Factors Associated with Participation in a Multidomain Web-Based Dementia Prevention Trial: Evidence from Maintain Your Brain (MYB)

Article type: Research Article

Authors: Welberry, Heidi J.^{a; b; *} | Chau, Tiffany^b | Heffernan, Megan^b | San Jose, Juan Carlo^b | Jorm, Louisa R.^a | Singh, Maria Fiatarone^{c; d} | Sachdev, Perminder S.^b | Anstey, Kaarin J.^{e; f; g} | Lautenschlager, Nicola T.^{h; i} | Valenzuela, Michael^b | McNeil, John J.^j | Brodaty, Henry^b

Affiliations: [a] Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia | [b] Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia | [c] School of Health Sciences and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia | [d] Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA | [e] UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia | [f] School of Psychology, University of New South Wales, Sydney, Australia | [g] Neuroscience Research Australia | [h] Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Australia | [i] North Western Mental Health, Royal Melbourne Hospital, Parkville, Australia | [j] School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia

Correspondence: [*] Correspondence to: Dr. Heidi J. Welberry, Centre for Big Data Research in Health, Level 2 AGSM Building, University of New South Wales, Sydney, New South Wales, 2052, Australia. Tel.: +61 2 9065 7850; E-mail: h.welberry@unsw.edu.au.

Abstract: Background:The Maintain Your Brain (MYB) trial aims to prevent cognitive decline and dementia through multidomain, web-based risk-reduction. To facilitate translation, it is important to understand drivers of participation. Objective:To describe characteristics associated with participation in MYB. Methods:This was an observational ancillary study of MYB, a randomized controlled trial nested within the 45 and Up Study in New South Wales, Australia. We linked 45 and Up Study survey and MYB participation data. The study cohort comprised 45 and Up Study participants, aged 55–77 years at 1 January 2018, who were invited to participate in MYB. 45 and Up Study participant characteristics and subsequent MYB consent and participation were examined. Results:Of 98,836 invited, 13,882 (14%) consented to participate and 6,190 participated (6%). Adjusting for age and sex, a wide range of factors were related to participation. Higher educational attainment had the strongest relationship with increased MYB participation (university versus school non-completion; AdjOR = 5.15; 95% CI:4.70–5.64) and lower self-rated quality of life with reduced participation (Poor versus Excellent: AdjOR = 0.19; 95% CI:0.11–0.32). A family history of Alzheimer’s disease was related to increased participation but most other dementia risk factors such as diabetes, obesity, stroke, high blood pressure, and current smoking were associated with reduced participation. Conclusion:Higher socio-economic status, particularly educational attainment, is strongly associated with engagement in online dementia prevention research. Increasing population awareness of dementia risk factors, and better understanding the participation barriers in at-risk groups, is necessary to ensure online interventions are optimally designed to promote maximum participation.

Keywords: Cognitive decline, dementia, health behaviors, internet-based intervention, preventive health, risk factors, risk reduction

DOI: 10.3233/JAD-220990

Journal: Journal of Alzheimer's Disease, vol. 92, no. 3, pp. 959-974, 2023