Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
School of Psychology, Massey University, Manawatū Campus, Palmerston North, New Zealand.
Alzheimers Dement. 2024 Jan;20(1):615-628. doi: 10.1002/alz.13486. Epub 2023 Sep 28.
We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia in Germany in a cluster-randomized trial.
Individuals with a Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score ≥ 9 aged 60 to 77 years were recruited. After randomization of their general practitioner (GP), patients received a multidomain intervention (including optimization of nutrition and medication, and physical, social, and cognitive activity) or general health advice and GP treatment as usual over 24 months. Primary outcome was global cognitive performance (composite z score, based on domain-specific neuropsychological tests).
Of 1030 participants at baseline, n = 819 completed the 24-month follow-up assessment. No differences regarding global cognitive performance (average marginal effect = 0.010, 95% confidence interval: -0.113, 0.133) were found between groups at follow-up. Perceived restrictions in intervention conduct by the COVID-19 pandemic did not impact intervention effectiveness.
The intervention did not improve global cognitive performance.
Overall, no intervention effects on global cognitive performance were detected. The multidomain intervention improved health-related quality of life in the total sample. In women, the multidomain intervention reduced depressive symptoms. The intervention was completed during the COVID-19 pandemic.
我们在德国进行了一项集群随机试验，旨在研究针对有痴呆风险的老年人的多领域干预措施对认知功能的保护作用。
我们招募了年龄在 60 至 77 岁、心血管危险因素、衰老和痴呆（CAIDE）风险评分≥9 的个体。在他们的全科医生（GP）随机分组后，患者接受了多领域干预（包括优化营养和药物治疗，以及身体、社会和认知活动）或一般健康咨询和 GP 常规治疗，为期 24 个月。主要结局是整体认知表现（基于特定领域神经心理学测试的综合 z 评分）。
在基线时有 1030 名参与者，n=819 人完成了 24 个月的随访评估。在随访时，两组之间在整体认知表现方面没有差异（平均边缘效应=0.010，95%置信区间：-0.113，0.133）。新冠疫情对干预措施实施的感知限制并未影响干预效果。
该干预措施并未改善整体认知表现。
总体而言，未检测到该干预措施对整体认知表现有任何影响。多领域干预措施改善了总样本的健康相关生活质量。在女性中，多领域干预措施减少了抑郁症状。该干预措施是在新冠疫情期间完成的。
