [PMID: 22542563]
[7]
Mehegan L, Rainville C. 2021 AARP aurvey on the perceptions related to a dementia diagnosis: Adults age 40. Washington, DC: AARP Research 2021.
[http://dx.doi.org/10.26419/res.00471.001]
[8]
Maust DT, Solway E, Langa KM, et al. Perception of dementia risk and preventive actions among US adults aged 50 to 64 years. JAMA Neurol 2020; 77(2): 259-62.
[http://dx.doi.org/10.1001/jamaneurol.2019.3946] [PMID: 31730178]
[9]
Friedman BB, Suri S, Solé-Padullés C, et al. Are people ready for personalized brain health? Perspectives of research participants in the Lifebrain Consortium. Gerontologist 2020; 60(6): 1050-9.
[http://dx.doi.org/10.1093/geront/gnz155] [PMID: 31682729]
[10]
Boyle PA, Wang T, Yu L, et al. To what degree is late life cognitive decline driven by age-related neuropathologies? Brain 2021; 144(7): 2166-75.
[http://dx.doi.org/10.1093/brain/awab092] [PMID: 33742668]
[11]
Gómez-Isla T, Frosch MP. Lesions without symptoms: Understanding resilience to Alzheimer disease neuropathological changes. Nat Rev Neurol 2022; 18(6): 323-32.
[http://dx.doi.org/10.1038/s41582-022-00642-9] [PMID: 35332316]
[12]
Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial. Lancet 2015; 385(9984): 2255-63.
[http://dx.doi.org/10.1016/S0140-6736(15)60461-5] [PMID: 25771249]
[13]
Blumenthal JA, Smith PJ, Mabe S, et al. Lifestyle and neurocognition in older adults with cognitive impairments. Neurology 2019; 92(3): e212-23.
[http://dx.doi.org/10.1212/WNL.0000000000006784] [PMID: 30568005]
[14]
Baker LD, Beavers DP, Cleveland M, Day CE, Decarli C, Espeland MAUS. POINTER: Study design and launch. Alzheimers Dement 2019; 15: 1262-3.
[15]
Baker LD, Espeland MA, Whitmer RA, et al. U.S. POINTER: Lessons learned about delivery of a multi-domain lifestyle intervention during the COVID-19 pandemic. Alzheimers Dement 2021; 17(S10): e055289.
[http://dx.doi.org/10.1002/alz.055289]
[16]
Yu JT, Xu W, Tan CC, et al. Evidence-based prevention of Alzheimer’s disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry 2020; 91(11): 1201-9.
[http://dx.doi.org/10.1136/jnnp-2019-321913] [PMID: 32690803]
[17]
Fancourt D, Steptoe A, Cadar D. Community engagement and dementia risk: time-to-event analyses from a national cohort study. J Epidemiol Community Health 2020; 74(1): 71-7.
[http://dx.doi.org/10.1136/jech-2019-213029] [PMID: 31662344]
[18]
Buchman AS, Buchman AS, Wilson RS, Yu L, Schneider JA, Bennett DA. Effect of purpose in life on the relation between Alzheimer disease pathologic changes on cognitive function in advanced age. Arch Gen Psychiatry 2012; 69(5): 499-505.
[http://dx.doi.org/10.1001/archgenpsychiatry.2011.1487] [PMID: 22566582]
[19]
Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol 2012; 11(11): 1006-12.
[http://dx.doi.org/10.1016/S1474-4422(12)70191-6] [PMID: 23079557]
[20]
Xu H, Yang R, Qi X, et al. Association of lifespan cognitive reserve indicator with dementia risk in the presence of brain pathologies. JAMA Neurol 2019; 76(10): 1184-91.
[http://dx.doi.org/10.1001/jamaneurol.2019.2455] [PMID: 31302677]
[21]
Bielak AAM, Hughes TF, Small BJ, Dixon RA. It’s never too late to engage in lifestyle activities: significant concurrent but not change relationships between lifestyle activities and cognitive speed. Journals of Gerontology: Series B 2007; 62(6): P331-9.
[http://dx.doi.org/10.1093/geronb/62.6.P331] [PMID: 18079417]
[22]
Krell-Roesch J, Syrjanen JA, Vassilaki M, et al. Quantity and quality of mental activities and the risk of incident mild cognitive impairment. Neurology 2019; 93(6): e548-58.
[http://dx.doi.org/10.1212/WNL.0000000000007897] [PMID: 31292224]
[23]
Edwards JD, Xu H, Clark DO, Guey LT, Ross LA, Unverzagt FW. Speed of processing training results in lower risk of dementia. Alzheimers Dement 2017; 3(4): 603-11.
[http://dx.doi.org/10.1016/j.trci.2017.09.002] [PMID: 29201994]
[24]
Ding Q, Ying Z, Gómez-Pinilla F. Exercise influences hippocampal plasticity by modulating brain-derived neurotrophic factor processing. Neuroscience 2011; 192: 773-80.
[http://dx.doi.org/10.1016/j.neuroscience.2011.06.032] [PMID: 21756980]
[25]
Vecchio LM, Meng Y, Xhima K, Lipsman N, Hamani C, Aubert I. The neuroprotective effects of exercise: Maintaining a healthy brain throughout aging. Brain Plast 2018; 4(1): 17-52.
[http://dx.doi.org/10.3233/BPL-180069] [PMID: 30564545]
[26]
Islam MR, Valaris S, Young MF, et al. Exercise hormone irisin is a critical regulator of cognitive function. Nat Metab 2021; 3(8): 1058-70.
[http://dx.doi.org/10.1038/s42255-021-00438-z] [PMID: 34417591]
[27]
You T, Ogawa EF. Effects of meditation and mind-body exercise on brain-derived neurotrophic factor: A literature review of human experimental studies. Sports Med Health Sci 2020; 2(1): 7-9.
[http://dx.doi.org/10.1016/j.smhs.2020.03.001] [PMID: 35783336]
[28]
Nuvagah Forti L, Van Roie E, Njemini R, et al. High versus low load resistance training: The effect of 24 weeks detraining on serum brain derived-neurotrophic factor (BDNF) in older adults. J Frailty Aging 2017; 6(1): 53-8.
[PMID: 28244559]
[29]
Cocco S, Podda MV, Grassi C. Role of BDNF signaling in memory enhancement induced by transcranial direct current timulation. Front Neurosci 2018; 12(427): 427.
[http://dx.doi.org/10.3389/fnins.2018.00427] [PMID: 29997473]
[30]
Ownby RL. Neuroinflammation and cognitive aging. Curr Psychiatry Rep 2010; 12(1): 39-45.
[http://dx.doi.org/10.1007/s11920-009-0082-1] [PMID: 20425309]
[31]
Kumar A. Editorial: Neuroinflammation and cognition. Front Aging Neurosci 2018; 10(413): 413.
[http://dx.doi.org/10.3389/fnagi.2018.00413] [PMID: 30618719]
[32]
Bradburn S, Sarginson J, Murgatroyd CA. Association of peripheral interleukin-6 with global cognitive decline in non-demented adults: A meta-analysis of prospective studies. Front Aging Neurosci 2018; 9(438): 438.
[http://dx.doi.org/10.3389/fnagi.2017.00438] [PMID: 29358917]
[33]
Lin T, Liu GA, Perez E, et al. Systemic inflammation mediates age-related cognitive deficits. Front Aging Neurosci 2018; 10(236): 236.
[http://dx.doi.org/10.3389/fnagi.2018.00236] [PMID: 30127734]
[34]
Lourida I, Soni M, Thompson-Coon J, et al. Mediterranean diet, cognitive function, and dementia: A systematic review. Epidemiology 2013; 24(4): 479-89.
[http://dx.doi.org/10.1097/EDE.0b013e3182944410] [PMID: 23680940]
[35]
Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol 2006; 59(6): 912-21.
[http://dx.doi.org/10.1002/ana.20854] [PMID: 16622828]
[36]
Sureda A, Bibiloni M, Julibert A, et al. Adherence to the Mediterranean diet and inflammatory markers. Nutrients 2018; 10(1): 62.
[http://dx.doi.org/10.3390/nu10010062] [PMID: 29320413]
[37]
Ballarini T, Melo van Lent D, Brunner J, et al. Mediterranean diet, Alzheimer disease biomarkers and brain atrophy in old age. Neurology 2021; 96(24): e2920-32.
[http://dx.doi.org/10.1212/WNL.0000000000012067] [PMID: 33952652]
[38]
Morris MC, Tangney CC, Wang Y, Sacks FM, Bennett DA, Aggarwal NT. MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimers Dement 2015; 11(9): 1007-14.
[http://dx.doi.org/10.1016/j.jalz.2014.11.009] [PMID: 25681666]
[39]
Baranowski BJ, Marko DM, Fenech RK, Yang AJT, MacPherson REK. Healthy brain, healthy life: A review of diet and exercise interventions to promote brain health and reduce Alzheimer’s disease risk. Appl Physiol Nutr Metab 2020; 45(10): 1055-65.
[http://dx.doi.org/10.1139/apnm-2019-0910] [PMID: 32717151]
[40]
Guyatt G, Drummond R, Meade MO, Cook DJ. Users’ guides to the medical literature: Essentials of evidence-based clinical practice. (3rd ed..), New York: McGraw-Hill Education 2014.
[41]
Cahn BR, Goodman MS, Peterson CT, Maturi R, Mills PJ. Yoga, meditation and mind-body health: Increased BDNF, cortisol awakening response, and altered inflammatory marker expression after a 3-month yoga and meditation retreat. Front Hum Neurosci 2017; 11(315): 315.
[http://dx.doi.org/10.3389/fnhum.2017.00315] [PMID: 28694775]
[42]
Kakulla B. 2022 tech trends and the 50-plus. Washington, DC: American Association for Retired Persons 2021.
[43]
Lee K, Hoti K, Hughes JD, Emmerton L. Dr Google is here to stay but health care professionals are still valued: An analysis of health care consumers’ internet navigation support preferences. J Med Internet Res 2017; 19(6): e210.
[http://dx.doi.org/10.2196/jmir.7489] [PMID: 28615156]
[44]
Zhang Y, Song S. Older adults’ evaluation of the credibility of online health information. CHIIR’20: Proceedings of the 2020 Conference on Human Information Interaction and Retrieval. Vancouver, BC, Canada. 2020; pp. 358-62.
[http://dx.doi.org/10.1145/3343413.3377997]
[45]
Ranganathan P, Pramesh CS, Buyse M. Common pitfalls in statistical analysis: Clinical versus statistical significance. Perspect Clin Res 2015; 6(3): 169-70.
[http://dx.doi.org/10.4103/2229-3485.159943] [PMID: 26229754]
[46]
Yang LJS, Chang KWC, Chung KC. Methodologically rigorous clinical research. Plast Reconstr Surg 2012; 129(6): 979e-88e.
[http://dx.doi.org/10.1097/PRS.0b013e31824eccb7] [PMID: 22634695]
[47]
Pusztai L, Hatzis C, Andre F. Reproducibility of research and preclinical validation: problems and solutions. Nat Rev Clin Oncol 2013; 10(12): 720-4.
[http://dx.doi.org/10.1038/nrclinonc.2013.171] [PMID: 24080600]
[48]
Elwyn G, Frosch D, Thomson R, et al. Shared decision making: A model for clinical practice. J Gen Intern Med 2012; 27(10): 1361-7.
[http://dx.doi.org/10.1007/s11606-012-2077-6] [PMID: 22618581]
[49]
Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2017; 2017: 4.
[http://dx.doi.org/10.1002/14651858.CD001431.pub5]
[50]
Kiesler DJ, Auerbach SM. Optimal matches of patient preferences for information, decision-making and interpersonal behavior: Evidence, models and interventions. Patient Educ Couns 2006; 61(3): 319-41.
[http://dx.doi.org/10.1016/j.pec.2005.08.002] [PMID: 16368220]
[51]
Lustria MLA, Noar SM, Cortese J, Van Stee SK, Glueckauf RL, Lee J. A meta-analysis of web-delivered tailored health behavior change interventions. J Health Commun 2013; 18(9): 1039-69.
[http://dx.doi.org/10.1080/10810730.2013.768727] [PMID: 23750972]
[52]
Arlinghaus KR, Johnston CA. Advocating for behavior change with education. Am J Lifestyle Med 2018; 12(2): 113-6.
[http://dx.doi.org/10.1177/1559827617745479] [PMID: 30283247]
[53]
Gates NJ, Sachdev PS, Fiatarone SMA, Valenzuela M. Cognitive and memory training in adults at risk of dementia: A systematic review. BMC Geriatr 2011; 11(1): 55.
[http://dx.doi.org/10.1186/1471-2318-11-55] [PMID: 21942932]
[54]
Ownby RL, Acevedo A, Waldrop-Valverde D, et al. A mobile app for chronic disease self-management: Protocol for a randomized controlled trial. JMIR Res Protoc 2017; 6(4): e53.
[http://dx.doi.org/10.2196/resprot.7272] [PMID: 28381395]
[55]
Ownby RL, Acevedo A, Waldrop-Valverde D. Enhancing the impact of mobile health literacy interventions to reduce health disparities. Q Rev Distance Educ 2019; 20(1): 15-34.
[http://dx.doi.org/10.31219/osf.io/5j2m6] [PMID: 31537979]
[56]
Doran GT. There’s a S.M.A.R.T. way to write managements’s goals and objectives. Manage Rev 1981; 70(11): 35.
[57]
Hooker S, Punjabi A, Justesen K, Boyle L, Sherman MD. Encouraging health behavior change: Eight evidence-based strategies. Fam Pract Manag 2018; 25(2): 31-6.
[PMID: 29537244]
[58]
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 2000; 55(1): 68-78.
[http://dx.doi.org/10.1037/0003-066X.55.1.68] [PMID: 11392867]
[59]
Ownby RL. An online dementia prevention intervention using the Cogstim model: A pilot study. J Prev Alzheimers Dis 2022; 9: S110-1.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy