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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Alzheimer disease seen through the lens of sex and gender

Nature Reviews Neurology, Journal Year: 2025, Volume and Issue: unknown

Published: April 14, 2025

Language: Английский

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Adherence to Lifestyle Intervention Activities in the SINgapore GERiatric Intervention Study to Reduce Cognitive Decline and Physical Frailty (SINGER) study: A One-Year Preliminary Analysis of Process Evaluation

Patient Education and Counseling, Journal Year: 2025, Volume and Issue: 137, P. 108797 - 108797

Published: April 23, 2025

Language: Английский

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A Scoping Review on Operationalizing Cognitive and Social Activities in Research on Dementia Risk Reduction

Published: Feb. 8, 2024

Engagement in cognitive and social activities can potentially preserve abilities, which makes their promotion a promising avenue for dementia risk reduction. However, insight into how to adequately measure engagement these is necessary precursor. A rapid scoping review was performed search relevant articles on PubMed. The aim obtain an initial understanding of (a) are measured research that investigates protective against (b) explore what extent this aligns with the operationalization preventive interventions. findings show across 58 studies, questionnaires were mostly used activities. wide variety items themes observed including: arts crafts; clubs, groups, communities; exercising; games puzzles; going out; household tasks; learning education; making music; multimedia usage; reading; socializing; work/volunteering; writing. There considerable variations number content items, ulitized response scales, recall periods, methods compose scores. Additionally, interventions stongly focused psychoeducation (computerized) training, limitedly reflect operationalized questionnaires.Many researchers investigate effects or but promote concepts completely differently. This results fragmented insights protective. Clarifying precisely entail, aspects would support development measurement instructions as well activities.Keywords: Dementia, Cognition, Social Participation, Cognitive Activities, Activities

Language: Английский

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Multidomain Dementia Risk Reduction in Primary Care is Feasible: A Proof-of-concept study

Journal of Alzheimer s Disease, Journal Year: 2024, Volume and Issue: 99(4), P. 1455 - 1471

Published: May 17, 2024

Dementia risk reduction is a public health priority, but interventions that can be easily implemented in routine care are scarce.

Language: Английский

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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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Adherence to intervention components: The key to success? Analysis on health-related outcomes of the AgeWell.de intervention to preserve cognition

Journal of Alzheimer s Disease, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 9, 2025

Background The aim of the study was to analyze impact adherence intervention components on effectiveness AgeWell.de, a multi-domain lifestyle against cognitive decline, function in everyday activities, quality life, depressiveness and social isolation. Objective Studying effect health-related outcomes. Methods Participants were aged 60–77 years at baseline risk (Cardiovascular Risk Factors, Ageing Dementia Score (CAIDE) ≥9). Adherence nutrition, enhancement physical activities training analyzed two ways, first continual within group (n = 378, mean age 69.1 years, 52.7% female) second as dichotomous split (75% adherence) reference control (received infomaterial regular health advice; n 441, 69 53% female). Generalized linear regression models then run outcomes functioning depressive symptoms, inclusion. Results Health-related life improved participants with better nutritional counselling activities. Better relevant for Effects high found improvements when comparing it group. No inclusion considering particular components. Conclusions extent most influenced such depressiveness. With this study, AgeWell.de can be understood greater depth. Trial Registration German Clinical Register (DRKS; ID: DRKS00013555).

Language: Английский

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Factors associated with a healthy diet and willingness to change dietary behavior in older adults at increased risk of dementia

Journal of Alzheimer s Disease, Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

Background Healthy dietary patterns have been linked to reduced risks for cardiovascular diseases and dementia, making nutrition an essential part of a comprehensive approach dementia prevention. Knowledge about factors associated with healthy diet in people increased risk is scarce. Objective To analyze habits older adults Germany. Methods We used baseline-data the AgeWell.de-trial (n = 1001, % female 52.2, M age 69.0, SD 4.9). Nutrition was assessed using composite score, comprising 11 components covered by national recommendations (range 0–11 points). Linear regressions associations sociodemographic, social, health-related psychological consumption diet. Further, we stages change based on transtheoretical model behavior change. Results Consumption moderate (Median 4, IQR 2). Female sex (b 0.64, 95% CI: 0.41, 0.88), higher levels motivation eating 0.22, 0.10, 0.34) self-efficacy 0.33, 0.20, 0.46) were Regarding change, majority maintenance stage (45.2%), followed contemplation (21.5%) precontemplation (21.2%) stages. Conclusions suggest room improvement regarding our sample. Lifestyle-based interventions should be tailored towards current participants. Including modules targeting might help maximize intervention effectiveness.

Language: Английский

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Exploring the effect of multi-modal intervention against cognitive decline on atrophy and small vessel disease imaging markers in the AgeWell.de imaging study

NeuroImage Clinical, Journal Year: 2025, Volume and Issue: unknown, P. 103796 - 103796

Published: May 1, 2025

Language: Английский

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Factors Associated with Lower Social Activity in German Older Adults at Increased Risk of Dementia: A Cross-Sectional Analysis

Journal of Alzheimer s Disease, Journal Year: 2024, Volume and Issue: 98(4), P. 1443 - 1455

Published: April 9, 2024

Background: Studies demonstrate associations between low social activity in older adults and cognitive decline. Little has been investigated regarding which factors are associated with at increased risk of dementia. Objective: We investigate sociodemographic, psychological, health-related, environmental Additionally, we describe the stages health behavior change, types activities, duration current level activity. Methods: used baseline data 1,015 participants from AgeWell.de trial. conducted logistic Poisson regression analyses to report descriptive statistics on change sample, activities most frequently pursued, Results: Lower income, non-usage public transport, depressive symptoms, cognitive, mobility, hearing impairment were negatively The majority sample was maintenance stage, followed by precontemplation stage. common traveling hobbies others. Participants have maintained their for several years. Conclusions: identified a lack resources (income, transport), symptoms poorer (cognitive, mobility impairment) as barriers Interventions promoting dementia may specifically target individuals these factors. Low-threshold opportunities be particularly beneficial.

Language: Английский

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