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Effects of a multidomain intervention against cognitive decline on dementia risk profiles -- results from the AgeWell.de trial [with consumer summary]
Zulke AE, Pabst A, Luppa M, Oey A, Weise S, Fankhanel T, Kosilek RP, Schillok H, Brettschneider C, Czock D, Wiese B, Thyrian JR, Hoffmann W, Frese T, Gensichen J, Konig HH, Kaduszkiewicz H, Riedel-Heller SG
Alzheimer's & Dementia 2024 Aug;20(8):5684-5694
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Dementia 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. METHODS: Secondary 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. RESULTS: The intervention reduced LIBRA scores, indicating decreased dementia risk at follow-up (b -0.63, 95% confidence interval (CI) -1.14 to -0.12). Intervention effects were particularly due to improvements in diet (odds ratio (OR) 1.60, 95% CI 1.16 to 2.22) and hypertension (OR 1.61, 95% CI 1.19 to 2.18). DISCUSSION: The AgeWell.de intervention reduced dementia risk. However, several risk factors did not improve, possibly requiring more intensive interventions.

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