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Aging-US: Multidomain interventions: a randomized controlled feasibility trial

07-25-2021

Aging-US published "Facility-based and home-based multidomain interventions including cognitive training, exercise, diet, vascular risk management, and motivation for older adults: a randomized controlled feasibility trial" which reported that in an outcome assessor-blinded, randomized controlled trial, participants without dementia and with one or more modifiable dementia risk factors, aged 60-79 years, were randomly assigned to the facility-based MI, the home-based MI, or the control group receiving general health advice.

The primary outcome was feasibility measured through retention, adherence, and at least no differences from the control group in the Repeatable Battery for the Assessment of Neuropsychological Status.

In the FMI and HMI groups, the retention rates were 88.2% and 96.1%, and adherence to the intervention was 94.5% and 96.8%, respectively.

The RBANS total scale index score improved significantly in the FMI and HMI groups compared to the control group.

The FMI and HMI are feasible and there are indicators of efficacy.

Dr. Seong Hye Choi from The Inha University School of Medicine and Dr. Jee Hyang Jeong from The Ewha Womans University School of Medicine said, "As life expectancy increases worldwide, dementia has rapidly become a huge public health problem."

Dr. Seong Hye Choi from The Inha University School of Medicine and Dr. Jee Hyang Jeong from The Ewha Womans University School of Medicine said, "As life expectancy increases worldwide, dementia has rapidly become a huge public health problem."

The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, a two-year randomized controlled trial, demonstrated that it is possible to improve the cognitive function of older adults at risk of developing dementia through multidomain lifestyle interventions, including dietary counseling, physical exercise, cognitive training, and vascular and metabolic risk monitoring.

Therefore, further evidence is necessary so that public health recommendations can encourage people to adopt lifestyle interventions that prevent dementia.

The SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people reported in this paper is also part of the WW-FINGERS network.

We developed a facility-based multidomain intervention program and a home-based multidomain intervention program suitable for older Koreans.

Figure 4. Mean changes from baseline at study end of exploratory blood biomarkers. Compared to the control group (-1.62 ± 19.01 ng/mL), serum brain-derived neurotrophic factor (BDNF) levels were significantly increased in the FMI group (11.83 ± 20.06 ng/mL) but not in the HMI group (0.67 ± 20.61 ng/mL). Compared to the control group (54.18 ± 136.01 ng/mL), plasma cortisol levels were significantly decreased in both the FMI (-5.29 ± 154.01 ng/mL) and HMI groups (-15.29 ± 172.09 ng/mL) at the study endpoint. The mean changes in serum neurofilament light chain (NFL) levels from baseline to the study endpoint were as follows: 4.21 (7.65) pg/ml decrease in the FMI group, 0.62 (8.74) pg/ml decrease in the HMI group, and 1.98 (9.77) pg/ml decrease in the control group. The mean changes in serum YKL-40 levels at the study endpoint from baseline were as follows: 2.19 (65.33) ng/mL decrease in the FMI group, 12.76 (68.58) ng/mL decrease in the HMI group, and 4.62 (57.49) ng/mL increase in the control group. Bars and lines show the mean and standard error of the mean, respectively. The P values represent the results of comparisons between each intervention group and the control group by the analysis of covariance with the baseline level as a covariate. FMI, facility-based multidomain intervention; HMI, home-based multidomain intervention.

The intervention programs are deemed feasible when the following criteria are met: participant retention rate of at least 75%, adherence rate to the intervention of at least 75%, and at least no differences from the control group in the primary cognitive outcome analysis.

The Choi/Jeong Research Team concluded in their Aging-US Research Output, "both the FMI and HMI programs of the SUPERBRAIN are feasible and likely to prevent cognitive impairment in at-risk older people. Multidomain lifestyle interventions may influence the brain through inactivation of the HPA axis and enhanced brain plasticity. Further verification through a large-scale RCT is required in the future."

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DOI - https://doi.org/10.18632/aging.203213

Full Text - https://www.aging-us.com/article/203213/text

Correspondence to: Seong Hye Choi email: seonghye@inha.ac.kr and Jee Hyang Jeong email: jjeong@ewha.ac.kr

Keywords: dementia, prevention, lifestyle, feasibility, randomized controlled trial

About Aging-US:

The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population.

The journal aims to promote 1) treatment of age-related diseases by slowing down aging, 2) validation of anti-aging drugs by treating age-related diseases, and 3) prevention of cancer by inhibiting aging. (Cancer and COVID-19 are age-related diseases.)

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