Department of Geriatrics, Gérontopôle, CHU Toulouse, Purpan University Hospital, Toulouse, France.
Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.
J Alzheimers Dis. 2018;64(1):71-78. doi: 10.3233/JAD-180209.
Findings from recent Alzheimer's disease prevention trials have shown subjects with increased dementia score based upon mid-life cardiovascular risk factors, to benefit from multi-domain intervention strategies to some extent. The effects of such interventions on cognitive functions remains yet to be well-established. This study is a secondary analysis of the MAPT study, 1,293 older subjects (mean age 75 years) with high CAIDE score (i.e., ≥6) were classified according to the four intervention groups: 1) multi-domain intervention plus placebo, 2) isolated supplementation with Omega-3 polyunsaturated fatty acid (n-3 PUFA), 3) combination of the two interventions, and 4) placebo alone. Linear mixed-model repeated-measures analyses were used to assess the cognitive changes according to various neuropsychological test scores between intervention groups compared to the placebo at 36 months from baseline. Compared to the placebo, group with multi-domain intervention in combination withn-3PUFA was found to show significant improvement in the delayed total recall test of the free and cued selective reminding test (FCSRT) (mean±standard error(SE) = 0.20±0.10) and MMSE orientation test (mean±SE = 0.15±0.06) at 36 months. Isolated multi-domain intervention group showed significant less decline in the MMSE orientation test (mean±SE = 0.12±0.06) compared to the placebo. There was significant less improvement (mean±SE = - 1.01±0.46) in the FCSRT free recall test in the n-3 PUFA intervention group compared to the placebo at 36 months. Our findings show high-risk subjects for dementia screened with CAIDE dementia score might benefit from multi-domain intervention strategies as in the MAPT study, particularly in the orientation and delayed recall domain.
最近的阿尔茨海默病预防试验的结果表明,基于中年心血管危险因素,痴呆评分增加的受试者在一定程度上受益于多领域干预策略。这些干预措施对认知功能的影响尚未得到充分确立。本研究是 MAPT 研究的二次分析,共有 1293 名年龄在 75 岁左右、CAIDE 评分较高(即≥6)的老年人被分为四个干预组:1)多领域干预加安慰剂,2)单独补充欧米伽-3 多不饱和脂肪酸(n-3PUFA),3)两种干预的组合,4)单独安慰剂。采用线性混合模型重复测量分析评估了根据不同神经心理测试分数,与基线相比,36 个月时干预组与安慰剂组之间的认知变化。与安慰剂组相比,联合使用多领域干预和 n-3PUFA 的组在自由和提示选择性回忆测试(FCSRT)的延迟总回忆测试(mean±standard error(SE)=0.20±0.10)和 MMSE 定向测试(mean±SE = 0.15±0.06)方面显示出显著改善。单独的多领域干预组在 MMSE 定向测试(mean±SE = 0.12±0.06)方面与安慰剂相比,下降幅度显著较小。与安慰剂相比,在 n-3PUFA 干预组,FCSRT 自由回忆测试的改善程度显著较小(mean±SE = -1.01±0.46)。在 CAIDE 痴呆评分筛选出的痴呆高危受试者可能受益于 MAPT 研究中的多领域干预策略,特别是在定向和延迟回忆方面。