Optimising activity and diet compositions for dementia prevention: Protocol for the ACTIVate prospective longitudinal cohort study
Authors: Smith Ashleigh E. , Wade Alexandra T. , Olds Timothy S. , Dumuid Dorothea , Breakspear Michael J. , Laver Kate E. , Goldsworthy Mitchell R. , Ridding Michael C. , Fabiani Monica , Dorrian Jillian , McKewen Montana , Paton Bryan , Abdolhoseini Mahmoud , Aziz Fayeem , Mellow Maddison L. , Collins Clare E. , Murphy Karen , Gratton Gabriele , Keage Hannah A.D. , Smith Ross T. , Karayanidis Frini 
Published: July 2021

ABSTRACTIntroductionApproximately 40% of late-life dementia may be prevented by addressing modifiable risk factors, including physical activity and diet. Yet, it is currently unknown how multiple lifestyle factors interact to influence cognition. The ACTIVate Study aims to 1) Explore associations between 24-hour time-use and diet compositions with changes in cognition and brain function; and 2) Identify durations of time-use behaviours and the dietary compositions to optimise cognition and brain function.Methods and analysisThis three-year prospective longitudinal cohort study will recruit 448 adults aged 60-70 years across Adelaide and Newcastle, Australia. Time-use data will be collected through wrist-worn activity monitors and the Multimedia Activity Recall for Children and Adults (MARCA). Dietary intake will be assessed using the Australian Eating Survey food frequency questionnaire. The primary outcome will be cognitive function, assessed using the Addenbrooke’s Cognitive Examination-III (ACE-III). Secondary outcomes include structural and functional brain measures using Magnetic Resonance Imaging (MRI), cerebral arterial pulse measured with Diffuse Optical Tomography (Pulse-DOT), neuroplasticity using simultaneous Transcranial Magnetic Stimulation (TMS) and Electroencephalography (EEG), and electrophysiological markers of cognitive control using event-related potential (ERP) and time-frequency analyses. Compositional data analysis, testing for interactions between time-point and compositions, will assess longitudinal associations between dependent (cognition, brain function) and independent (time-use and diet compositions) variables.ConclusionsThe ACTIVate Study will be the first to examine associations between time-use and diet compositions, cognition and brain function. Our findings will inform new avenues for multidomain interventions that may more effectively account for the co-dependence between activity and diet behaviours for dementia prevention.Ethics and disseminationEthics approval has been obtained from University of South Australia’s Human Research Ethics committee (202639). Findings will be disseminated through peer reviewed manuscripts, conference presentations, targeted media releases and community engagement events.Registration DetailsAustralia New Zealand Clinical Trials Registry (ACTRN12619001659190).Strengths and limitationsThe ACTIVate Study will collect comprehensive measures of lifestyle behaviours and dementia risk over time in 448 older adults aged 60-70 years.Using newly developed Compositional Data Analysis (CoDA) techniques we will examine the associations between time-use and diet compositions, cognition and brain function.Data will inform the development of a digital tool to help older adults obtain personalised information about how to reduce their risk of cognitive decline based on changes to time use and diet.Recruitment will be focussed on older adults to maximise the potential of making an impact on dementia prevention in the next 10 years.Findings may not be generalisable to younger adults.