High health coaching adherence increases Alzheimer’s protection in at‐risk inviduals following a 4‐month intervention

Background Alzheimer’s disease and related dementias (ADRD) imposed an estimated financial cost to Americans of $355 billion in 2021 and is projected to rise to $1.1 trillion by 2050. ADRD affects more than 6 million Americans and is expected to rise to more than 13 million by 2050. Health coaching (HC) interventions improve many lifestyle factors also known to be protective against ADRD; however, their ability to provide protection in individuals at‐risk for developing cognitive decline is unknown. The purpose of the present investigation was to examine the effect of HC intervention adherence on ADRD protective factor score after 4 months. Method Adults aged 45‐75 years (n = 104) with at least two ADRD risk factors and a maximum of one protective factor participated in this study. Participants completed the Australian National University Alzheimer’s Disease Risk Index (ANU‐ADRI) both before and after a 4‐month HC protocol focusing on reducing modifiable risk factors for ADRD in six domains (diet, exercise, sleep, stress, social engagement, and cognitive activity). Participants who completed a number of check‐ins with the health coach greater than the group mean (5.6 check‐ins) were placed in the high adherence (HA) group, and individuals with fewer were placed in the low adherence (LA) group. A mixed factorial ANOVA was conducted to determine if there was a difference in pre‐ and post‐ANU‐ADRI overall protective factor score. Result After the 4‐month HC intervention, ANU‐ADRI scores did not change overall in the pooled sample (F(1,102) = 1.45, p = .23). However, a significant adherence*time interaction effect indicated that HA improved overall protective factor score significantly more than LA (F(1,102) = 4.85, p = .03), and pairwise comparisons revealed that protective factor scores improved only in the HA group (p = .02 for HA versus p = .47 for LA). Conclusion These results indicate an HC intervention may effect behaviors and emotional states understood to be ADRD protective factors when adherence with the protocol is high. This has the potential to improve the quality of life for individuals at‐risk for ADRD. Further investigation will shed light on whether the ADRD protection derived from HC is iterative and durable.