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坚持生活方式干预——仅仅是自我效能感的问题吗?对 AgeWell.de 认知能力下降干预措施的分析。

Adherence to a lifestyle intervention - just a question of self-efficacy? Analysis of the AgeWell.de-intervention against cognitive decline.

机构信息

Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Phillip-Rosenthal-Str. 55, 04103, Leipzig, Germany.

Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany.

出版信息

Alzheimers Res Ther. 2024 Jun 22;16(1):133. doi: 10.1186/s13195-024-01499-4.


DOI:10.1186/s13195-024-01499-4
PMID:38909256
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11193217/
Abstract

BACKGROUND: Aim of this study was to detect predictors of better adherence to the AgeWell.de-intervention, a two-year randomized multi-domain lifestyle intervention against cognitive decline. METHODS: Data of 317 intervention group-participants comprising a risk group for dementia (Cardiovascular Risk Factors, Ageing and Dementia (CAIDE) score of  ≥ 9; mean age 68.9 years, 49.5% women) from the AgeWell.de intervention study were analysed. Regression models with four blocks of predictors (sociodemographic, cognitive and psychosocial, lifestyle factors and chronic conditions) were run on adherence to the components of nutrition, enhancement of social and physical activity and cognitive training. Adherence to each component was operationalised by assessing the degree of goal achievement per component at up to seven time points during the intervention period, measured using a 5-point Likert scale (mean score of goal achievement). RESULTS: Increasing age was negatively associated with adherence, while higher education positively predicted adherence. Participants with better mental state (Montreal Cognitive Assessment (MoCA)-score > 25) at baseline and higher self-efficacy adhered better. Diabetes and cardiovascular conditions were not associated with adherence, whereas smoking negatively affected adherence. Highest education and quitting smoking in the past were the only predictors associated with all four intervention components. CONCLUSION: Results identified predictors for better and worse adherence. Particularly self-efficacy seems to be of considerable influence on adherence. This should be considered when designing future intervention trials. TRIAL REGISTRATION: German Clinical Trials Register (ref. number: DRKS00013555).

摘要

背景:本研究旨在检测更能坚持 AgeWell.de 干预措施的预测因素,这是一项为期两年的针对认知能力下降的多领域生活方式干预随机对照研究。

方法:分析了来自 AgeWell.de 干预研究的 317 名干预组参与者的数据,这些参与者构成了痴呆风险组(心血管风险因素、衰老和痴呆评分≥9;平均年龄 68.9 岁,49.5%为女性)。使用四个预测因素块(社会人口统计学、认知和心理社会、生活方式因素和慢性疾病)的回归模型对营养、增强社会和身体活动以及认知训练的各个组成部分的依从性进行了分析。每个组成部分的依从性通过在干预期间多达七个时间点评估每个组成部分的目标实现程度来衡量,使用 5 点李克特量表(目标实现的平均得分)。

结果:年龄的增加与依从性呈负相关,而较高的教育程度则正向预测了依从性。基线时精神状态较好(蒙特利尔认知评估量表(MoCA)得分>25)和自我效能感较高的参与者依从性较好。糖尿病和心血管疾病与依从性无关,而吸烟则对依从性有负面影响。最高的教育程度和过去戒烟是与所有四个干预组成部分相关的唯一预测因素。

结论:结果确定了更好和更差依从性的预测因素。特别是自我效能感似乎对依从性有相当大的影响。在设计未来的干预试验时应考虑到这一点。

试验注册:德国临床试验注册中心(注册号:DRKS00013555)。

相似文献

[1]
Adherence to a lifestyle intervention - just a question of self-efficacy? Analysis of the AgeWell.de-intervention against cognitive decline.

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[10]
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引用本文的文献

[1]
Multidomain interventions for prevention of dementia: Achievements, challenges and future perspectives.

Geriatr Gerontol Int. 2025-8

[2]
Oral health behaviours and metabolic syndrome: mediation effect of lifestyle habits.

BMC Oral Health. 2025-4-10

[3]
Exploring the Discontinuous Usage Behavior of Digital Cognitive Training Among Older Adults With Mild Cognitive Impairment and Their Family Members: Qualitative Study Using the Extended Model of IT Continuance.

J Med Internet Res. 2025-3-25

[4]
Global, Regional, and National Burden of Early-Onset Alzheimer's Disease and Other Dementias in Young Adults Aged 40-64 Years, 1990-2021: A Population-Based Study.

Eur J Neurol. 2025-3

[5]
Factors associated with adherence to tablet-based cognitive training: J-MINT study.

Alzheimers Dement (N Y). 2025-3-10

本文引用的文献

[1]
Who Benefited the Most? Effectiveness of a Lifestyle Intervention Against Cognitive Decline in Older Women and Men - Secondary Analysis of the AgeWell.de-trial.

J Prev Alzheimers Dis. 2024

[2]
A multidomain intervention against cognitive decline in an at-risk-population in Germany: Results from the cluster-randomized AgeWell.de trial.

Alzheimers Dement. 2024-1

[3]
Public Perspectives on Lifestyle-Related Behavior Change for Dementia Risk Reduction: An Exploratory Qualitative Study in The Netherlands.

J Alzheimers Dis. 2023

[4]
The affordability of lecanemab, an amyloid-targeting therapy for Alzheimer's disease: an EADC-EC viewpoint.

Lancet Reg Health Eur. 2023-5-22

[5]
Dementia in Germany: Epidemiology and Prevention Potential.

Dtsch Arztebl Int. 2023-7-10

[6]
Multidomain interventions for risk reduction and prevention of cognitive decline and dementia: current developments.

Curr Opin Psychiatry. 2022-7-1

[7]
Determinants of Adherence to a "GRADIOR" Computer-Based Cognitive Training Program in People with Mild Cognitive Impairment (MCI) and Mild Dementia.

J Clin Med. 2022-3-19

[8]
Social Factors of Dietary Risk Behavior in Older German Adults: Results of a Multivariable Analysis.

Nutrients. 2022-3-2

[9]
Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial: an exploratory analysis of a randomised clinical trial.

Aging Clin Exp Res. 2022-8

[10]
The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER).

Alzheimers Dement. 2022-7

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