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An internet-based intervention augmented with a diet and physical activity consultation to decrease the risk of dementia in at-risk adults in a primary care setting: pragmatic randomized controlled trial


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Anstey, KJ, Cherbuin, N, Kim, S ORCID: 0000-0003-4869-9255, McMaster, M, D'Este, C, Lautenschlager, N, Rebok, G, McRae, I, Torres, SJ, Cox, KL and Pond, CD 2020 , 'An internet-based intervention augmented with a diet and physical activity consultation to decrease the risk of dementia in at-risk adults in a primary care setting: pragmatic randomized controlled trial' , Journal of Medical Internet Research, vol. 22, no. 9 , pp. 1-15 , doi: 10.2196/19431.

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Background: There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course.Objective: This study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care.Methods: A pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of ≥25 kg/m2 or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation; (2) a single clinician–led group, Lifestyle Modification Program (LMP); and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF).Results: Baseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group; 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group; and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means −3.86, 95% CI −6.81 to −0.90, P=.01; week 18: difference in means −4.05, 95% CI −6.81 to −1.28, PPPConclusions: A web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small sample size, and replication on a larger sample with longer follow-up will strengthen the results.Trial Registration: Australian clinical trials registration number (ACTRN): 12616000868482; Med Internet Res 2020;22(9):e19431doi:10.2196/19431CitationPlease cite as:Anstey KJ, Cherbuin N, Kim S, McMaster M, D'Este C, Lautenschlager N, Rebok G, McRae I, Torres SJ, Cox KL, Pond CDAn Internet-Based Intervention Augmented With a Diet and Physical Activity Consultation to Decrease the Risk of Dementia in At-Risk Adults in a Primary Care Setting: Pragmatic Randomized Controlled TrialJ Med Internet Res 2020;22(9):e19431DOI: 10.2196/19431PMID: 32969833PMCID: <a href=" 32">7545332KEYWORDSrisk reduction behavior; dementia prevention & control; primary prevention; pragmatic clinical trial; prevention; primary care  We also recommend The Impact of the Virtual Cognitive Health Program on the Cognition and Mental Health of Older Adults: Pre-Post 12-Month Pilot Study Shefali Kumar et al., JMIR Aging Web-Based Multidomain Lifestyle Programs for Brain Health: Comprehensive Overview and Meta-Analysis Linda MP Wesselman et al., J Med Internet Res, 2019 <a class="trendmd-widget-list-item__link" data-trendmd-id="dbfcb7a7-0a2a-45a5-80d0-2b9412cc09ad" data-trendmd-journal-id="1" data-trendmd-content-category="Scholarly" data-trendmd-campaign-id="0" data-trendmd-ct="%7B%22i%22:%5B%5D,%22c%22:%5B%5D,%22n%22:%5B%5D%7D" data-trendmd-sponsored=" false" href="" rel="noindex, nofollow" target="_self" data-trendmd-flags="10" data-trendmd-model-type="0">A Remote Intervention to Prevent or Delay Cognitive Impairment in Older Adults: Design, Recruitment, and Baseline Characteristics of the Virtual Cognitive Health (VC Health) Study Nicholas Bott et al., J Med Internet Res, 2018 Motion-Based Technology for People With Dementia Training at Home: Three-Phase Pilot Study Assessing Feasibility and Efficacy Jindong Ding Petersen et al., J Med Internet Res, 2020 Effectiveness of Exergaming in Improving Cognitive and Physical Function in People With Mild Cognitive Impairment or Dementia: Systematic Review Yinan Zhao et al., J Med Internet Res, 2020 Multifaceted intervention to enhance cognition in older people at risk of cognitive decline: study prot ocol for the Protein Omega-3 and Vitamin D Exercise Research (PONDER) study Helen Macpherson et al., BMJ Open, 2019 Exercise and Quality of Life in Women With Subclinical Hypothyroidism1 By staff, US Pharmacist, 2018 Are lifestyle behavioral factors associated with health‐related quality of life in long‐term survivors of non‐Hodgkin lymphoma? 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Item Type: Article
Authors/Creators:Anstey, KJ and Cherbuin, N and Kim, S and McMaster, M and D'Este, C and Lautenschlager, N and Rebok, G and McRae, I and Torres, SJ and Cox, KL and Pond, CD
Keywords: risk reduction behavior, dementia prevention and control, primary prevention, pragmatic clinical trial, prevention, primary care
Journal or Publication Title: Journal of Medical Internet Research
Publisher: J M I R Publications, Inc.
ISSN: 1439-4456
DOI / ID Number: 10.2196/19431
Copyright Information:

Copyright 2020 The Authors. This is an open-access article distributed under the terms of the Creative Commons AttributionLicense (,

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