Zeitschrift für Gerontologie und Geriatrie, Год журнала: 2024, Номер 57(6), С. 442 - 446
Опубликована: Авг. 22, 2024
Alzheimer s Research & Therapy, Год журнала: 2025, Номер 17(1)
Опубликована: Март 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.
Язык: Английский
Процитировано
0
Nature Reviews Neurology, Год журнала: 2025, Номер unknown
Опубликована: Апрель 14, 2025
Язык: Английский
Процитировано
0
Patient Education and Counseling, Год журнала: 2025, Номер 137, С. 108797 - 108797
Опубликована: Апрель 23, 2025
Язык: Английский
Процитировано
0
NeuroImage Clinical, Год журнала: 2025, Номер 46, С. 103796 - 103796
Опубликована: Янв. 1, 2025
Multimodal lifestyle interventions might help to maintain healthy cognition in older age and delay onset of dementia. Here, we studied the effects a multi-modal lifestyle-based intervention, based on FINGER trial, magnetic resonance imaging (MRI) markers hippocampal-limbic atrophy cerebral small vessel disease adults at increased risk for dementia Germany. Leipzig participants multicenter AgeWell.de randomized controlled trial underwent neuroimaging before after two year intervention 3 Tesla MRI. We extracted hippocampal volume entorhinal cortex thickness (ECT), free water fraction (FW), peak width skeletonized mean diffusivity (PSMD), white matter hyperintensity gray blood flow assessed effect these using linear mixed models. also tested hippocampus-dependent Mnemonic Similarity Test fixel-based microstructure. 56 individuals (mean (sd) age: 68.8 (4.2) years, 26 females, 24/32 intervention/control group) were included baseline 41 returned an average 28 months second assessment. ECT FW exhibited stronger decline compared control group preregistered models but not when adjusted differences. All other progressed similarly across groups, however sample size was smaller than expected. In exploratory analyses, more this change associated with decreases systolic pressure. dementia, find no conclusive evidence whether improves brain neurodegeneration disease. Preliminary suggested association pressure reductions. ECT, thickness; FW, fraction; WHO, world health organization; AD, Alzheimer's disease; VCI, vascular cognitive impairment; FINGER, Finnish Geriatric Intervention Study Prevent Cognitive Impairment Disability; MTL, medial temporal lobe; MIND, Mediterranean-DASH Neurodegenerative Delay diet; cSVD, WMH, hyperintensities presumed origin; PSMD, distribution; WW-FINGERS, wide studies; CAIDE, Cardiovascular Risk Factors, Aging, Incidence Dementia; GPP, general practitioner praxis; MRI, imaging; MST, Test; TE, echo time; TR, repetition FA, flip angle; FOV, field view; GRAPPA, GeneRalized Autocalibrating Partial Parallel Acquisition; CMRR, Center Magnetic Resonance Research; BOLD, oxygenation level dependent; pcASL: pseudo-continuous arterial spin labeling; EPI, echo-planar FLAIR, fluid attenuated inversion recovery; CBF, flow; QA, quality assessment; GM, matter; HCV, volume; eICV, estimated intracranial DWI, diffusion-weighted MD, diffusivity; fractional anisotropy TBSS: tract-based spatial statistics; CSF, spinal fluid; ISI, inter-stimulus interval; LDI, lure discrimination index; REC, recognition score; CG, group; IG, MoCA, Montreal Assessment; CASMIN, Comparative Analysis Social Mobility Industrial Nations; BMI, body mass SBP/DBP, systolic/diastolic pressure; OSF, open science framework; LMM, model; ANOVA, analysis covariance.
Язык: Английский
Процитировано
0
Опубликована: Фев. 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
Язык: Английский
Процитировано
3
Journal of Alzheimer s Disease, Год журнала: 2024, Номер 99(4), С. 1455 - 1471
Опубликована: Май 17, 2024
Dementia risk reduction is a public health priority, but interventions that can be easily implemented in routine care are scarce.
Язык: Английский
Процитировано
3
Alzheimer s & Dementia Translational Research & Clinical Interventions, Год журнала: 2025, Номер 11(1)
Опубликована: Янв. 1, 2025
Abstract INTRODUCTION The societal costs of dementia and cognitive decline are substantial likely to increase during the next decades due increasing number people in older age groups. aim this multicenter cluster‐randomized controlled trial was assess cost‐effectiveness a multi‐domain intervention prevent who at risk for dementia. METHODS We used data from multi‐centric, two‐armed, ( AgeWell.de trial, ID: DRKS00013555). Eligible participants with increased baseline (Cardiovascular Risk Factors, Aging, Incidence Dementia/CAIDE Dementia Score ≥ 9), 60–77 years age, were recruited by their general practitioners, assigned randomly lifestyle or health advice. performed analysis perspective. time horizon 2 years. Health care utilization measured using “Questionnaire Health‐Related Resource Use Older Populations.” As effect measure, we quality‐adjusted life‐years (QALYs) based on 5‐level EQ‐5D version (EQ‐5D‐5L). calculated incremental ratios (ICER) acceptability curves (CEAC) net‐benefit approach. Exploratory analyses considering women EQ visual analogue scale (EQ VAS) conducted. RESULTS Data available 819 (mean 69.0 [standard deviation (SD)5‐level 4.9]); 378 treated group 441 control group. caused higher (+€445.88 [SD: €1,244.52]) gained additional effects (+0.026 QALY 0.020]) compared (the difference statistically significant). ICER €17,149.23/QALY. CEAC showed that probability being cost‐effective moderate, reaching 59% willingness‐to‐pay (WTP) €50,000/QALY. exploratory promising results, especially female subsample. DISCUSSION Considering aspects like WTP limited horizon, Highlights first German randomized (RCT) evaluating multicomponent approach against decline. found favorable ratio. reached 78.6%. Women could be an important target A longer is needed.
Язык: Английский
Процитировано
0
Journal of Alzheimer s Disease, Год журнала: 2025, Номер unknown
Опубликована: Фев. 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).
Язык: Английский
Процитировано
0
Journal of Alzheimer s Disease, Год журнала: 2025, Номер unknown
Опубликована: Апрель 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.
Язык: Английский
Процитировано
0
Journal of Alzheimer s Disease, Год журнала: 2024, Номер 98(4), С. 1443 - 1455
Опубликована: Апрель 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.
Язык: Английский
Процитировано
1