Efficacy of MindAhead's Digital Behavioral Activation Therapy in Adults with MCI or Mild Dementia

Inclusion Criteria:

• Diagnosis of cognitive impairment in MCI stage (ICD-10 codes: F06.7, F07.8) or milddementia stage (ICD-10: F00.-*, F01.-, F03) due to all etiologies apart frometiologies described in F02.- (Pick's disease, Parkinson's disease, multiplesclerosis, Huntington's disease, HIV, Lewy body disease). Hence, etiologies of MCIand mild dementia include

• Alzheimer's disease (e.g., F00.-*)

• Vascular disease (e.g., F01.-) (exception in case of stroke: event occurred > 12 months ago without ongoing spontaneous remission)

• Mixed diseases

• Unclear etiologies

• MCI or mild dementia diagnosis assigned within the last 12 months by a neurologistor psychiatrist from our cooperation partners that fulfil adequate diagnosisprocedures such as neuropsychological assessment, brain imaging, self- and/orthird-party medical history interview, and potentially cerebrospinal fluid, positronemission tomography, or electrophysiological measures

• MCI or mild dementia diagnosis confirmed by a treating physician

• MMSE ≥ 24 or MoCA ≥ 18 (last date of assessment is decisive; needs to be within thelast 12 months)

• Sufficient physical fitness to engage in physical activities (e.g., walking orcycling) as confirmed by a treating physician

• Age ≥ 50

• German language skills sufficient to understand German instructions of studyassessments and of the intervention

• Ability and sufficient vision to operate a smartphone

Exclusion Criteria:

• possibly moderate or severe cognitive impairment (moderate or severe dementia),indicated by MMSE < 24 or MoCA < 18 (last date of assessment is decisive; needs tobe within the last 12 months)

• Specific brain injury events within the last 12 months or with ongoing spontaneousremission due to

• Stroke (ischemic, hemorrhagic)

• Traumatic brain injury

• Specific etiologies of MCI or mild dementia (F02.-) that show a variable course or afast progression including

• Multiple sclerosis

• Parkinson's disease

• Pick's disease / Frontotemporal lobar degeneration

• Lewy body disease

• Brain tumors

• Autosomal dominant form of Alzheimer's disease with early first manifestation

• Creutzfeldt-Jakob disease

• German language restrictions or visual restrictions which prevent from understandingwritten German instructions of assessment or intervention procedures (e.g. severeaphasia, lack of sufficient German language skills, severe non-corrected visualimpairment)