针对主观认知衰退的脑健康：一项多领域随机对照试验的见解

Targeting brain health in subjective cognitive decline: insights from a multidomain randomized controlled trial.

作者信息

Rolandi Elena, Dodich Alessandra, Mandelli Sara, Canessa Nicola, Ferrari Clarissa, Ribaldi Federica, Munaretto Giulio, Ambrosi Claudia, Gasparotti Roberto, Violi Davide, Iannaccone Sandro, Marcone Alessandra, Falini Andrea, Frisoni Giovanni B, Galluzzi Samantha, Cerami Chiara, Cavedo Enrica

机构信息

Golgi Cenci Foundation, 20081, Abbiategrasso, Italy.

Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100, Pavia, Italy.

出版信息

Aging Clin Exp Res. 2025 May 14;37(1):151. doi: 10.1007/s40520-025-03062-z.

DOI:10.1007/s40520-025-03062-z

PMID:40366507

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12078420/

Abstract

BACKGROUND

Multidomain lifestyle interventions are a promising approach to prevent cognitive decline, but their effects in subjective cognitive decline (SCD) remain controversial. We investigated the effects of lifestyle interventions on cognition and brain integrity in these at-risk individuals.

METHODS

One-hundred twenty-eight older adults with SCD were randomly assigned to either Active Control Intervention (ACI), i.e. health education; Partial Intervention (PI), i.e. tramiprosate supplementation (100 mg/die) and dietary advice; or Multilevel Intervention (MI), i.e. PI plus computerized cognitive training and physical exercise, for one year. Neuropsychological assessment and MRI were performed at baseline and at 1-year follow-up. Analyses of covariance were used to measure the effects of interventions on predefined outcomes.

RESULTS

The MI group significantly improved in attention-executive functioning (p = 0.003) compared to ACI (Cohen's d: 0.47, 95% CI 0.13-0.79). In addition, depressive symptoms (Cohen's d: - 0.48, 95% C.I. - 0.81 to - 0.14) and memory concerns (Cohen's d: - 0.77, 95% C.I. - 1.12 to - 0.41) decreased in the MI and PI respectively, relative to the ACI. The MI group also showed increased resting-state (i.e., intrinsic) brain activity in the right fronto-parietal executive network. No significant intervention effects on brain structural or vascular outcomes were found.

CONCLUSION

The study shows that a multidomain lifestyle intervention can enhance attention-executive function, ameliorate depressive symptoms and increase functional connectivity in SCD. These findings support the role of lifestyle interventions in public health strategies to mitigate cognitive decline risk.

TRIAL REGISTRATION

The trial has been registered at the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT04744922 on December 9th, 2017 ( https://www.

CLINICALTRIALS

gov/ct2/show/NCT03382353 ).

摘要

背景

多领域生活方式干预是预防认知能力下降的一种有前景的方法，但其对主观认知下降（SCD）的影响仍存在争议。我们研究了生活方式干预对这些高危个体认知和脑完整性的影响。

方法

128名患有SCD的老年人被随机分配到主动对照干预组（ACI），即健康教育组；部分干预组（PI），即曲美司他补充剂（100毫克/天）和饮食建议组；或多水平干预组（MI），即PI加上计算机化认知训练和体育锻炼组，为期一年。在基线和1年随访时进行神经心理学评估和磁共振成像（MRI）。采用协方差分析来测量干预对预定义结果的影响。

结果

与ACI相比，MI组在注意力执行功能方面有显著改善（p = 0.003）（科恩d值：0.47，95%置信区间0.13 - 0.79）。此外，相对于ACI，MI组的抑郁症状（科恩d值：- 0.48，95%置信区间- 0.81至- 0.14）和记忆问题（科恩d值：- 0.77，95%置信区间- 1.12至- 0.41）分别有所减轻。MI组在右侧额顶叶执行网络的静息态（即内在）脑活动也有所增加。未发现干预对脑结构或血管结果有显著影响。