Together Senior Health, Inc. (TOGETHER) is a woman-owned small business that is dedicated to helping older adults with cognitive decline or Alzheimer’s disease and related dementias (ADRD) maintain quality of life and independence by offering innovative, evidence-based, online, livestream, group programs. Our first product on the TOGETHER audio/video platform is Moving TogetherTM—which combines movements to support daily function with mindful body awareness exercises and social engagement and is designed for people with mild ADRD and their caregivers who participate together from home. The primary goal of this Phase II Small Business Innovation Research (SBIR) grant is to expand our product line by developing and testing a comprehensive BRAIN HEALTH TOGETHER program for people living with mild cognitive impairment (MCI). This goal represents a critically important next step for our company from both public health and business perspectives. Older adults with MCI represent a large market with important unmet needs: approximately 20% of older adults (>2.7 million Americans) are currently living with MCI, which places them at increased risk of developing ADRD. There are no medications that can prevent development of ADRD in people with MCI; however, there is growing evidence that behavioral interventions targeting modifiable dementia risk factors—such as physical inactivity, social isolation, and depression—may help improve cognitive function and could potentially delay dementia onset. Our preliminary results suggest that our product, Moving Together is associated with significant improvements in cognitive function, physical function, social isolation, and self-regulation as well as increased default mode network connectivity on pre/post resting state functional magnetic resonance imaging (rs-fMRI) scans in people with MCI. We believe that these benefits would be even greater if Moving Together were combined with a comprehensive brain health coaching program. Therefore, our Specific Aims are to: 1) Work with our Scientific Advisory Board and use humancentered design to develop evidence-based content for Brain Health Together, a 12-week, group-based, livestreaming, digital program that will combine Moving Together with brain health coaching to address modifiable dementia risk factors in people with MCI; 2) Perform a randomized, controlled trial to determine whether the Brain Health Together program improves cognitive function in people with MCI over 12 weeks compared to a Successful Aging comparison group; and 3) Determine whether weekly maintenance classes help to sustain the effects of the Brain Health Together program over 12 weeks after the intervention. If we can demonstrate that BRAIN HEALTH TOGETHER has immediate and sustained cognitive benefits in people with MCI, it will position TOGETHER as a national leader in evidence-based programs to improve quality of life and prevent decline in older adults with cognitive impairment.

Approximately one in five older adults has mild cognitive impairment (MCI), which places them at increased risk of developing Alzheimer’s disease and related dementias. This Phase II Small Business Innovation Research grant will enable Together Senior Health to develop and test a comprehensive BRAIN HEALTH TOGETHER program designed to improve cognitive outcomes in older adults with MCI.