HAPPCAP‐AD (Human‐Application Combined Approach for Prevention of Alzheimer's Disease): A novel feasibility study of a personalized midlife intervention to prevent AD

Background Developing efficient Alzheimer's disease (AD) prevention strategies is imperative as AD has no cure. Physical inactivity, obesity, type 2 diabetes [T2D], hypertension, smoking, depression, and low educational attainment, are the seven major potentially modifiable risk factors showing consistent association with AD. We have launched a novel, "real‐life", feasibility study of personalized 18‐months intervention for prevention of cognitive decline in middle‐aged individuals at high AD risk due to a parental family history. Our study implements an innovative approach combining a smartphone application (app) with study team guidance through phone‐calls. Our aims are to investigate: 1) The feasibility of our novel intervention and factors associated with adherence to it; 2) Whether our intervention improves AD risk factors and whether greater adherence is associated with larger improvement; and 3) Whether our intervention improves cognition and cerebral blood flow. Method We will recruit one hundred 40‐65 years old AD patients' offspring, to two groups (67 at the intervention group and 33 at the passive control). All participants will have at least two risk factors of the seven major modifiable AD risk factors. The 18‐months intervention will include advice for risk factors improvement, interactive follow‐up using a smartphone app and dynamic feedback on risk factors management for its modification, through both the app and the study team. Result Recruitment has recently begun, through publishing an online eligibility questionnaire. Thus far, 200 individuals have completed the questionnaire, with 113 fulfilling eligibility criteria‐ among them 86% with physical inactivity, 87% with obesity, 38% with T2D, 17% with hypertension, 13% smoking, and 32% with depression. Thus far 33 participants have been recruited‐ Among them, 10 participants have completed the baseline evaluation, and have been randomized to the study's arms (8 of them had started the active intervention, with an average app‐adherence of 83%). additional 23 participants have completed partial base‐line evaluation. Conclusion Results of this study will provide feasibility data on the adherence to the human‐app approach, characteristics of those who adhere, on whether the approach improves risk factors, and will provide initial data on intervention effects on cognition. At AAIC, interim results will be presented.