Searching for responders to multidomain dementia prevention in late life: A pooled analysis of individual participant data from the MAPT and preDIVA trials

Alzheimer s & Dementia, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 17, 2025

Abstract INTRODUCTION It is unknown in which, if any, subgroups of older adults multidomain interventions are effective at reducing long‐term dementia incidence. METHODS We pooled up to 12 years follow‐up data from 5205 participants aged > 70 the Multidomain Alzheimer Preventive Trial (MAPT) and Prevention Dementia by Intensive Vascular Care (preDIVA) studies. The primary outcome was incident all‐cause dementia. Pre‐specified were defined risk factors (age, sex, education, apolipoprotein E [ APOE ] genotype, cognitive status, cardiovascular factors). RESULTS Four hundred eighty‐six developed during 37,782 person‐years follow‐up. Higher incidence associated with baseline age, ε4 physical inactivity, Mini‐Mental State Examination, blood pressure. intervention had no effect on overall (hazard ratio = 0.98, 95% confidence interval 0.80–1.21), or any pre‐specified subgroup. A recursive partitioning algorithm also did not detect subgroups, single multiple factors, showing a differential effect. DISCUSSION identify whom significantly reduced CLINICAL TRIAL REGISTRATION MAPT: NCT00672685 (clinicaltrials.gov); PreDIVA: ISRCTN29711771 (ISRCTN registry) Highlights two prevention trials. Five thousand five ≥ included. Subgroups pre‐defined modifiable non‐modifiable factors. data‐driven used. lower

Language: Английский

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Acceptability and fidelity of the multidomain ‘Brain Bootcamp’ dementia risk reduction program: a mixed-methods approach

BMC Public Health, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 14, 2025

Abstract Background Interventions targeting dementia prevention typically lack comprehensive exploration of feasibility, acceptability, and long-term translation factors prior to deployment. Our study aimed explore the fidelity participants’ experiences with Brain Bootcamp, a multi-domain behaviour change intervention reduced risk increased factor awareness for older adults. Methods Conducted in New South Wales, Australia, from January August 2021, our concurrent single-group mixed-methods feasibility involved post-intervention surveys qualitative interviews community-dwelling Descriptive statistics were used assess acceptability methods, outcome measures, program components. Thematic analysis semi-structured explored participant experiences, preferences, barriers, recommendations. Results Out 853 enrolled participants, only 355 completed (41.6%). Among these 79.1% agreed that improved their factors, 92.4% expressed intent continue maintaining brain healthy behaviours post- program. Participants set 2–4 modifiable lifestyle goals, which most often related physical activity (83.7%). A majority (91.5%) successfully achieved at least one health goal. Qualitative analyses ( n = 195) identified three overarching themes on role education modification (i.e., transformative enhancing knowledge about fostering behavioral modifications), psychological considerations (e.g., intrinsic versus extrinsic motivation engagement perception program) future directions sustainability concerns need tailored strategies specific demographics). Conclusions While Bootcamp had low completion rates, those who reported high acceptability. Future refinements, incorporating targeted enhanced support communication, will facilitate pragmatic initiatives. Clinical trial number ACTRN12621000165886.

Language: Английский

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Adherence and intensity in multimodal lifestyle-based interventions for cognitive decline prevention: state-of-the-art and future directions

Alzheimer s Research & Therapy, Journal Year: 2025, Volume and Issue: 17(1)

Published: March 17, 2025

Abstract Preventing dementia and Alzheimer’s disease (AD) is a global priority. Multimodal interventions targeting several risk factors mechanisms simultaneously are currently being tested worldwide under the World-Wide FINGERS (WW-FINGERS) network of clinical trials. Adherence to these crucial for their success, yet there significant heterogeneity in adherence reporting across studies, hindering understanding barriers facilitators. This article narrative review available evidence from multimodal prevention A literature search was conducted using medical databases (MEDLINE via PubMed SCOPUS) select relevant studies: nonpharmacological (i.e., combining three or more intervention domains), individuals without dementia, changes cognitive performance and/or incident mild impairment as primary outcomes. Based on findings, we propose future encompass both participation (average attendance each component) lifestyle change scores (e.g., LIBRA index). Moreover, provide an estimation expected intensity interventions, defined ratio dose overall amount offered specified trial protocol) duration (in months). Adjusting by average enables observed intensity, which could be informative identifying optimal dosage thresholds that maximize benefits different populations. Finally, this provides overview determinants emphasizing need improved inform design implementation precision interventions.

Language: Английский

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A Non-Randomized Pilot Trial of Brain-WISE: A Group-Based Program for Brain Health and Dementia Risk Reduction in Community Settings

Journal of Geriatric Psychiatry and Neurology, Journal Year: 2025, Volume and Issue: unknown

Published: May 3, 2025

Background Addressing modifiable risk factors can potentially prevent 45% of cases dementia. Here, we present the development Brain-WISE, a low-intensity, group-based intervention to improve brain health in community settings. We conducted preliminary testing refine materials and procedures, assess acceptability adherence, evaluate effects. Methods 143 community-dwelling adults aged 56-93 completed non-randomized pilot trial. The 6-session included psychoeducation, discussion/activities, screenings. Adherence was measured by attendance with questionnaires. Brain knowledge motivation were assessed before after program. Results Across 6 cohorts, 80% - 97% 96% participants agreed that program worthwhile. Knowledge (d = 0.83, P < .001) 0.43, increased significantly. Conclusions Brain-WISE displayed good adherence evidence an effect on motivation. Further is warranted.

Language: Английский

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Association between experiencing low healthcare quality and developing dementia

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: 72(7), P. 2126 - 2132

Published: Feb. 28, 2024

Abstract Background Low healthcare quality has been found to predict the development of a number illnesses in older adults. However, it not investigated as determinant dementia. Thus, goal this study was assess whether experiencing low is associated with developing dementia people aged 60 and older. Methods Participants Health Retirement Study, without at baseline, were followed from 2006 2019. Experiencing assessed baseline through questions about discrimination dissatisfaction services. The outcome, new cases dementia, determined physician diagnosis or cognition score compatible (assessed by Telephone Interview for Cognitive Status). Cox regression used estimate hazard ratio (HR) adjusting participants' demographic, health, socioeconomic factors. Results Among 3795 participants included cohort, 700 developed increased risk over 12 years (unadjusted HR: 1.68, 95% CI: 1.27–2.21, p ‐value <0.001; fully adjusted 1.50, 1.12–2.01, ‐value: 0.006). Healthcare received independently risk. Conclusions As predicted, greater To date, most measures reduce have focused on individual‐level behaviors. Our findings suggest that implementing structural changes improve delivery persons could prevalence.

Language: Английский

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