When dementia prevention is front of mind

A project supporting middle to-older age people to make small but impactful changes to their physical activity to improve their mental and physical health has achieved promising early data.

Dementia is the second leading cause of death of Australians and the leading cause of death for women. However, there is a lack of awareness about non-medicinal ways to improve brain health, reduce dementia risk, support cognition and help with depression, anxiety and stress, says Professor Nicola Lautenschlager, Professor of Psychiatry of Old Age and Director of the Academic Unit for Psychiatry of Old Age (AUPOA).

“When it comes to ageing, whether it be for teaching, research or clinical expertise, a singular approach just won’t work, and we are committed to applying the brakes on dementia, ” Professor Lautenschlager said.

Professor Lautenschlager and her research team work closely with the Aged Mental Health Program at Royal Melbourne Hospital (RMH), which uses a multi-disciplinary approach.

“You need lots of different backgrounds including psychiatrists, psychologists, occupational therapists, exercise physiologists, social workers and other clinical and non-clinical staff to tackle such a complex issue from multiple angles. Vision and leadership is shared.” Professor Lautenschlager said.

In 2019, Professor Lautenschlager’s research team received funding to develop national guidelines to give older Australians in the 50+ age group, who have concerns about their cognition, information about the kind of physical activity needed not only to stay fit and prevent falls, but to also support brain and mental health.

These guidelines led to The EXCEL Study – a project aimed at supporting middle to-older age people to make small but impactful changes to their physical activity to improve their mental and physical health.

With funding from the Medical Research Future Fund (MRFF) Professor Lautenschlager and her team were all set to implement the guidelines and then the pandemic hit, putting a halt to their plans.

“We knew that the isolation from continued lockdowns was seeing a big decline in people’s mental health, so rather than delaying the project, we started again and redesigned the program with approval from MRFF and moved the program to an online model.”

Fifty-five people took part in the program - 87 per cent were Victorians - from the safety of their home via tele-video communication. These participants had self-identified as struggling with symptoms of depression or anxiety and memory loss. They were sent equipment and completed a twelve-week home-based physical activity program delivered remotely online and supported via regular virtual sessions with research team members.

The intervention was highly successful, with participants reporting high levels of satisfaction. Early data analysis shows that the program was effective in helping both middle and older aged adults with mental and cognitive concerns, to maintain or increase their physical activity levels across aerobic, strength and balance domains.

These results provide a strong foundation for changing protocols in clinical care of older adults with mental and cognitive health concerns. The close collaboration between University researchers and RMH clinicians creates a unique platform to role out the learning from EXCEL in clinical settings

A next stage of this research is to explore whether some principles applied in EXCEL can be automated with the help if AI, to reach more Australians, for example through the delivery of web-based physical activity programs for middle and older age adults with mild to moderate anxiety.