EFFECTIVENESS OF AN ADAPTIVE APPROACH FOR PERSONALIZED DEMENTIA PREVENTION IN BRAIN HEALTH SERVICE (ADAPT-BHS): A RANDOMIZED SINGLE-BLIND CONTROLLED STUDY

Although multidomain dementia prevention strategies have demonstrated efficacy, their real-world implementation is often limited by feasibility and sustainability, underscoring the need for personalized approaches tailored to individual risk profiles. The Adaptive Approach for Personalized Dementia Prevention in a Brain Health Service (ADAPT-BHS) was developed as a clinic-based model for dementia prevention in non-demented adults. In this single-blind randomized controlled trial, 90 non-demented adults aged ≥45 years were randomized (1:1) to an intervention or control group. Dementia risk was assessed using the ANU-ADRI. The intervention group received a personalized 24-week program consisting of a 12-week intensive phase followed by a 12-week maintenance phase, supported by trained coaches, while the control group received education and usual care. Changes in ANU-ADRI total, risk factor, and protective factor scores at baseline, 12, and 24 weeks were analyzed using linear mixed-effects models. Of the randomized participants, 72 completed at least one follow-up assessment and were included in modified intention-to-treat analyses. Linear mixed-effects analyses demonstrated a significant group×time interaction for the ANU-ADRI total score at 12 weeks (β = 3.10, SE = 1.53, p < 0.05). ANU-ADRI protective factors improved significantly at both 12 weeks (β = 4.27, SE = 1.06, p < 0.01) and 24 weeks (β = 3.01, SE = 1.02, p < 0.01), whereas no significant interaction was observed for risk factor scores. ADAPT-BHS is a feasible clinic-based brain health service that improves dementia-protective lifestyle factors and provides empirical evidence supporting a shift from treatment-centered memory clinics toward prevention-oriented brain health services.