Innovation in aging · 2026
A community-based model for multimodal brain-health screening and Alzheimer's disease and related dementia risk prediction in mid-sized cities and surrounding rural communities: a mixed-methods evaluation.
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Kemp Amy M
Аннотация
BACKGROUND AND OBJECTIVES: Rural adults (those residing in nonmetropolitan counties) face persistent barriers to brain-health assessment that may help prevent or delay cognitive decline. This study reports protocol and pilot feasibility findings from year 1 of a 3-year longitudinal project evaluating Building a Rural Aging and Intervention Network: Factors that Impact Trajectories (BRAIN-FIT), a community-embedded program to improve access to multidomain screening and awareness of modifiable dementia risk factors.
RESEARCH DESIGN AND METHODS: Using a mixed-methods design, 119 adults aged 45 or older completed a single-day interdisciplinary screening incorporating clinical-standard measures (cardiovascular, physical, lifestyle, social-emotional, sensory, cognitive, and speech-language health), followed by individualized-results review. 63 participants completed a 4-week post-event behavior change evaluation.
RESULTS: BRAIN-FIT, delivered across 7 community sites in 3 cities through 18 events, enrolled 163 adults (aged 46-95; M = 67.5) with socioeconomic and clinical heterogeneity. Engagement was strong: 119 consented to longitudinal participation, 95% completed all stations and rated the program highly feasible (3.7-4.4 out of 5). Screening identified prevalent modifiable risk factors: elevated cardiometabolic indicators, reduced physical endurance, sleep disturbance, and sensory impairment. Cognitive and language performance remained largely within functional limits, suggesting engagement during a preventive window.
DISCUSSION AND IMPLICATIONS: Community-embedded multimodal screening appears to be a viable program for identifying actionable brain-health risk prior to substantial decline. By reaching diverse adults outside traditional care pathways, BRAIN-FIT advances a pragmatic population-health approach to dementia prevention. Longitudinal follow-up will evaluate sustained behavior change, strengthen referral integration, and inform hybrid effectiveness-implementation trials to promote healthier aging trajectories.
RESEARCH DESIGN AND METHODS: Using a mixed-methods design, 119 adults aged 45 or older completed a single-day interdisciplinary screening incorporating clinical-standard measures (cardiovascular, physical, lifestyle, social-emotional, sensory, cognitive, and speech-language health), followed by individualized-results review. 63 participants completed a 4-week post-event behavior change evaluation.
RESULTS: BRAIN-FIT, delivered across 7 community sites in 3 cities through 18 events, enrolled 163 adults (aged 46-95; M = 67.5) with socioeconomic and clinical heterogeneity. Engagement was strong: 119 consented to longitudinal participation, 95% completed all stations and rated the program highly feasible (3.7-4.4 out of 5). Screening identified prevalent modifiable risk factors: elevated cardiometabolic indicators, reduced physical endurance, sleep disturbance, and sensory impairment. Cognitive and language performance remained largely within functional limits, suggesting engagement during a preventive window.
DISCUSSION AND IMPLICATIONS: Community-embedded multimodal screening appears to be a viable program for identifying actionable brain-health risk prior to substantial decline. By reaching diverse adults outside traditional care pathways, BRAIN-FIT advances a pragmatic population-health approach to dementia prevention. Longitudinal follow-up will evaluate sustained behavior change, strengthen referral integration, and inform hybrid effectiveness-implementation trials to promote healthier aging trajectories.