Arrotta, Kayela

Objectives This study evaluated the efficacy of a multidomain brain health intervention on health behavior change and sought to understand whether health literacy or brain health knowledge predicted engagement with the intervention. Methods One-hundred thirty midlife and older adults were assigned to one of three intervention conditions: brain fitness (B-Fit) utilizing education and goal setting, education-only, or waitlist. Questionnaires were completed at baseline and post-intervention. Results Both B-Fit and education-only conditions reported improvements in health behaviors over time. Although effect size for the education-only condition was moderate, only the B-Fit condition differed significantly in health behaviors from the waitlist post-intervention. Lower baseline brain health knowledge predicted improvements in health behaviors for education-only condition. Discussion The multidomain brain health intervention was successful in helping participants change their behaviors, but it was not more effective than the education-only condition. For those with lower brain health knowledge, an education-only intervention may be sufficient to encourage behavior change.

Abstract Objective The night out task (NOT) was developed as a naturalistic, open-ended, multitasking measure that requires individuals to complete eight subtasks comparable to those encountered during real-world functioning (e.g., pack travel bag, prepare tea). We examined psychometric properties and administration feasibility of this direct observation measure within a clinic-like setting using a tablet-based coding application. Method A sample of 148 community-dwelling older adults (82% cognitively healthy; 18% mild cognitive impairment) and 57 younger adults completed the NOT along with other neurocognitive tests and questionnaires. Results Inter-rater reliability across NOT primary (i.e., time, accuracy, efficiency) and process-related (e.g., error-types, self-corrections) variables was mostly excellent. NOT primary measures showed expected patterns of convergent and discriminant validity with measures of cognition, demographics, and well-being. External validity was established by the NOT ability to distinguish between age and diagnostic (cognitively healthy vs. mild cognitive impairment) groups. Demonstrating incremental validity, the NOT primary variables (execution time in particular) were predictive of self-reported functional abilities and completion quality of in-home everyday tasks over and earlier variables such as demographics, cognition, and mobility. Conclusions These findings suggest that the NOT and its app interface, which allows for continuous logging of observations, are a feasible in-clinic measure to assess cognitive capacities important for real-world functioning. With further validation, the NOT may allow for earlier detection of functional difficulties. Understanding errors and strategies used during NOT performance could also have implications for individualized interventions.