Theme 2 | E- & M-health in mental health care and research

Using mHealth for dementia risk reduction: a proof-of-concept study of the MijnBreincoach app. 

Irene Heger

Irene Hegera, Kay Deckersa, Martin van Boxtela, Marjolein de Vugta, Frans Verheya, Anke Oenemab, Sebastian Köhlera

a Maastricht University, School for Mental Health and Neuroscience; Alzheimer Centrum Limburg
b Maastricht University, Department of Health Promotion; School of Care and Public Health Research Institute (CAPHRI); School of Nutrition and Translational Research in Metabolism (NUTRIM)

A growing body of evidence shows that health and lifestyle factors account for up to 40% of all dementia cases worldwide1. Most people, however, seem unaware of the potential of dementia prevention, let alone of specific actions that are required to improve brain health2,3. mHealth tools could potentially increase awareness and motivation to change4. The aim of this study was to investigate a mobile app (MijnBreincoach) on feasibility, increase in knowledge and motivation to change.

A pre-post design was used, assessing self-reported data, user tracking and informal focus groups. Participants were community-dwelling, Dutch speaking and in midlife (40-75y), living in the Province of Limburg. During the 3-month intervention period, people used the app to identify room-for-improvement, based on the LIBRA score consisting of 12 modifiable factors5, and chose a lifestyle topic to receive daily notifications. Linear mixed models were used for statistical analyses.

Of the total study sample (n=299), 190 (63.6%) participants completed the post-evaluation and 167 (55.9%) installed the app. Reasons for dropout were mostly technical problems during installation and use, above motivational issues or lack of time. Women (63.1%) installed the app more often than men did (48.7%; p=0.012). 78.4% of the participants stated that this app provided a positive approach towards brain health and >80% felt better informed about dementia risk reduction. User-tracking showed that the usage of the behavioral change functions was low, resulting in no or only modest effects on motivation to change behavior. Women, younger (<60y) and low-to-middle educated participants evaluated the app most positive.

Most participants evaluated the app as positive and increased their knowledge on the topic. Usage of the app did not result in changes in attitudes and beliefs related to behavioral change. Results will be used to further develop the MijnBreincoach app. Future (controlled) studies are needed to further explore the role of mHealth in dementia risk reduction. 

Dementia; Primary Prevention; Mobile Applications.

1. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020.  
2. Cations M, Radisic G, Crotty M, et al. What does the general public understand about prevention and treatment of dementia? A systematic review of population-based surveys. PLoS One 2018;13.  
3. Heger I, Deckers K, van Boxtel M, et al. Dementia awareness and risk perception in middle-aged and older individuals: baseline results of the MijnBreincoach survey on the association between lifestyle and brain health. BMC Public Health 2019;19:678.  
4. Wesselman LM, Hooghiemstra AM, Schoonmade LJ, et al. Web-Based Multidomain Lifestyle Programs for Brain Health: Comprehensive Overview and Meta-Analysis. JMIR mental health 2019;6:e12104.  
5. Deckers K, van Boxtel MP, Schiepers OJ, et al. Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies. Int J Geriatr Psychiatry 2015;30:234-46.  

The School for Mental Health and Neuroscience (MHeNs) strives to advance our understanding of brain-behaviour relationships by using an approach integrating various disciplines in neuro- and behavioural science, medicine, and the life sciences more widely. MHeNs performs high-impact mental health and neuroscience research and educates master's students and PhD researchers. MHeNs performs translational research, meaning practical collaboration between researchers in the lab and in the hospital. MHeNs is one of six graduate schools of the Faculty of Health, Medicine and Life Sciences (FHML) aligned to the Maastricht University Medical Centre+ (MUMC+).