Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission

The Lancet, Journal Year: 2024, Volume and Issue: 404(10452), P. 572 - 628

Published: July 31, 2024

Language: Английский

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Effect of Personalized Risk-Reduction Strategies on Cognition and Dementia Risk Profile Among Older Adults

JAMA Internal Medicine, Journal Year: 2023, Volume and Issue: 184(1), P. 54 - 54

Published: Nov. 27, 2023

Importance Modifiable risk factors are hypothesized to account for 30% 40% of dementia; yet, few trials have demonstrated that risk-reduction interventions, especially multidomain, efficacious. Objective To determine if a personalized, multidomain reduction intervention improves cognition and dementia profile among older adults. Design, Setting, Participants The Systematic Multi-Domain Alzheimer Risk Reduction Trial was randomized clinical trial with 2-year intervention. A total 172 adults at elevated (age 70-89 years ≥2 8 targeted factors) were recruited from primary care clinics associated Kaiser Permanente Washington. Data collected August 2018 2022 analyzed October September 2023. Intervention randomly assigned the (personalized goals health coaching nurse visits) or education control. Main Outcomes Measures outcome change in composite modified Neuropsychological Test Battery; preplanned secondary outcomes quality life (QOL). assessed baseline 6, 12, 18, 24 months. Linear mixed models used compare, by intention treat, average treatment effects (ATEs) over follow-up. initially person but then, due onset COVID-19 pandemic, remote. Results participants had mean (SD) age 75.7 (4.8) years, 108 (62.8%) women. After 2 compared 90 control group, 82 larger improvements cognitive score (ATE SD, 0.14; 95% CI, 0.03-0.25; P = .02; 74% improvement group), better factor 0.11; 0.01-0.20; .03), improved QOL (ATE, 0.81 points; −0.21 1.84; .12). There no between-group differences serious adverse events (24 group 23 group; .59), greater treatment-related such as musculoskeletal pain (14 vs 0 < .001). Conclusions Relevance In this trial, 2-year, led modest cognition, factors, QOL. strategies should be considered dementia. Registration ClinicalTrials.gov Identifier: NCT03683394

Language: Английский

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Lifetime risk and projected burden of dementia

Nature Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 13, 2025

Language: Английский

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An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial

Nature Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 28, 2025

Language: Английский

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Evaluation of efficiency and effectiveness of different recruitment strategies for the FINGER‐NL multidomain lifestyle intervention trial via the Dutch Brain Research Registry

Alzheimer s & Dementia Translational Research & Clinical Interventions, Journal Year: 2025, Volume and Issue: 11(1)

Published: Jan. 1, 2025

Abstract INTRODUCTION Recruitment of participants for intervention studies is challenging. We evaluated the effectiveness and efficiency a participant recruitment campaign through an online registry FINGER‐NL study, multi‐domain lifestyle trial targeting cognitively healthy individuals aged 60–79 with dementia prevention potential. Additionally, we explored which strategy successfully reached from underrepresented groups in research. METHODS The entailed seven strategies referring to Dutch Brain Research Registry (DBRR): (1) Facebook advertisements, (2) appearance on national television, (3) newspaper articles, (4) researcher outreach, (5) patient organizations, (6) search engines, (7) other. For each strategy, describe number (a) registered, (b) potentially eligible, (c) included FINGER‐NL. Subsequently, efficiency, defined by eligibility ratio (eligible/registered), effectiveness, inclusion (included/registered) were calculated. Associations between sociodemographic factors tested binomial logistic regressions. RESULTS resulted 13,795 new DBRR registrants, n = 3475 eligible (eligibility 0.25) 1008 (inclusion 0.07). advertisements television highest numbers registrants ( 4678 2182) translated inclusions 288 262). 0.35), articles (0.26), campaigns (0.26) most efficient strategies. 0.13) was effective strategy. performed relatively better recruiting groups. DISCUSSION A multipronged via prescreening adequate years potential multi‐site within limited time frame 15 months. Social media are preferred recruit Highlights An brain research recruited successfully. Mass reaching large numbers. Direct researchers organizations seems more effective. Online registries offer automated alternatives screen‐failures. Tailored needed reach improve diversity.

Language: Английский

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Breakdown and repair of metabolism in the aging brain

Frontiers in Science, Journal Year: 2025, Volume and Issue: 3

Published: March 25, 2025

Age-related neurodegenerative disorders, including dementia, are a major global health concern. This article describes the first comprehensive, data-driven molecular model of neuro-glia-vascular system to explore complex relationships between aging brain, energy metabolism, blood flow, and neuronal activity. Comprising 16,800 interaction pathways, includes all key enzymes, transporters, metabolites, circulatory factors vital for electrical We found significant alterations in metabolite concentrations differential effects on adenosine triphosphate (ATP) supply neurons astrocytes within subcellular compartments aged brains identified reduced sodium/potassium triphosphatase (Na + /K -ATPase) activity as leading cause impaired action potentials. The predicts that metabolic pathways cluster more closely suggesting loss robustness adaptability. Additionally, displays flexibility, undermining its capacity efficiently respond stimuli recover from damage. Through transcription factor analysis, estrogen-related receptor alpha (ESRRA) emerged central target connected these aging-related changes. An unguided optimization search pinpointed potential interventions capable restoring brain’s flexibility generation. These strategies include increasing nicotinamide adenine dinucleotide (NADH) cytosol-mitochondria shuttle, NAD pool, ketone β-hydroxybutyrate, lactate, Na -ATPase, while reducing glucose levels. is open sourced help guide further research into brain metabolism.

Language: Английский

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Plasma p-tau181 as an outcome and predictor of multidomain intervention effects: a secondary analysis of a randomised, controlled, dementia prevention trial

The Lancet Healthy Longevity, Journal Year: 2024, Volume and Issue: 5(2), P. e120 - e130

Published: Feb. 1, 2024

Summary

Background

It is unknown whether multidomain interventions, which might preserve late-life cognition, affect Alzheimer's disease pathology. Previous studies measured cerebrospinal fluid and imaging biomarkers in small subsamples of trial participants. Newly developed assays enable the measurement blood-based larger samples. We aimed to assess plasma tau phosphorylated at threonine 181 (p-tau181) was able detect or predict 3-year intervention effects.

Methods

This a secondary analysis randomised, controlled, Multidomain Alzheimer Prevention Trial (MAPT) testing intervention, omega-3 fatty acid supplementation, both versus placebo, individuals aged 70 years older 13 memory centres France Monaco. Plasma p-tau181 stored blood samples subsample 527 participants on an intention-to-treat basis. Changes cognitive score were calculated as composite measure using average Z scores for following tests: Mini Mental State Examination orientation items, Free Cued Selective Reminding Test (sum free total recall scores), category fluency, Digit Symbol Substitution Test. Intervention effects change concentration estimated by use linear mixed model with centre-specific random intercepts.

Findings

Recruitment took place between May 30, 2008, Feb 24, 2011. Median baseline 8·8 pg/mL (IQR 6·7–11·9) sample, significantly higher individuals, men, APOE ε4 carriers, renal dysfunction positive PET amyloid scan. During follow-up, raised underwent greater decline (eg, mean difference control group normal abnormal levels p-tau −0·34 [effect size −0·52; 95% CI −0·61 0·07] fully adjusted 12·4 cutoff p-tau181), but there no either this subgroup population, effect abnormality, [95% CI] + group, was, respectively: 0·13 [−0·21 0·47], 0·03 [−0·30 0·36], 0·10 [−0·26 0·46]). Surprisingly, showed decrease during follow-up unadjusted −3·01 (−4·45 −1·56) subjects [using cutoff]).

Interpretation

Our results support utility prognostic biomarker, it did not study. Further investigation its usefulness prevention outcome required.

Funding

Toulouse Gérontopôle, French Ministry Health Pierre Fabre Research Institute.

Language: Английский

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Effect of long-term physical exercise and multidomain interventions on cognitive function and the risk of mild cognitive impairment and dementia in older adults: a systematic review with meta-analysis

Ageing Research Reviews, Journal Year: 2024, Volume and Issue: 100, P. 102463 - 102463

Published: Aug. 23, 2024

Language: Английский

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Intersectionality in Alzheimer's Disease: The Role of Female Sex and Black American Race in the Development and Prevalence of Alzheimer's Disease

Neurotherapeutics, Journal Year: 2023, Volume and Issue: 20(4), P. 1019 - 1036

Published: July 1, 2023

Language: Английский

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Modifiable dementia risk factors and AT(N) biomarkers: findings from the EPAD cohort

Frontiers in Aging Neuroscience, Journal Year: 2024, Volume and Issue: 16

Published: Feb. 7, 2024

Introduction Modifiable risk factors account for a substantial proportion of Alzheimer’s disease (AD) cases and we currently have discrete AT(N) biomarker profile AD biomarkers: amyloid (A), p-tau (T), neurodegeneration (N). Here, investigated how modifiable relate to the three hallmark biomarkers AD. Methods Participants from European Prevention Dementia (EPAD) study underwent clinical assessments, brain magnetic resonance imaging, cerebrospinal fluid collection analysis. Generalized additive models (GAMs) with penalized regression splines were modeled in Workbench on NTKApp. Results A total 1,434 participants included (56% women, 39% APOE ε4+) an average age 65.5 (± 7.2) years. We found that less education ( t = 3.9, p < 0.001), exercise 2.1, 0.034), traumatic injury −2.1, 0.036), higher body mass index −4.5, 0.001) all significantly associated burden. Discussion This cross-sectional provides further support displaying neuroprotective associations characteristic

Language: Английский

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