Tailored Brain Health Insights Through Nurturing Knowledge-based Change - Stakeholder-driven, Human-centered, AI-powered Refinement for Prevention

NCT07612800 | Not Yet Recruiting DMC

• 2 other identifiers: 2025-1562NICCOG2024-0027
• Study Type: interventional
• Target: 350
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to evaluate whether an AI-powered digital brain health coaching intervention can improve modifiable brain health risk factors in community-dwelling adults aged 40 and above in Singapore. The main question it aims to answer is: does the use of BLAZE, an AI-powered digital brain health coaching intervention, lead to a greater improvement in Brain Care Score (BCS) compared to usual care at 6 months? Researchers will compare participants receiving BLAZE to those receiving usual care (waitlist control) to see if BLAZE leads to greater improvements in brain health risk factors, behavioural outcomes, quality of life, and cost-effectiveness. Participants will:

• Be randomly assigned to either receive BLAZE immediately for 12 months or be placed on a waitlist receiving usual care for the first 6 months before receiving BLAZE for a further 6 months
• Complete a series of assessments at baseline, 6 months, and 12 months including the Brain Care Score, physical function tests, cognitive assessments, quality of life measures, and lifestyle behaviour questionnaires
• If assigned to the intervention group, interact with BLAZE via a WhatsApp-based platform that delivers personalised brain health recommendations, behavioural nudges, educational content, and goal-setting support based on their individual Brain Care Score profile

Conditions

MCI; Dementia

Keywords

COM-B; artificial intelligence; digital health intervention; mHealth; conversational agent; large language model; Whatsapp-based intervention; Just-in-time adaptive intervention (JITAI); brain health coaching; behavioural nudging

Outcome Measures

Primary Outcomes (1)

• Brain Care Score

  To evaluate whether the AI-powered Brain Health Coach, BLAZE, improves BCS in community-dwelling adults versus usual care.

  12 months

Secondary Outcomes (13)

• NHG Healthy Eating Score

  12 months

• EuroQol-5 (EQ-5D)

  12 months

• Lawton Instrumental Activities of Daily Living (IADL)

  12 months

• Katz Index of Independence in Activities of Daily Living (ADL)

  12 months

• UCLA Loneliness Scale (UCLA-3)

  12 months

Study Arms (2)

Waitlist Control

OTHER

Participants assigned to the waitlist control arm will receive usual care for the first 6 months of the study, consisting of standard educational materials on brain health. Following the 6-month assessment, waitlist control participants will receive full access to BLAZE for a further 6 months (months 6-12), identical to the intervention described in the immediate intervention arm.

Behavioral: BLAZE (Brain health Lifestyle Action with personaliZed Engagement)

BLAZE Intervention

ACTIVE COMPARATOR

Participants assigned to the immediate intervention arm will receive access to BLAZE (Brain health Lifestyle Action with personaliZed Engagement) for 12 months.

Behavioral: BLAZE (Brain health Lifestyle Action with personaliZed Engagement)

Interventions

BLAZE (Brain health Lifestyle Action with personaliZed Engagement) BEHAVIORAL

BLAZE is an AI-powered digital brain health coaching intervention delivered via a WhatsApp-based platform integrated with a large language model (LLM). Grounded in the COM-B behavioural framework, BLAZE operates through four integrated modules - Assessment, Education, Nudge, and Coaching - to deliver personalised recommendations, behavioural nudges, educational content, and goal-setting support. Personalisation is driven by each participant's Brain Care Score (BCS) profile, with intervention intensity stratified according to domain-specific scores. All content is informed by a curated knowledge base developed in collaboration with neurologists and geriatricians

BLAZE Intervention; Waitlist Control

Eligibility Criteria

• Age: 40 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Community-dwelling adults
• Aged 40 years and above at time of recruitment
• Able to use a smartphone and smartphone applications
• Able to provide written informed consent

You may not qualify if:

• Been diagnosed wotj dementia, neurocognitive disorder or any major psychiatric illness
• Have severe sensory or physical disability precluding usage of the application
• Terminal illness or expected survival of less than 12 months at point of recruitment

Sponsors & Collaborators

• Alexandra Hospital: lead
• National University Hospital, Singapore: collaborator
• National University Polyclinics, Singapore: collaborator

Study Sites (1)

Alexandra Hospital

Singapore, Singapore, Singapore

Location

Related Publications (42)

• Kashdan TB, Disabato DJ, Goodman FR, et al. The Five-Dimensional Curiosity Scale Revised (5DCR): Briefer subscales while separating overt and covert social curiosity. Personality and Individual Differences 2020;157:109836.

  BACKGROUND

• Virginia B, Victoria C. Using thematic analysis in psychology. Qualitative Research in Psychology 2006;3(2):77--101

  BACKGROUND

• Guest G, Bunce A, Johnson L. How Many Interviews Are Enough?:An Experiment with Data Saturation and Variability. Field Methods 2006;18(1):59-82

  BACKGROUND

• Lubben JE. Assessing social networks among elderly populations. Family & Community Health 1988;11(3):42-52.

  BACKGROUND

• Petkov J, Harvey P, Battersby M. The internal consistency and construct validity of the partners in health scale: validation of a patient rated chronic condition self-management measure. Qual Life Res. 2010 Sep;19(7):1079-85. doi: 10.1007/s11136-010-9661-1. Epub 2010 May 1.

  PMID: 20437206 BACKGROUND

• Balestroni G, Bertolotti G. [EuroQol-5D (EQ-5D): an instrument for measuring quality of life]. Monaldi Arch Chest Dis. 2012 Sep;78(3):155-9. doi: 10.4081/monaldi.2012.121. Italian.

  PMID: 23614330 BACKGROUND

• Matthews JA, Matthews S, Faries MD, Wolever RQ. Supporting Sustainable Health Behavior Change: The Whole is Greater Than the Sum of Its Parts. Mayo Clin Proc Innov Qual Outcomes. 2024 May 18;8(3):263-275. doi: 10.1016/j.mayocpiqo.2023.10.002. eCollection 2024 Jun.

  PMID: 38807973 BACKGROUND

• Bowen PG, Jones CD, Myers T, Martin R, Knight A, Azuero A, Smith T, Lancaster C, Brewer M, Davuluri S, Delaney E, Asif I, Lazar RM. Implementing brain health strategies in primary care: methods and baseline findings from the BHAM registry. Arch Public Health. 2025 Dec 29;83(1):306. doi: 10.1186/s13690-025-01768-0.

  PMID: 41462348 BACKGROUND

• Tan BY, Tan LF, Rosand J. Shifting the needle in cognitive health: urgent action on modifiable risk factors to prevent dementia in Singapore. Singapore Med J. 2025 Mar 7. doi: 10.4103/singaporemedj.SMJ-2024-216. Online ahead of print. No abstract available.

  PMID: 40125579 BACKGROUND

• Shelkey M, Wallace M. Katz Index of Independence in Activities of Daily Living. J Gerontol Nurs. 1999 Mar;25(3):8-9. doi: 10.3928/0098-9134-19990301-05. No abstract available.

  PMID: 10362969 BACKGROUND

• Krol MW, de Boer D, Delnoij DM, Rademakers JJ. The Net Promoter Score--an asset to patient experience surveys? Health Expect. 2015 Dec;18(6):3099-109. doi: 10.1111/hex.12297. Epub 2014 Oct 27.

  PMID: 25345554 BACKGROUND

• de Miquel C, Haro JM, van der Feltz-Cornelis CM, Ortiz-Tallo A, Chen T, Sinokki M, Naumanen P, Olaya B, Lima RA. Differential attrition and engagement in randomized controlled trials of occupational mental health interventions in person and online: A systematic review and meta-analysis. Scand J Work Environ Health. 2024 Dec 1;50(8):588-601. doi: 10.5271/sjweh.4173. Epub 2024 Jul 29.

  PMID: 39072699 BACKGROUND

• Dhinagaran DA, Sathish T, Soong A, Theng YL, Best J, Tudor Car L. Conversational Agent for Healthy Lifestyle Behavior Change: Web-Based Feasibility Study. JMIR Form Res. 2021 Dec 3;5(12):e27956. doi: 10.2196/27956.

  PMID: 34870611 BACKGROUND

• Maher CA, Davis CR, Curtis RG, Short CE, Murphy KJ. A Physical Activity and Diet Program Delivered by Artificially Intelligent Virtual Health Coach: Proof-of-Concept Study. JMIR Mhealth Uhealth. 2020 Jul 10;8(7):e17558. doi: 10.2196/17558.

  PMID: 32673246 BACKGROUND

• Loughnane C, Laiti J, O'Donovan R, Dunne PJ. Systematic review exploring human, AI, and hybrid health coaching in digital health interventions: trends, engagement, and lifestyle outcomes. Front Digit Health. 2025 Apr 24;7:1536416. doi: 10.3389/fdgth.2025.1536416. eCollection 2025.

  PMID: 40343215 BACKGROUND

• Fu L, Burns R, Xie Y, Shen J, Zhe S, Estabrooks P, Bai Y. The Development and Use of AI Chatbots for Health Behavior Change: Scoping Review. J Med Internet Res. 2026 Jan 28;28:e79677. doi: 10.2196/79677.

  PMID: 41604667 BACKGROUND

• Freitas S, Simoes MR, Alves L, Santana I. Montreal cognitive assessment: validation study for mild cognitive impairment and Alzheimer disease. Alzheimer Dis Assoc Disord. 2013 Jan-Mar;27(1):37-43. doi: 10.1097/WAD.0b013e3182420bfe.

  PMID: 22193353 BACKGROUND

• Russell DW. UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. J Pers Assess. 1996 Feb;66(1):20-40. doi: 10.1207/s15327752jpa6601_2.

  PMID: 8576833 BACKGROUND

• Hamplova D, Klusacek J, Mracek T. Assessment of self-rated health: The relative importance of physiological, mental, and socioeconomic factors. PLoS One. 2022 Apr 18;17(4):e0267115. doi: 10.1371/journal.pone.0267115. eCollection 2022.

  PMID: 35436307 BACKGROUND

• Park TS, Shin MJ. Comprehensive Assessment of Lower Limb Function and Muscle Strength in Sarcopenia: Insights from the Sit-to-Stand Test. Ann Geriatr Med Res. 2024 Mar;28(1):1-8. doi: 10.4235/agmr.23.0205. Epub 2024 Feb 8.

  PMID: 38325818 BACKGROUND

• Bohannon RW. Grip Strength: An Indispensable Biomarker For Older Adults. Clin Interv Aging. 2019 Oct 1;14:1681-1691. doi: 10.2147/CIA.S194543. eCollection 2019.

  PMID: 31631989 BACKGROUND

• Annear MJ, Toye C, Elliott KJ, McInerney F, Eccleston C, Robinson A. Dementia knowledge assessment scale (DKAS): confirmatory factor analysis and comparative subscale scores among an international cohort. BMC Geriatr. 2017 Jul 31;17(1):168. doi: 10.1186/s12877-017-0552-y.

  PMID: 28760154 BACKGROUND

• Hansra GK, Lim H, Cheong CY, Yap P. Knowledge and Attitudes towards Dementia among the General Public in Singapore: A Comparative Analysis. Dement Geriatr Cogn Disord. 2023;52(4):214-221. doi: 10.1159/000530271. Epub 2023 Apr 20.

  PMID: 37080177 BACKGROUND

• Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis. 2006 Oct;3(4):A118. Epub 2006 Sep 15.

  PMID: 16978493 BACKGROUND

• Graf C. The Lawton instrumental activities of daily living scale. Am J Nurs. 2008 Apr;108(4):52-62; quiz 62-3. doi: 10.1097/01.NAJ.0000314810.46029.74.

  PMID: 18367931 BACKGROUND

• Allen DM, Kiyota E, Wong JEL; Health District @ Queenstown. Health District at Queenstown: Catalyst for translational research. Ann Acad Med Singap. 2024 Apr 29;53(4):264-267. doi: 10.47102/annals-acadmedsg.2023369. No abstract available.

  PMID: 38920183 BACKGROUND

• Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011 Apr 23;6:42. doi: 10.1186/1748-5908-6-42.

  PMID: 21513547 BACKGROUND

• Harrison RM, Lapteva E, Bibin A. Behavioral Nudging With Generative AI for Content Development in SMS Health Care Interventions: Case Study. JMIR AI. 2024 Oct 15;3:e52974. doi: 10.2196/52974.

  PMID: 39405108 BACKGROUND

• Bouton ME. Why behavior change is difficult to sustain. Prev Med. 2014 Nov;68:29-36. doi: 10.1016/j.ypmed.2014.06.010. Epub 2014 Jun 15.

  PMID: 24937649 BACKGROUND

• Kinoshita S, Hirooka N, Kusano T, Saito K, Aoyagi R. Does health literacy influence health-related lifestyle behaviors among specialists of health management? A cross-sectional study. BMC Prim Care. 2024 Jan 20;25(1):29. doi: 10.1186/s12875-024-02263-1.

  PMID: 38245688 BACKGROUND

• Kimball TN, Tack RWP, Parodi L, Prapiadou S, Senff JR, Tan BYQ, Duperron MG, Choksi D, Reinders EM, Rivier CA, Falcone GJ, Yechoor N, Singh SD, Rosand J, Mayerhofer E, Anderson CD. Longitudinal Trajectories of Brain Health Risk Factors Measured by the Brain Care Score and Risk of Stroke, Dementia, and Depression. Ann Neurol. 2026 May;99(5):1113-1123. doi: 10.1002/ana.78145. Epub 2026 Jan 9.

  PMID: 41510843 BACKGROUND

• Choksi D, Gutierrez-Martinez L, Rist PM, Buring JE, Senff JR, Marini S, Kourkoulis C, Chemali Z, Newhouse A, Westover MB, Tanzi RE, Fricchione G, Singh S, Rosand J, Anderson CD, Yechoor N. Use of the Brain Care Score to Estimate the Risk of Incident Cerebrovascular Events in Middle-Aged Women. Neurology. 2025 Jun 10;104(11):e213674. doi: 10.1212/WNL.0000000000213674. Epub 2025 May 16.

  PMID: 40378376 BACKGROUND

• Baker LD, Espeland MA, Whitmer RA, Snyder HM, Leng X, Lovato L, Papp KV, Yu M, Kivipelto M, Alexander AS, Antkowiak S, Cleveland M, Day C, Elbein R, Tomaszewski Farias S, Felton D, Garcia KR, Gitelman DR, Graef S, Howard M, Katula J, Lambert K, Matongo O, McDonald AM, Pavlik V, Raman R, Salloway S, Tangney C, Ventrelle J, Wilmoth S, Willliams BJ, Wing R, Woolard N, Carrillo MC. Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial. JAMA. 2025 Aug 26;334(8):681-691. doi: 10.1001/jama.2025.12923.

  PMID: 40720610 BACKGROUND

• Subramaniam M, Abdin E, Asharani PV, Roystonn K, Devi F, Peizhi W, Shafie S, Sagayadevan V, Jeyagurunathan A, Chua BY, Tan B, Vaingankar JA, Yao F, Magadi H, Ma S, Chow WL, McCrone P, Heng D, Mahendran R, Prince M, Ng LL, Chong SA. Prevalence of dementia in Singapore: Changes across a decade. Alzheimers Dement. 2025 Feb;21(2):e14485. doi: 10.1002/alz.14485. Epub 2025 Jan 27.

  PMID: 39868432 BACKGROUND

• Singh SD, Gutierrez-Martinez L, Newhouse A, Sonni A, Chemali Z, Rosand J. Brain health begins with brain care. Lancet Neurol. 2022 Nov;21(11):961-962. doi: 10.1016/S1474-4422(22)00397-0. No abstract available.

  PMID: 36270304 BACKGROUND

• Xiaopeng Z, Jing Y, Xia L, Xingsheng W, Juan D, Yan L, Baoshan L. Global Burden of Alzheimer's disease and other dementias in adults aged 65 years and older, 1991-2021: population-based study. Front Public Health. 2025 Jul 1;13:1585711. doi: 10.3389/fpubh.2025.1585711. eCollection 2025.

  PMID: 40666154 BACKGROUND

• Michaelsen MM, Esch T. Understanding health behavior change by motivation and reward mechanisms: a review of the literature. Front Behav Neurosci. 2023 Jun 19;17:1151918. doi: 10.3389/fnbeh.2023.1151918. eCollection 2023.

  PMID: 37405131 BACKGROUND

• Ngandu T, Lehtisalo J, Solomon A, Levalahti E, Ahtiluoto S, Antikainen R, Backman L, Hanninen T, Jula A, Laatikainen T, Lindstrom J, Mangialasche F, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015 Jun 6;385(9984):2255-63. doi: 10.1016/S0140-6736(15)60461-5. Epub 2015 Mar 12.

  PMID: 25771249 BACKGROUND

• Livingston G, Huntley J, Liu KY, Costafreda SG, Selbaek G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivimaki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024 Aug 10;404(10452):572-628. doi: 10.1016/S0140-6736(24)01296-0. Epub 2024 Jul 31. No abstract available.

  PMID: 39096926 BACKGROUND

• Abdin E, Subramaniam M, Achilla E, Chong SA, Vaingankar JA, Picco L, Sambasivam R, Pang S, Chua BY, Ng LL, Chua HC, Heng D, Prince M, McCrone P. The Societal Cost of Dementia in Singapore: Results from the WiSE Study. J Alzheimers Dis. 2016;51(2):439-49. doi: 10.3233/JAD-150930.

  PMID: 26890766 BACKGROUND

• GBD 2019 Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022 Feb;7(2):e105-e125. doi: 10.1016/S2468-2667(21)00249-8. Epub 2022 Jan 6.

  PMID: 34998485 BACKGROUND

• GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):459-480. doi: 10.1016/S1474-4422(18)30499-X. Epub 2019 Mar 14.

  PMID: 30879893 BACKGROUND

Related Links

• Eatwise Questionnaire

MeSH Terms

Conditions

Dementia

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Central Study Contacts

Dr Li Feng Tan

CONTACT

(65)85018320; ah_brainhealth@nuhs.edu.sg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study is a two-arm, parallel-group randomised controlled trial with a 1:1 allocation ratio. Following recruitment, participants will be randomly allocated to either the intervention or control group. The intervention group will receive personalised brain health coaching through the AI-coach for 12 months, while the control group will receive standard care, followed by access to the AI-coach for the subsequent 6 months. This delayed introduction of the AI-coach allows comparison of intervention effectiveness at 6 months as the primary outcome timepoint, with secondary assessments at 12 months to evaluate sustainability of change and within-group effects

Study Record Dates

• First Submitted: May 21, 2026
• First Posted: May 29, 2026
• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): December 31, 2029
• Study Completion (Estimated): December 31, 2029
• Last Updated: May 29, 2026

Record last verified: 2026-05

Locations

SG (1)