ENHANCE

We have created a program called ENHANCE to help keep older people's brains healthy. It comes with an app and a personal coach who helps people make healthy changes in their daily life. These changes can help their brain stay healthy as they get older.

Why is this important?

• Dementia cases are rising because people are living longer. We aim to help people without a dementia diagnosis to reduce their risk of developing the condition as they get older. - Encouraging research shows that in some richer countries like the UK, the risk of a person getting dementia has decreased, suggesting we may be able to prevent or delay its onset.
• Unfortunately, certain groups, particularly those from less privileged backgrounds or ethnic minority communities, remain at higher risk of developing dementia.
• Research shows that if we delay dementia by just 5 years, it could halve the number of people affected, helping both individuals and families while saving money for the NHS and social care. This is because the risk of developing dementia increases with age, so by delaying its onset, fewer people will reach the age where they would typically be diagnosed, significantly reducing the overall number of cases.

How does ENHANCE work?

• It combines a tablet-based application with support from coaches, both face-to-face and online
• The programme is tailored to each individual's needs and circumstances.
• The research team is working with diverse community groups to ensure the programme is accessible and beneficial for everyone, particularly those who have historically had less access to healthcare interventions. 

The above image shows both the modifiable and unknown risk factors associated with developing dementia. It also highlights how much each risk factor contributes to developing dementia and the potential impact of eliminating each of them. 

What risk factors does ENHANCE help tackle?

ENHANCE aims to tackle the following risk factors for developing dementia: high blood pressure, hearing loss, smoking, obesity, depression, lack of exercise, diabetes, excessive alcohol use, and limited social interaction, and we are also including cognitive stimulation through games. These risk factors have been identified by the Lancet Commission (a global initiative that makes research-backed recommendations for public health issues) as significant contributors to dementia development.

The ENHANCE programme is a new approach designed to help people take control of these risk factors. Using a specially developed tablet-based app, created in collaboration with the app company GLITCHERS – Games for Good, participants are supported by a coach to make small but effective changes to their daily routines. The app has been carefully designed to be accessible and engaging for people from all walks of life, particularly those from minority ethnic groups and socioeconomically disadvantaged backgrounds. This ensures the programme is relevant and helpful for those who may be at the greatest risk.

What are we trying to achieve?

The ENHANCE study aims to find out if this blended approach, combining digital tools and personalised coaching, can successfully reduce dementia risk factors and improve brain health. Specifically, the study is exploring whether this method:

• Is easy to use and deliver, and enjoyable (feasibility and acceptability).
• Can lead to real improvements in memory and other brain health outcomes.
• Offers a cost-effective way to deliver support to a large number of individuals, possibly through the NHS.

We are starting with a randomised feasibility trial to refine the programme, before moving on to a larger trial to test how well it works. The learnings from the feasibility trial, which will happen on a smaller scale than the main trial, will enable us to better prepare for the main randomised controlled trial with a larger group of participants.

Why does this matter?

If ENHANCE proves successful, it could change the way we approach dementia prevention. This programme empowers individuals to take control of their own health, using practical tools and personalised support. By reducing the burden on GPs and other primary care services, ENHANCE could offer a scalable and effective solution for tackling dementia risk on a national level.

This is a bold step forward in dementia prevention—connecting people, technology, and healthcare to create a brighter, healthier future for all.

Recruitment update - North London & Hull only

At this stage, we are specifically recruiting participants from North London and Hull. Please note that we are not currently accepting participants from other areas.

If you are interested and would like to know more about the project or future opportunities, feel free to get in touch. However, please be aware that this does not necessarily mean you will be invited to participate at this time.

Thank you for your understanding!

Contact us

Email us at: enhance@ucl.ac.uk

Funding and Awards 

This project is funded by the National Institute for Health Research (NIHR) HTA Reference Number: NIHR203670