a study on the effectiveness of multidomain intervention program for reducing risks of dementia

Conditions: Alzheimer Disease

Summary: investigators aimed to examine the feasibility and effectiveness of a multidomain intervention strategy involving intensive and maintenance programs aimed at reducing the risk of alzheimer's disease (ad) in at-risk older adults. participants were randomly allocated into three groups: (1) intensive plus maintenance program (int+mnt group), (2) intensive program only (int-only group), and (3) active control (control group). there were two study hypotheses: 1) the participants in the 4-week intensive program (int+mnt and int-only group) would show reduced dementia risk scores compared to control; and 2) that the participants in the added 20-week maintenance program (int+mnt group) would show greater improvement in dementia risk scores compared to the int-only and control groups.

objectives: to examine the feasibility and effectiveness of a multidomain intervention strategy involving intensive and maintenance programs aimed at reducing the risk of alzheimer's disease (ad) in at-risk older adults. design: a prospective randomized controlled trial with participants assigned to three parallel programs: intensive plus maintenance (int+mnt), intensive only (int-only), and active control. setting: a community center for dementia in south korea. participants: community-dwelling older adults (aged ≥ 60 years) without dementia, but having several risk factors for ad. measurements: the study subjects participated in a 4-week intensive group-based lifestyle modification program that focused on physical activity, vascular risk factors, dietary habits, cognitive activities, and social engagement. then, the participants underwent a 20-week maintenance program to consolidate modified habits. linear mixed models were used to examine the changes in modified australian national university-alzheimer's disease risk index (anu-adri) scores in each group. additional analyses of secondary outcomes, including cognitive function, were also performed.

Eligibility criteria:
inclusion criteria: * subjects aged 60 years and over with age-, sex-, education-adjusted z-score of the korean version of mini-mental state examination for dementia screening (mmse-ds) -1.5 standard deviation and above, but having some risk factors for dementia were included: at least two of following risk factors in a recent year (1) do not exercise with moderate degree more than 3 times a week, (2) do not read books, newspapers or magazine more than once a week; (3) do not meet friends, relatives, or close person more than once a week, (4) have depressed mood or low volition. exclusion criteria: * exclusion criteria were previously diagnosed with dementia or other neurologic disorders (e.g., parkinson's disease); stroke in a recent year or having significant sequelae of past stroke; major psychiatric disorders (e.g., major depressive disorder) in a recent year; having absolute contraindication to participate in exercise program (e.g., need a wheelchair for mobility). also, subjects who were already participated in other exercise or cognitive stimulating program in the community center for dementia were excluded in the present study.

Keywords: risk reduction community older adults lifestyle modification