A Multidomain Intervention for Modifying Lifestyle Habits Reduces the Dementia Risk in Community-Dwelling Older Adults: A Single-Blinded Randomized Controlled Pilot Study

Article type: Research Article

Authors: Park, Jee Eun^{a; b; c} | Jeon, So Yeon^d | Kim, Se An^e | Kim, Jin Ha^f | Kim, Seon Hwa^g | Lee, Kyung Won^c | Hwang, Yun Jung^{b; h} | Jung, Gijung^{h; i} | Suk, Hye Won^j | Park, Saejong^k | Lee, Dong Young^{a; b; g; h; l; *}

Affiliations: [a] Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea | [b] Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea | [c] Jongno Community Center for Dementia, Seoul, South Korea | [d] Department of Psychiatry, Chungnam National University Hospital, Daejeon, South Korea | [e] Gachon University College of Nursing, Incheon, South Korea | [f] Siheung Community Center for Dementia, Siheung, South Korea | [g] Seoul Metropolitan Center for Dementia, Seoul, South Korea | [h] Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, South Korea | [i] Department of Nursing, Graduate School, Kyung Hee University, Seoul, South Korea | [j] Department of Psychology, Sogang University, Seoul, South Korea | [k] Korea Institute of Sport Science, Seoul, South Korea | [l] Interdisiplinary Program in Cognitive science, Seoul National University, Seoul, South Korea

Correspondence: [*] Correspondence to: Dong Young Lee, MD, PhD, Department of Psychiatry, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, South Korea. Tel.: +82 2 2072 2205; Fax: +82 2 733 7241; E-mail: selfpsy@snu.ac.kr.

Abstract: We aimed to examine the feasibility and effectiveness of a multidomain intervention including intensive and maintenance programs for reducing the risk of dementia in at-risk older adults. Community-dwelling older adults (aged ≥60 years) without dementia but having several risk factors for dementia (N = 32; 89% female; mean age±standard deviation, 76.8±4.7 years) were assigned to three parallel programs: intensive plus maintenance (INT+MNT), intensive only (INT-only), and active control. Subjects in INT+MNT and INT-only groups participated in a 4-week intensive group-based lifestyle modification program that focused on physical activity, vascular risk factors, dietary habits, cognitive activities, and social engagement. INT+MNT participants underwent an additional 20-week maintenance program to consolidate modified habits. The modified Australian National University-Alzheimer’s Disease Risk Index (ANU-ADRI) score was used as the primary outcome measure for dementia risk. The changes in ANU-ADRI scores exhibited a significant group-by-time interaction: the INT+MNT group showed significant improvement at 24 weeks (β= –6.05; SE = 1.86; p = 0.002), while the INT-only group did not. Additional exploratory analyses showed that the reduction in ANU-ADRI scores was caused by changes in protective factors rather than in risk factors. The INT + MNT group also showed greater improvement in executive function at 4 and 24 weeks (both p = 0.044), whereas changes in global cognitive function did not reach significance (p = 0.055). A 24-week multidomain dementia prevention involving a maintenance strategy for sustaining modified lifestyle habits reduced the risk of dementia and improved executive function in at-risk older adults.

Keywords: Aged, alzheimer’s disease, dementia, health promotion, risk reduction behavior

DOI: 10.3233/JAD-190016

Journal: Journal of Alzheimer's Disease, vol. 70, no. 1, pp. 51-60, 2019