Dementia is now Australia’s leading cause of death in Australia and its burden on older adults, their families and health systems is growing rapidly. The 2024 Lancet Commission estimates that 45% of dementia cases may be prevented by addressing modifiable lifestyle risk factors. Evidence from multidomain trials have shown favourable cognitive and functional outcomes in cognitively unimpaired older adults at risk of dementia. In the absence of a curative treatment, risk identification and mitigation strategies are critical towards the development of effective prevention and treatment for dementia.

Mild cognitive impairment (MCI) is a transitional stage between healthy ageing and dementia marked by subtle changes to memory but preserved everyday functioning. While MCI is associated with greater risk of progression to dementia, 30% of MCI cases return to normal cognition. This makes MCI a promising window for timely intervention, however it remains unclear whether risk reduction can prevent further decline in individuals with MCI.

Ziyi’s project builds on BetterBrains, a two-year online multidomain risk management program that used a person-centred approach to risk factor identification, goal setting and behaviour modification to prevent cognitive decline in cognitively unimpaired, at-risk middle-aged adults with family history of dementia. Through personalised coaching, participants engaged in preference-driven risk factor management across four risk categories (i.e., cardiovascular health, social and cognitive engagement, mood and sleep). Findings showed improved cognitive function after two years, with strong engagement and retention. Importantly, participants with below-average cognitive function at baseline benefitted the most from the program, suggesting that similar approaches may reduce decline in individuals experiencing early cognitive impairment i.e., MCI.

In partnership with in-home aged care service provider Aunty Grace, Ziyi’s project will co-design and pilot BetterBrains-Next: an adaptation tailored for individuals with MCI, delivered within an existing model of care for older Australians enrolled in the government-funded Support at Home program.

Primary Aims
1. To co-design an adaptation of a person-centred multidomain lifestyle intervention
(BetterBrains-Next) with Aunty Grace clients and care managers to better suit individuals diagnosed with MCI.
2. To pilot BetterBrains-Next’s feasibility and acceptability for individuals with MCI in an aged care setting.

Secondary Aim
1. To examine whether BetterBrains-Next may have potential benefits in preserving activities of daily living, reducing cognitive decline and improving quality of life.