The Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia – CAN-THUMBS UP (or CTU) is a group of over 100 Canadian researchers within the Canadian Consortium on Neurodegeneration in Aging focused on addressing dementia prevention.
The CTU platform was initiated in 2019 and is part of the World Wide FINGERS (WW-FINGERS) prevention initiative.

Brain Health PRO at the forefront of CTU
BHPro is an innovative online program designed to help reduce the risk of dementia by providing individuals with the tools and knowledge needed to make positive lifestyle changes. The original program consists of 181 chapters within 8 modules that are progressively delivered over 45 weeks and is available online in English and French. The program was developed as a collaborative effort by investigators with recognized expertise in the program’s content areas, along with input from older-adult citizen advisors.
BHPro is organized into the following 8 content modules: 1) general information on cognition, dementia, genetic risk and healthy lifestyle, 2) physical activity, 3) cognitive engagement, 4) diet, 5) sleep, 6) social and psychological health, 7) vascular health, 8) vision and hearing. Content format includes visual and auditory text, pictures, animations, quizzes, questionnaires, and interactive exercises. A personalized profile is developed for each participant based on their responses to lifestyle questionnaires at intervals throughout the program and is provided back in a personalized profile display.
Starting in 2019, we established Brain Health PRO (BHPro), as described above, and carried out two fully remote research projects with the program: a pilot study with 20 participants in 3 provinces, followed by a large follow-up study with 350 participants from across Canada. Work was also done to assess the barriers and facilitators of implementing BHPro within community organizations and to assess BHPro for use/adaptation in Indigenous communities.


SYNERGIC studies
The SYNERGIC studies (SYNchronizing Exercises, Remedies in GaIt and Cognition) are included under the CTU Umbrella.
The SYNERGIC approach is designed to evaluate the effect of aerobic and progressive resistance training exercises, isolated or combined with cognitive training and vitamin D supplementation, in older adults with Mild Cognitive Impairment (MCI).
The SYNERGIC study started in 2016 and future adaptations were incorporated into the CTU platform when it was established in 2019. The SYNERGIC @ HOME study, a 16-week interventional study providing at-home physical exercise guidance and cognitive training delivered online, has been completed.
Protocol
Montero-Odasso, M., et al. (2018). SYNERGIC trial (synchronizing exercises, remedies in gait and cognition) a multi-centre randomized controlled double blind trial to improve gait and cognition in mild cognitive impairment. BMC Geriatrics, 18(1). doi.org/10.1186/s12877-018-0782-7
Main Results
Bray, N. W., et al. (2023). Combining exercise with cognitive training and vitamin D3 to improve functional brain connectivity (FBC) in older adults with mild cognitive impairment (MCI). results from the SYNERGIC trial. GeroScience, 45(3), 1967–1985. doi.org/10.1007/s11357-023-00805-6
Bray, N. W., et al. (2022). Frailty and functional brain connectivity (FBC) in older adults with mild cognitive impairment (MCI): Baseline results from the SYNERGIC trial. GeroScience, 45(2), 1033–1048. https://doi.org/10.1007/s11357-022-00702-4
Montero-Odasso, M., et al. (2023). Effects of exercise alone or combined with cognitive training and vitamin D supplementation to improve cognition in adults with mild cognitive impairment. JAMA Network Open, 6(7). doi.org/10.1001/jamanetworkopen.2023.24465
Current and upcoming studies and initiatives
Phase III (2024-2029) of CCNA is now underway with several studies featuring BHPro which have begun or are slated to kick off over the next year including:
The SYNERGIC 2 study
A Canada-wide study to prepare for the implementation of BHPro
A Canada-wide risk factor reduction study
A study at the Kimel Centre in Toronto comparing the online-only BHPro program to an in-person lifestyle programming with the online BHPro program
A sleep study featuring the educational sleep component of BHPro in addition to the use of CPAP
Continued work on the adaptation of BHPro for Indigenous Communities
The next four years will also see the design of several variations of BHPro being developed, including a 6-month version, a general library, and further development of gamification and engagement features. Modular functionality is also being incorporated to allow collaborators/researchers to use relevant components of BHPro to accommodate their needs and research questions. The program is undergoing updates to improve stability to accommodate new collaborations and an increasing number of participants and users.
Potential participants
For more details and to sign up to be contacted about future CTU research studies, please visit our website and click on “Get Involved” and then on “Participate in Research”.
Researchers
If you are interested in learning more about data already collected using Brain Health PRO, or collaborating on a future project once the modular version of Brain Health PRO is available, please visit our website and click on “Get Involved” and then on “Collaborate”.
CAN-THUMBS UP publications
2022
Authors:
McGibbon, C., Jarrett, P., Handrigan, G., Bouchard, D., Tranchant, C.C., Sexton, A.M., Yetman, L., Robinson, B., Crapoulet, S., Chamard-Witkowski, L., Liu-Ambrose, T., Middleton, L.A., Almeida, Q.J., Bherer, L., Lim, A., Speechley, M., Kamkar, N., Monterro-Odasso, M., The Canadian Consortium on Neurodegeneration in Aging, CAN-THUMBS UP Group
Journal:
BMJ Open
2025
Authors:
Belleville, S., Anderson, N. D., Bherer, L., Camicioli, R., Carrier, J., Chan, S., Cuesta, M., Dang-Vu, T. T., Dwosh, E., Fiocco, A. J., Ferland, G., Gilbert, B., Harris, E., Itzhak, I., Jarrett, P., Kadri, M. A., Laurin, D., Liu-Ambrose, T., McGibbon, C. A., Middleton, L., … CTU expert group for the Canadian Consortium on Neurodegeneration in Aging (CCNA), CAN-THUMBS UP Study Group
Journal:
The Journal of Prevention of Alzheimer's Disease
2024
Authors:
D'Amico, D., Savundranayagam, M. Y., Biles, R., Itzhak, I., Anderson, N. D., & Canadian Consortium on Neurodegeneration in Aging (CCNA) CAN-THUMBS UP Study Group
Journal:
Research Involvement and Engagement
2024
Authors:
Chertkow, H., Phillips, N., Rockwood, K., Anderson, N., Andrew, M. K., Bartha, R., Beaudoin, C., Bélanger, N., Bellec, P., Belleville, S., Bergman, H., Best, S., Bethell, J., Bherer, L., Black, S., Borrie, M., Camicioli, R., Carrier, J., Cashman, N., Chan, S., … Wittich, W.
Journal:
Journal of Alzheimer's Disease
2024
Authors:
Anderson, N. D.,* D'Amico, D.,** Rotenberg, S.,* Addis, D. R., Gillen, J., Moore, D., Furlano, J. A.,** Tan, B., Binns, M., Santarossa, M., & Chertkow, H.*
Journal:
The Journal of Prevention of Alzheimer's Disease
2023
Authors:
Belleville, S., Chertkow, H., Feldman, H. H., Nygaard, H. B., Montero‐Odasso, M., Anderson, N. D., ... & CCNA‐CAN‐THUMBS UP Study Group
Journal:
Alzheimer's & Dementia
2023
Authors:
Wittich, W.*, Kröger, E., Aubin, G.**, Fadhlaoui, A., Anderson, N. D.*, Ben Gaied, N., Itzhak, I.*, Belleville, S.*, & Canadian Consortium on Neurodegeneration (CCNA) CAN-THUMBS UP Study Group
Journal:
BMJ open
2023
Authors:
Feldman, H.H.*, Belleville, S.*, Nygaard, H.B.*, Montero-Odasso, M.*, Durant, J., Lupo, J-L., Revta, C., Chan, S., Cuesta, M., Slack, P.J., Winer, S., Brewster, P.W.H.*, Hofer, S.M.*, Lim, A.*, Centen, A., Jacobs, D.M.*, Anderson, N.D.*, Walker, J.D.*, Speechley, M.R.*, Zou, G.Y.*, Chertkow, H.*, & Canadian Consortium on Neurodegeneration in Aging (CCNA), CAN-THUMBS UP Study Group
Journal:
The Journal of Prevention of Alzheimer's Disease
2022
Authors:
McGibbon C.*, Jarrett P.*, Handrigan G., Bouchard D., Tranchant C.C., Sexton A.M., Yetman L., Robinson B.*, Crapoulet S., Chamard-Witkowski L., Liu-Ambrose T.*, Middleton L.E.*, Almeida Q.J.*, Bherer L.*, Lim A*, Speechley M.*, Kamkar N., Montero Odasso M.*; Canadian Consortium on Neurodegeneration in Aging (CCNA)*, & CAN-THUMBS UP Group*.
Journal:
BMJ Open
2021
Authors:
Nygaard HB*, Chertkow H*, Feldman HH*, Belleville S*, Montero-Odasso M*
Journal:
Alzheimer's & Dementia
2020
Authors:
Kivipelto, M, Mangialasche, F, Snyder, HM, Allegri R, Andrieu S, Arai H, Baker L, Belleville S*, Brodaty H, Brucki SM, Calandri I, Caramelli P, Chen C, Chertkow H*, Chew E, Choi SH, Chowdhary N, Crivelli L, De La Torre R, Du Y, Dua T, Espeland M, Feldman HH*, Hartmanis M, Hartmann T, Hefferman M, Henry CJ, Hong CH, Hâkansson K, Iwatsubo T, Jeong JH, Jimenez-Maggiora G, Koo EH, Launer LJ, Lehtisale J, Lopera F, Martinez-Lage P, Martins R, Middleton L, Molinuevo JL, Montero-Odasso M*, Moon SY, Morales-Perez K, Nitrine R, Nygaard HB*, Park YK, Peltonen M, Qiu C, Quiroz YT, Raman R, Rao N, Ravindranath V, Rosenberg A, Sakurai T, Salinas RM, Scheltens P, Sevlever G, Soininen H, Sosa AL, Suemoto CK, Tainta-Cuezva M, Velilla L, Wang Y, Whitmer R, Xu X, Bain LJ, Solomon A, Ngandu T, Carrillo M.
Journal:
Alzheimer's & Dementia


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