The Effects, Usability, Satisfaction, Barriers, and Benefits of a Remote, Multidomain Website-based Intervention to Prevent Cognitive Decline in Older Adults

Mexico exhibits a high prevalence of dementia, exceeding 8%, and it is estimated that by 2050 around 3.5 million older adults will be living with this condition. In light of this scenario, it becomes a priority to intervene on the factors associated with the development of dementia through preventive strategies, particularly via multicomponent programs that integrate physical activity, cognitive training, and other components aimed at modifying lifestyles, applied early, before the appearance of clinical symptoms. In order to expand access to this type of intervention for older adults with limited time or resources for face-to-face care, the implementation of preventive programs remotely through the use of digital media has been proposed. Web platforms constitute an accessible and cost-effective alternative for delivering complex interventions, such as the 'Mind and Movement for Cognitive Health (MeMo-Salud-Cog)' program, designed to promote lifestyles conducive to cognitive health and which has shown promising preliminary results in overall cognitive function, memory, executive function, and attention. However, the use of digital systems by older adults may be limited by barriers associated with ageing (cognitive, sensory, physical, and motivational), as well as social aspects (education and social isolation) or cultural factors (beliefs and perceived usefulness), which can affect the continuity of their participation. In this context, the present proposal suggests adapting the MeMo-Salud-Cog program to a remote modality, through a website and remote monitoring by healthcare professionals, with the aim of evaluating its feasibility based on usability, satisfaction, effect, and adherence, as well as analyzing perceived acceptability, emphasizng the barriers and benefits of remote intervention. The investigators will employ a mixed design combining quantitative and qualitative methods, with a pre-post evaluation without a control group in the quantitative part and semi-structured interviews in the qualitative part (pilot study). The study population will consist of independent individuals aged 60 to 75 years affiliated with IMSS at the Family Medicine Unit 1 and 28, with or without cognitive complaints, but without impairment (MMSE ≥ 24), functional independence, at least one vascular risk factor, with a mobile phone or computer, and an informed consent letter.

Inclusion Criteria: * With and without cognitive complaints (i.e., they have responded 'yes' to the question: 'Do you feel that your memory or learning abilities have worsened recently?"). * They demonstrate independence in activities of daily living and instrumental activities of daily living. • With one or more vascular risk factors (for example, type 2 diabetes or hypertension). * With a score on the overall cognitive function test of≥ 24 on the Mini-Mental State Examination. * With a score between 0-4 on the Blessed Dementia Scale. * With a mobile phone or computer. * Have a companion, such as a child, spouse, or friend, who can support you during the assessment in case of an emergency. * Voluntary acceptance to participate in the study through a signed informed consent form prior to your participation. Exclusion Criteria: * Depression (score \> 15 according to the Epidemiological Studies Center Depression Scale - Revised \[CESD-R\]). * With a clinical diagnosis of any significant neurological or psychiatric disorder (for example, Parkinson's disease, schizophrenia). * With any heart disease. * Presence of a recent cancer diagnosis. * History of recent severe cardiovascular event (for example, myocardial infarction, stroke). * Significant orthopedic conditions (for example, severe osteoarthritis). * Uncontrolled blood pressure (very high \> 180/100 mmHg or very low \< 100/60 mmHg). * Severe visual or hearing impairment. * Type 2 Diabetes Mellitus requires insulin to control hyperglycemia.