Brain health initiative: protocol for a longitudinal study with a multifaceted intervention

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Abstract
Objectives: This protocol aims to explore the relationship between lifestyle and brain health biomarkers, assess the effects of a multifaceted intervention, and identify factors linked to brain resilience in middle-aged adults. Methods: Adults aged 40–59 years from Porto Alegre, RS, Brazil without neurodegenerative or severe psychiatric disorders will be included. The study consists of 3 phases: (1) online questionnaires assessing 7 brain health domains (general health, physical activity, cognition, social life, purpose, sleep, and nutrition); (2) clinical and functional assessments through biomarker collection, using instruments such as a P-WALK 2.0 baropodometric platform, a Cybex isokinetic dynamometer, an InBody 770, an OMRON sphygmomanometer, the Short Physical Performance Battery, and the Timed Up and Go test; (3) a 16-week randomized trial with 4 weekly sessions of strength and aerobic training. Post-intervention assessments will be conducted. Statistical analyses will include t-tests, ANOVA, regressions, and normality tests, using IBM SPSS Statistics, with significance set at p < 0.05. The study has been approved by the Institutional Research Ethics Committee (No. 7.323.434) and was funded by the National Council for Scientific and Technological Development (CNPq). Expected results: Brain health biomarkers should improve, especially in individuals with lower cognitive reserve, and we expect to identify modifiable factors associated with neuropsychological decline. Relevance: Midlife is a critical window for targeting brain health due to its relevance in preventing neurodegenerative diseases. This study seeks to support public health strategies promoting cognitive resilience.

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