Effects of a multidomain intervention against cognitive decline on dementia risk profiles — Results from the AgeWell.de trial

Author:

Zülke Andrea E.1ORCID,Pabst Alexander1,Luppa Melanie1,Oey Anke2,Weise Solveig3,Fankhänel Thomas3,Kosilek Robert P.4,Schillok Hannah4,Brettschneider Christian5,Czock David6,Wiese Birgitt7,Thyrian Jochen René8910,Hoffmann Wolfgang89,Frese Thomas3,Gensichen Jochen4,König Hans‐Helmut5,Kaduszkiewicz Hanna11,Riedel‐Heller Steffi G.1

Affiliation:

1. Institute of Social Medicine, Occupational Health and Public Health (ISAP) University of Leipzig Leipzig Germany

2. State Health Department of Lower Saxony Hannover Germany

3. Institute of General Practice and Family Medicine Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany

4. Institute of General Practice and Family Medicine University Hospital LMU Munich Munich Germany

5. Department of Health Economics and Health Service Research University Medical Centre Hamburg‐Eppendorf Hamburg Germany

6. Department of Clinical Pharmacology and Pharmacoepidemiology Heidelberg University Hospital Heidelberg Germany

7. MHH Information Technology–Science & Laboratory Hannover Medical School Hannover Germany

8. German Centre for Neurodegenerative Diseases (DZNE) Greifswald Germany

9. Institute for Community Medicine University Medicine Greifswald (UMG) Greifswald Germany

10. Faculty V: School of Life Sciences University of Siegen Siegen Germany

11. Institute of General Practice University of Kiel Kiel Germany

Abstract

AbstractINTRODUCTIONDementia risk scores constitute promising surrogate outcomes for lifestyle interventions targeting cognitive function. We investigated whether dementia risk, assessed using the LIfestyle for BRAin health (LIBRA) index, was reduced by the AgeWell.de intervention.METHODSSecondary analyses of the AgeWell trial, testing a multicomponent intervention (including optimization of nutrition, medication, and physical, social, and cognitive activity) in older adults with increased dementia risk. We analyzed data from n = 461 participants with complete information on risk/protective factors comprised by LIBRA at the 24‐month follow‐up. Intervention effects on LIBRA and LIBRA components were assessed using generalized linear models.RESULTSThe intervention reduced LIBRA scores, indicating decreased dementia risk at follow‐up (b = –0.63, 95% confidence interval [CI]: –1.14, –0.12). Intervention effects were particularly due to improvements in diet (odds ratio [OR]: 1.60, 95% CI: 1.16, 2.22) and hypertension (OR: 1.61, 95% CI: 1.19, 2.18).DISCUSSIONThe AgeWell.de intervention reduced dementia risk. However, several risk factors did not improve, possibly requiring more intensive interventions.Highlights The AgeWell.de intervention reduced dementia risk according to LIfestyle for BRAin health (LIBRA) scores. Beneficial effects on LIBRA are mainly due to changes in diet and blood pressure. A pragmatic lifestyle intervention is apt to reduce dementia risk in an at‐risk population.

Publisher

Wiley

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