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<p>Effective, scalable dementia prevention interventions are needed to address modifiable risk factors given global burden of dementia and challenges in developing disease-modifying treatments. A single-blind randomized controlled trial assessed an online multidomain lifestyle intervention to prevent cognitive decline over 3 years. Participants were dementia-free community-dwelling Australians aged 55–77 years with modifiable dementia risk factors. Eligible participants (<i>n</i> = 6,104, 64% female) were randomized 1:1 to a personalized schedule of online coaching in two to four modules (targeting physical activity, nutrition, cognitive activity and depression or anxiety) or a control group that received module-eligible information only. At 3 years, the mean change in a global cognitive composite, the primary outcome, was met. The mean changes in <i>z</i> scores were 0.28 (95% confidence interval (CI): 0.25–0.32) for intervention, 0.10 (95% CI: 0.07–0.13) for control and 0.18 (95% CI: 0.13–0.23, <i>P</i> &lt; 0.001) for the between-group difference. Trial-related adverse events occurred in 19 (0.60%) intervention and 1 (0.03%) control participant. Randomization of this internet-delivered lifestyle intervention tailored to individual dementia risk factors resulted in significantly better cognition in older adults over 3 years. This intervention is scalable with the potential for population-level rollout that may delay cognitive decline in the general community. Australian New Zealand ClinicalTrials.gov registration: ACTRN12618000851268.</p>

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An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial

  • 期刊论文

  • 发表日期：

    2025年1月28日

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  • Henry Brodaty,
  • Tiffany Chau,
  • Megan Heffernan,
  • Jeewani A. Ginige,
  • Gavin Andrews,
  • Michael Millard,
  • Perminder S. Sachdev,
  • Kaarin J. Anstey,
  • Nicola T. Lautenschlager,
  • John J. McNeil,
  • Louisa Jorm,
  • Nicole A. Kochan,
  • Anthony Maeder,
  • Heidi Welberry,
  • Juan Carlo San Jose,
  • Nancy E. Briggs,
  • Gordana Popovic,
  • Yorgi Mavros,
  • Carolina Almendrales Rangel,
  • Yian Noble,
  • Sue Radd-Vagenas,
  • Victoria M. Flood,
  • Fiona O’Leary,
  • Amit Lampit,
  • Courtney C. Walton,
  • Polly Barr,
  • Maria Fiatarone Singh,
  • Michael Valenzuela

摘要

Effective, scalable dementia prevention interventions are needed to address modifiable risk factors given global burden of dementia and challenges in developing disease-modifying treatments. A single-blind randomized controlled trial assessed an online multidomain lifestyle intervention to prevent cognitive decline over 3 years. Participants were dementia-free community-dwelling Australians aged 55–77 years with modifiable dementia risk factors. Eligible participants (n = 6,104, 64% female) were randomized 1:1 to a personalized schedule of online coaching in two to four modules (targeting physical activity, nutrition, cognitive activity and depression or anxiety) or a control group that received module-eligible information only. At 3 years, the mean change in a global cognitive composite, the primary outcome, was met. The mean changes in z scores were 0.28 (95% confidence interval (CI): 0.25–0.32) for intervention, 0.10 (95% CI: 0.07–0.13) for control and 0.18 (95% CI: 0.13–0.23, P < 0.001) for the between-group difference. Trial-related adverse events occurred in 19 (0.60%) intervention and 1 (0.03%) control participant. Randomization of this internet-delivered lifestyle intervention tailored to individual dementia risk factors resulted in significantly better cognition in older adults over 3 years. This intervention is scalable with the potential for population-level rollout that may delay cognitive decline in the general community. Australian New Zealand ClinicalTrials.gov registration: ACTRN12618000851268.