MindAhead Offers Digital Alzheimer’s Therapy Through a Clinical Trial-Backed Behavior Activation Program
With MindAhead, serial entrepreneur Nina Kiwit and her team are bringing to market an Alzheimer’s digital therapy that leverages behavioral activation. This therapeutic strategy – one of the most effective methods for slowing cognitive decline – focuses on restoring a person’s ability to do the things they enjoy in life.
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The Challenge
When a patient comes into their doctor’s office with forgetfulness or other self-reported symptoms of “mild cognitive impairment,” the current standard of care falls flat. It’s not the physician’s fault, they just don’t have many tools in their toolbox for early stage cognitive decline. Usually the response from the healthcare provider is to simply watch and wait until things get worse.
Which, for many people, is exactly what will happen.
It’s estimated that 20% of people over 65 have mild cognitive impairment. And according to the Mayo Clinic, around 10% to 15% of people with MCI develop dementia each year, compared with 1% to 3% in the general population of aging adults.
Left on their own, people concerned about cognitive decline turn to the myriad apps on the market or simply Google their way to a pseudo-answer. Or they do nothing at all. Some of the most prominent apps that target early stage dementia or mild cognitive impairment use something called cognitive stimulation therapy or cognitive test therapy. These often focus on in-app exercises, like math problems or puzzles. The problem, according to Nina Kiwit, CEO & Co-founder of MindAhead, is that these exercises mainly make the patient better at the specific activity at hand.
“It doesn't really train your brain in a way to prevent dementia,” says Kiwit. “You learn the task itself.”
For Kiwit, a serial entrepreneur and digital health expert based in Berlin, that problem begged for an answer.
Origin Story
Nina Kiwit studied economics in Germany, but after school fell in love with the startup life. She worked at big startups in eCommerce but quickly realized she wanted to have a more lasting impact in the world. She got an advanced degree in digital health at the Hasso Plattner Institute and Mount Sinai New York and dove into electronic health records and machine learning. She has served as COO of multiple digital health startups.
While working with a subsidiary of Roche, Kiwit met Manual Kraus, who had trained in psychology and had founded the app Stresscoach. Kraus had been on a parallel path, in many ways. He started out in traditional business, working with tech startups, and then began yearning for more. He wanted to scale companies to improve lives, not just for financial gain. Looking back, he roots that desire in his experience watching his grandmother slowly decline into dementia. For years he felt helpless. There was no clear diagnosis and nothing concrete he could do to help besides show up and try to make her life a little better.
That frustration became an inspiration, and when Kraus met Kiwit, he was primed to tackle the problem of slowing the progression of mild cognitive impairment.
Under the Hood
Kiwit and Kraus, along with their co-founders Pasquale Fedele (CTO) and Patrick Fissler, PhD (CSO), have built an app designed to be prescribed to patients diagnosed with mild cognitive impairment. The app guides users through brain teasers and physical activities that improve brain function. The short-term objective (three to six months) is a measurable increase in quality of life. The two-year goal is to bend the curve on cognitive decline and slow the progression towards dementia.
Where MindAhead differentiates its therapeutic approach is in the use of behavioral activation therapy, a strategy that has been tested and proven effective in the treatment of depression. The therapies focus on helping people become more active in life again and perform activities that are enjoyable or personally meaningful to them.
While well understood in depression therapy, behavioral activation therapy is a relatively new concept for treating early-stage cognitive disorders. In 2018, researchers in the United States conducted a large-scale clinical study in which they adapted the approach for older people with cognitive impairment and dementia. The results were eye-opening. With behavioral activation therapy only about 1% of patients showed significant cognitive decline within two years, the percentage for patients without this program was over 9% in the same period.
“There is no other digital therapy that uses the behavioral activation approach for dementia. It is a unique approach designed to give back some degree of control over the rate of cognitive decline,” says neuroscientist Patrick Fissler, PhD, who is one of the co-founders of MindAhead.
The app includes an AI assistant named after Barry Rovner, MD, the doctor who proved the efficacy of the therapy in the United States.
So far, MindAhead’s results have been positive. The team tested the platform with more than 50 patients and then conducted a clinical trial with another 50. They’re expecting results from their most recent study this autumn.
With a patient population struggling with cognitive impairment, ease of use is paramount for the app. Kiwit and Kraus have made sure that their app has simple controls, large fonts, and visual support. They’ve also stressed user testing, inviting folks with MCI in to review the app at every stage.
Final Word
We don’t have a cure for dementia, unfortunately. But we do know how to slow it down, and the team at MindAhead want to put the best tools for doing so in everyone’s hands.
One of the interesting things about MindAhead that we believe gives them an advantage is that they’re launching their product in Germany first, which has advantageous digital health reimbursement laws. This could give the company a robust onramp to revenue, setting them up for larger European markets and the United States.
MindAhead has also been strategic in building technical partnerships. Most recently, NeuroSys from Ulm became a founding member of the project, developing a physician portal that connects the dots between a consumer-facing app and care in the clinic. They’ve also seen early traction with an investment from RoX (Roche Pharma).
Finally, we’re proud to support MindAhead because they’re meeting an unmet need in a population where the stakes are incredibly high. The sweet spot for MindAhead is patients aged 60, with an upper limit around 75. That’s a massive population of people who, if their dementia is delayed or stopped, if their health is managed, have literally decades of high quality life to live. If MindAhead can delay cognitive decline for folks in their 60s, that means seeing children and loved ones graduate high school, get married, have children. These are massive years and we need more scalable tools to preserve them.
Join us in welcoming Nina Kiwit, Manuel Kraus, and the MindAhead team to StartUp Health’s Alzheimer’s Moonshot Community.
Connect with MindAhead via email
Call for Alzheimer’s Innovation
With support from the Alzheimer’s Drug Discovery Foundation (ADDF) and Gates Ventures, we’ve launched a new global initiative created to develop a collaborative innovation community alongside leading companies, research teams, and stakeholders with a mission to accelerate progress in prevention, diagnosis, and management of Alzheimer’s disease and related dementias. Learn more and apply for an Alzheimer’s Moonshot Fellowship.
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Published: Jul 3, 2024