New research led by Monash University shows a multi-domain dementia risk reduction program delivered by general practice nurses can improve estimated dementia profiles in middle-aged adults, offering a practical new model for proactive brain health.
Published in The Lancet Regional Health - Western Pacific, the study evaluated more than 403 adults aged 45 to 65 years with modifiable risk factors across 31 Australian general practices. It found that a 12-month, nurse-led intervention involving the HAPPI MIND app produced a statistically significant improvement in participants' dementia risk scores compared to standard care.
Senior author Associate Professor Johnson George, from the Centre for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences (MIPS), said embedding strategies into primary care is key to long term community health.
"Think of it as a personalised health check and coaching program for brain health," Associate Professor George said.
"The nurse helps people identify areas they can work on and turn advice into practical targets, while the purpose-built self-monitoring and goal-tracking app helps them track progress between appointments."
Lead author and CMUS Research Fellow Dr Muhammad Rehan Sarwar said Australian general practice provides a crucial opportunity to help middle-aged adults take action.
"The findings suggest that personalised support through general practice may help people act on modifiable risk factors relevant to brain health," Dr Sarwar said.
"If further evaluation supports wider delivery, this approach could give middle-aged adults more structured support to make and sustain lifestyle changes."
Participants in the trial received five nurse consultations, a custom action plan and access to the app, while the control group received standard risk assessment results and educational material.
Analyses revealed that 56 per cent of participants in the intervention program showed improvement, compared with 44 per cent in the comparison group. These gains were driven primarily by positive changes in protective lifestyle behaviours within the intervention group, including increased physical activity, improved fish intake and better body mass index status.
Co-author and Senior CMUS Research Fellow Dr Amanda Cross said the trial measured changes in estimated risk profiles over 12 months, rather than tracking long term clinical diagnoses or preventing cognitive decline, but the metrics remain important predictors.
"Improvements in midlife risk factors can help lay a vital foundation for long term brain health. Many of the risk factors we were targeting can also have more immediate benefits on cardiovascular or metabolic health," Dr Cross said.
Future work will examine 36-month follow-up data to determine whether these early improvements last over the longer term.
The study follows the recent publication of the World Health Organization Guidelines for Risk Reduction of Cognitive Decline and Dementia, and the Monash-led update to Australia's Clinical Practice Guidelines for Dementia.
The Australian Institute of Health and Welfare estimates that 459,000 Australians are living with dementia in 2026. The total number is expected to exceed 1 million by 2066.
Read the research paper: doi.org/10.1016
RESEARCHERS
The Monash University-led research includes collaborators from the University of Newcastle, the University of New South Wales, Flinders University, University College Dublin, CSIRO's Australian e-Health Research Centre, the University of Melbourne and Deakin University, alongside support from North Western Melbourne Primary Health Network, Hunter New England and Central Coast Primary Health Network, participating clinics, nurses, trial participants, motivational interviewing designer Ben Britton from What Works in Health, app developers Derek Ireland and Liz Cooper-Williams from CSIRO, and Project Steering Group members Dimity Pond, Michael Woodward, Ralph Maddison, Jan Donovan and Caroline Gibson.
The HAPPI MIND trial was funded by the Australian Government National Health and Medical Research Council through the Boosting Dementia Research Grants scheme (GNT1171851).
