Effects of a 6-Month Multifaceted Diet and Exercise Intervention on Cognition in Older Adults at Risk of Cognitive Decline: The PONDER Double-Blind, Placebo-Controlled Randomized Trial

Article type: Research Article

Authors: Macpherson, Helen^{a; *} | Brownell, Sarah^a | Harris, Elizabeth^a | Duckham, Rachel L.^{a; b} | O’Connell, Stella^a | Meyer, Barbara J.^c | Mirzaee, Sam^d | Daly, Robin M.^a

Affiliations: [a] Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia | [b] Australian Institute for Musculoskeletal Sciences (AIMSS), University of Melbourne and Western Health, St. Albans, Melbourne, Australia | [c] School of Medical, Indigenous and Health Science, Molecular Horizons, Lipid Research Centre, University of Wollongong, and Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia | [d] Monash Cardiovascular Research Centre, MonashHEART, Monash Health, Monash University, Melbourne, Victoria, Australia

Correspondence: [*] Correspondence to: Helen Macpherson, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia. Tel.: +61 3 9244 5317; E-mail: helen.macpherson@deakin.edu.au.

Note: [1] The study was prospectively registered on the Australian New Zealand Clinical Trials Registry on 10 November 2016 ACTRN12616001549415.

Abstract: Background:Multidomain interventions which incorporate exercise and dietary supplementation to target both cognitive and physical health domains may be an important approach to delay cognitive decline. Objective:The Protein Omega-3 aNd vitamin D Exercise Research (PONDER) study investigated the effects of a 6-month multifaceted intervention in community-dwelling older adults with subjective memory impairment on cognition (primary outcome), physical function, and body composition with a further 6-month follow up for cognition (secondary outcomes). Methods:Single-center, community-based, parallel-group, randomized, double-blind placebo-controlled trial involving a 6-month multifaceted intervention with a further follow-up at 12 months. A total of 147 participants [mean age 70.2 years (SD 6.1), 70% female] were randomized to a multimodal exercise program consisting of twice-weekly supervised resistance and aerobic training, combined with a daily omega-3 (900 mg EPA, 600 mg DHA), vitamin D (1000 IU) and protein (20 g) supplement (n = 73), or a control condition (n = 74) comprising stretching/flexibility sessions combined with a placebo. The primary outcome was a composite CogState measure and Trail-Making Test B-A. Results:There were no significant between-group differences in the change of cognition at 6 or 12 months or physical function outcomes at 6 months, but the intervention significantly improved total lean mass compared to controls [0.72 kg (95% CI 0.26–1.19), p = 0.001]. Conclusion:A multi-faceted intervention including an omega-3, vitamin D and protein-enriched supplement with twice-weekly exercise training did not provide any benefits to cognitive or physical function in older adults with subjective memory impairment, despite improvements in lean mass.

Keywords: Cognition, dietary proteins, exercise, fatty acids, omega-3, vitamin D, white matter hyperintensities, white matter lesions

DOI: 10.3233/JAD-220234

Journal: Journal of Alzheimer's Disease, vol. 89, no. 1, pp. 247-263, 2022