The Brain Health Champion study: Health coaching changes behaviors in patients with cognitive impairment

Hope E M Schwartz; Camden P Bay; Brittany M McFeeley; Taylor J Krivanek; Kirk R Daffner; Seth A Gale

doi:10.1016/j.trci.2019.09.008

The Brain Health Champion study: Health coaching changes behaviors in patients with cognitive impairment

Alzheimers Dement (N Y). 2019 Nov 12:5:771-779. doi: 10.1016/j.trci.2019.09.008. eCollection 2019.

Authors

Hope E M Schwartz¹, Camden P Bay², Brittany M McFeeley¹, Taylor J Krivanek¹, Kirk R Daffner¹, Seth A Gale¹

Affiliations

¹ Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA.
² Center for Clinical Investigation, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Abstract

Introduction: Converging evidence suggests that increasing healthy behaviors may slow or prevent cognitive decline.

Methods: We piloted a six-month, randomized, controlled investigation of 40 patients with mild dementia, mild cognitive impairment, or subjective cognitive decline. The intervention consisted of weekly motivational interviewing phone calls and three visits with a "Brain Health Champion" health coach, who guided participants to achieve personalized goals. Changes in behavior were measured using validated questionnaires.

Results: Compared with the standard-of-care control group, Brain Health Champion participants had statistically significant and clinically meaningful increases in physical activity (Cohen's d = 1.37, P < .001), adherence to the Mediterranean diet (Cohen's d = 0.87, P = .016), cognitive/social activity (Cohen's d = 1.09, P = .003), and quality of life (Cohen's d = 1.23, P < .001). The magnitude of behavior change strongly predicted improvement in quality of life.

Discussion: Our results demonstrate the feasibility and potential efficacy of a health coaching approach in changing health behaviors in cognitively impaired and at-risk patients.

Keywords: Behavior change; Clinical care delivery; Cognitive and social activity; Dementia; Exercise; Health coaching; Mediterranean diet; Mild cognitive impairment; Quality of life; Risk reduction.