UCSF

BACKGROUND: Addressing modifiable risk factors such as physical inactivity and social isolation could reduce risk of Alzheimers 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. OBJECTIVE: To examine and describe behavior change goals set by participants during the Systematic Multi-domain Alzheimers Risk Reduction Trial (SMARRT). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.