By 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults. During the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional ‘guiding principles’ and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content. Scoping reviews and qualitative interviews suggested that the same intervention content may be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of intervention content and functionality that appeared highly acceptable amongst a sample of target users. A digitally delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.

中文翻译：

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规划和优化数字干预以保护老年人的认知健康

到 2050 年，全球痴呆症患病率预计将增加两倍。需要负担得起的、可扩展的干预措施来支持身体活动、认知训练和健康饮食等保护性行为。本文概述了“活跃大脑”的理论、证据和以人为本的发展：一种多领域的数字行为改变干预措施，以减少老年人的认知能力下降。在最初的计划阶段，范围审查、与 PPI 贡献者和专家共同调查员的协商以及行为分析整理和记录了三角化的证据，以告知临时“指导原则”和干预逻辑模型。接下来的优化阶段涉及对 52 名认知表现得分较高和较低的老年人进行定性大声思考和半结构化访谈。对数据进行了专题分析，并告知指导原则、行为分析和逻辑模型的变化和补充，进而告知干预内容的变化。范围审查和定性访谈表明，相同的干预内容可能适用于认知能力较高和较低的个体。定性研究结果表明，保持独立和享受会促使人们参与有针对性的干预行为，而管理疾病是一个潜在的障碍。参与此类活动的社会支持可以提供动力，但并不是所有人都希望得到的。这些发现为干预内容和功能的开发提供了信息，这些内容和功能在目标用户样本中似乎非常可接受。以最少支持进行的数字化干预似乎可以接受，并且可能会吸引认知能力水平较高和较低的老年人。除了为我们自己的干预开发提供信息外，通过此过程获得的见解可能对其他与老年人和/或认知障碍患者一起工作和开发干预措施有用。