How a lifestyle makeover could delay dementia among older Aussies
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A landmark Australian trial has sparked calls for a nationwide dementia prevention program after demonstrating that an online lifestyle intervention can significantly improve cognition in older adults. The three-year study, known as Maintain Your Brain, tested whether personalised coaching in diet, exercise and brain training could slow or even reverse cognitive decline.
Researchers recruited more than 6000 adults between 55 and 77 years old through the Sax Institute’s 45 and Up Study. Half of these participants received tailored guidance in up to four lifestyle modules—physical activity, brain training, nutrition and mental health—depending on their individual risk factors. The control group, by contrast, accessed only publicly available health information.
“We could essentially reduce worldwide dementia prevalence if this trial were implemented to the wider population,”
says Professor Henry Brodaty AO, Co-Director of UNSW’s Centre for Healthy Brain Ageing (CHeBA) and study lead.
Published in Nature Medicine, the Maintain Your Brain trial is the largest internet-based study ever undertaken to attempt dementia prevention. It relied on online tests measuring memory, reasoning, and processing speed to calculate participants’ global cognition scores—factors known to predict dementia risk.
Bowral resident and trial participant, 82-year-old Paddy Goldsmith, describes the positive impact of changing her lifestyle habits with her husband, Geoff:
“I continue to do weekly balance and strength training as well as online brain training, which I would never have done without the knowledge learned in the trial,” says Goldsmith.
Encouragingly, data from the study suggests that the intervention’s benefits might be even greater than reported, since both the control and intervention groups improved over time. According to Professor Brodaty, “If we were able to compare the intervention with a control group that received no information at all, we would likely find out that the benefits of this trial would be even greater. Participants aged 55-65 showed greater benefit than those aged 66-77, suggesting we should consider starting prevention programs earlier.”
Related: 10-year plan to tackle dementia crisis in Australia
A Push for a National Plan
The trial’s success has fueled calls for a formal dementia prevention strategy, reflecting Australia’s history of public health campaigns that helped reduce smoking, skin cancer, and HIV. CHeBA Advisory Committee Chair, Ita Buttrose AC OBE, believes the country can build upon this legacy: “We now have clear evidence to support a national dementia prevention program,” says Buttrose.
“Previously Australia has been a leader in prevention, particularly with smoking, skin cancer and HIV minimisation, but we have dropped the ball. Dementia is a prime example of where we can and must act now. This evidence demonstrates significant benefits to improving cognition and potentially delaying the onset of dementia.”
“It is now time for Australia to think seriously about long term goals, to acknowledge the evidence and embrace the need for investment in prevention.”
One key finding is that tailoring interventions to match each individual’s dementia risk factors appears far more effective than a one-size-fits-all approach. Professor Brodaty’s team tackled as many of the 14 modifiable risk factors as possible—accounting for nearly half of all dementia cases, according to the Lancet Commission’s estimates.
“Previous trials have largely not tailored interventions to match dementia risk factors of individual participants,” says Prof Brodaty.
“Our findings suggest personalising interventions and targeting a broad range of lifestyle factors are important for success.”
Given the study’s largely well-educated and less diverse participant pool, researchers believe further trials involving more varied populations will clarify how best to deliver interventions more widely. Still, the results offer fresh hope that cognitive decline—and ultimately dementia—may be delayed or prevented by thoughtful, scalable online coaching.
“Future developments could focus on cultural adaptation, particularly targeting groups from lower socio-economic backgrounds and those with less education,” says Prof Brodaty.
With more than 55 million people living with dementia worldwide—and that figure set to grow—these findings offer new momentum for prevention campaigns. Experts argue the time is ripe for Australia to champion a program that could set an international benchmark in reducing dementia risk through lifestyle interventions accessible to all.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
