Active through BLEnded Interventions despite Mild Cognitive Impairment (ABLE-MCI)

• Applicant: Professorin Dr. Verena Klusmann-Weißkopf
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry ; Public Health, Healthcare Research, Social and Occupational Medicine
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 540368705

Main goals: We seek to improve Quality of Life (QoL; primary outcome) in patients with Mild Cognitive Impairment (MCI) and their (future) carers by developing, evaluating, and implementing a smartphone and wearable-based and chatbot-delivered, just-in-time-adaptive digital health intervention (JITAI) blended with state-of-the-art therapy encouraging a lifestyle which reduces the risk of developing dementia. Novelty: Most interventional studies in MCI focus on improving cognition; few studies focus explicitly on coping with MCI. Current therapist-led multicomponent interventions, esp. when focusing on patient-carer dyads, are effective but resource-intensive with benefits rapidly declining after treatment. JITAIs are a novel and highly scalable approach to guide healthcare behavior and allow situation-sensitive chatbot-delivered interventions to be informed by a user’s health data, preferences, behaviors, and current state-of-receptivity. The JITAI condition also allows to explore potential wearable and smartphone-sensor-based digital biomarkers for passive detection and prediction of cognitive decline in MCI patients. Further, our health promotion intervention implements the Health Action Process Approach (HAPA) towards a high and persisting motivation, taking into consideration both individual values and individual impact of MCI on the dyad. Interventions: Sessions with an online therapist blended in with web-based online resources reflect the current state-of-the-art (SOA) treatment and will be available to all participants. This involves health education and peer support to set own goals in nine available modules (topics on e.g. nutrition, exercise, stress reduction). Participants will complete these sessions over five weeks and have continuous access to relevant web-based online resources. In a two-arm RCT with a total of 168 dyads, participants in the treatment arm will gain additional access to the smartphone-supported JITAI. Here, therapy sessions will be tailored based on a stepped-care approach: Initially, the JITAI condition only receives about half of the resource-intensive therapy sessions; additional sessions may be offered should smartphone-based monitoring indicate a failure to reach interim goals. Expected Outcomes: We expect JITAI to outperform a SOA blended approach regarding both QoL and secondary outcomes i.e. lifestyle change and blood biomarkers related to dementia six months after the therapy sessions end. We seek to identify which motivational levers are most effective and when in the behavior change process they become active.Broader impact: We will develop a highly scalable, resource-effective intervention that can be broadly distributed across care settings and extended in its spectrum (i.e., detection of depression, sleep-based-interventions). Focusing on QoL is considered most relevant for addressees and is key component of a future value-based healthcare system that puts patient-related-outcomes measures first.

• DFG Programme: Research Grants
• International Connection: Switzerland
• Cooperation Partners: Professor Dr. Stefan Klöppel; Professor Dr. Tobias Kowatsch