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基于生活方式干预以降低痴呆风险后的饮食变化——来自AgeWell.de研究的结果

Dietary changes following a lifestyle-based intervention for dementia risk reduction - results from the AgeWell.de study.

作者信息

Zülke Andrea E, Blotenberg Iris, Luppa Melanie, Löbner Margrit, Döhring Juliane, Williamson Martin, Kosilek Robert P, Michel Irina, Oey Anke, Brettschneider Christian, Gensichen Jochen, Czock David, Wiese Birgitt, König Hans-Helmut, Frese Thomas, Kaduszkiewicz Hanna, Hoffmann Wolfgang, Thyrian René, Riedel-Heller Steffi G

机构信息

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

German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany.

出版信息

Eur J Nutr. 2024 Dec 30;64(1):58. doi: 10.1007/s00394-024-03563-z.

Abstract

PURPOSE

We investigated the effects of a multidomain lifestyle intervention conducted in older adults at increased risk for dementia on participants' diet.

METHODS

Secondary analyses of the cluster-randomized AgeWell.de-trial, testing a multidomain intervention (optimization of nutrition and medication, enhancement of physical, social and cognitive activity) in older adults at increased dementia risk. Intervention effects on a healthy diet (composite score) and its components were analyzed using Poisson- and logistic regression analyses. Stages of behavior change (transtheoretical model), and respective changes between baseline and follow-up were analyzed using mixed regression analyses.

RESULTS

A total of 819 individuals were analyzed (M = 69.0, SD = 4.9, n = 378/441). We observed a significant intervention effect on the healthy diet score (b = 0.06, IRR: 1.06, 95% CI: 1.01, 1.11). Changes were particularly due to increased fruit- and vegetable consumption, while other food components were not improved by the intervention. The intervention did not induce transitions to advanced stages of behavior change regarding a healthy diet, however, participants in the control group moved to initial stages of behavior change (OR = 1.95, 95% CI: 1.30, 2.92).

CONCLUSION

A multidomain lifestyle intervention improved participants' diet and maintained motivation to change in an at-risk-sample. However, only fruit- and vegetable consumption increased. Additional support might be necessary to encourage older adults to integrate new, healthier food components into their diet. Control group participants transitioned to initial stages of behavior change, stressing the need to encourage older adults to maintain a healthy diet as they age. AGEWELL.DE WAS PROSPECTIVELY REGISTERED IN THE GERMAN CLINICAL TRIALS REGISTER (DRKS; IDENTIFIER: DRKS00013555) ON DECEMBER 7TH, 2017: DRKS00013555.

摘要

目的

我们研究了对患痴呆症风险增加的老年人实施多领域生活方式干预对参与者饮食的影响。

方法

对整群随机分组的AgeWell.de试验进行二次分析,该试验在患痴呆症风险增加的老年人中测试一种多领域干预措施(优化营养和药物治疗、增强身体、社交和认知活动)。使用泊松回归分析和逻辑回归分析干预措施对健康饮食(综合评分)及其组成部分的影响。使用混合回归分析分析行为改变阶段(跨理论模型)以及基线与随访之间的相应变化。

结果

共分析了819名个体(平均年龄M = 69.0,标准差SD = 4.9,n = 378/441)。我们观察到干预措施对健康饮食评分有显著影响(b = 0.06,发病率比IRR:1.06,95%置信区间CI:1.01,1.11)。变化尤其归因于水果和蔬菜摄入量的增加,而其他食物成分并未因干预措施而得到改善。干预措施并未促使在健康饮食方面向行为改变的高级阶段转变,然而,对照组的参与者转向了行为改变的初始阶段(优势比OR = 1.95,95%置信区间CI:1.30,2.92)。

结论

多领域生活方式干预改善了参与者的饮食,并在高危样本中维持了改变的动力。然而,只有水果和蔬菜的摄入量增加了。可能需要额外的支持来鼓励老年人将新的、更健康的食物成分纳入他们的饮食中。对照组参与者转向了行为改变的初始阶段,强调了鼓励老年人随着年龄增长保持健康饮食的必要性。AgeWell.de于2017年12月7日在德国临床试验注册中心(DRKS;标识符:DRKS00013555)进行了前瞻性注册:DRKS00013555 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a987/11685242/5a3facb60883/394_2024_3563_Fig1_HTML.jpg

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