The APPLE Tree programme: Active Prevention in People at risk of dementia through Lifestyle, bEhaviour change and Technology to build REsiliEnce-randomised controlled trial.

Autor: Poppe M; UCL Division of Psychiatry, University College London, London, UK., Duffy L; UCL Division of Psychiatry, University College London, London, UK., Marchant NL; UCL Division of Psychiatry, University College London, London, UK., Barber JA; Department of Statistical Science, University College London, London, UK., Hunter R; Research Department of Primary Care and Population Health, University College London, London, UK., Bass N; UCL Division of Psychiatry, University College London, London, UK., Minihane AM; Norwich Medical School, University of East Anglia, Norwich, UK., Walters K; Research Department of Primary Care and Population Health, University College London, London, UK., Higgs P; UCL Division of Psychiatry, University College London, London, UK., Rapaport P; UCL Division of Psychiatry, University College London, London, UK., Lang IA; College of Medicine and Health, University of Exeter, Exeter, UK., Morgan-Trimmer S; College of Medicine and Health, University of Exeter, Exeter, UK., Huntley J; UCL Division of Psychiatry, University College London, London, UK., Walker Z; UCL Division of Psychiatry, University College London, London, UK., Brodaty H; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia., Kales HC; Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, USA., Ritchie K; Institut de Neurosciences de Montpellier (INM), Montpellier, France., Burton A; Department of Behavioural Science and Health, University College London, London, UK., Wenborn J; UCL Division of Psychiatry, University College London, London, UK., Betz A; Queen Mary University London, Centre for Psychiatry and Mental Health, Wolfson Institute for Population Health, London, UK., Cooper C; Queen Mary University London, Centre for Psychiatry and Mental Health, Wolfson Institute for Population Health, London, UK. Claudia.cooper@qmul.ac.uk.
Jazyk: angličtina
Zdroj: Trials [Trials] 2022 Jul 26; Vol. 23 (1), pp. 596. Date of Electronic Publication: 2022 Jul 26.
DOI: 10.1186/s13063-022-06557-6
Abstrakt: Background: Large-scale trials of multidomain interventions show that modifying lifestyle and psychological risk factors can slow cognitive decline. We aim to determine if a lower intensity, personally tailored secondary dementia prevention programme for older people with subjective or mild objective memory decline, informed by behaviour change theory, reduces cognitive decline over 2 years.
Methods: A multi-site, single-blind randomised controlled trial recruiting 704 older adults at high dementia risk due to mild cognitive impairment (MCI) or subjective cognitive decline (SCD). Participants are randomised using 1:1 allocation ratio to the APPLE Tree intervention versus control arm (dementia prevention information), stratified by site. The intervention explores and implements strategies to promote healthy lifestyle, increase pleasurable activities and social connections and improve long-term condition self-management. Two facilitators trained and supervised by a clinical psychologist deliver ten, 1-h group video call sessions over 6 months (approximately every fortnight), video-call 'tea breaks' (less structured, facilitated social sessions) in intervening weeks and individual goal-setting phone calls every 2 weeks. From 6 to 12 months, participants meet monthly for 'tea breaks', with those not attending receiving monthly goal-setting phone calls. Participants receive a food delivery, pedometer and website access to cognitive training and information about lifestyle modification. Follow-ups for all outcome measures are at 12 and 24 months. The primary outcome is cognition (Neuropsychological Test Battery (NTB) score) at 24 months. Secondary outcomes are quality of life, cost per quality-adjusted life year (QALY) and wellbeing and lifestyle factors the intervention targets (diet, vascular risk, body weight, activity, sleep, anxiety, depression, social networks and loneliness, alcohol intake and smoking). Participants from purposively selected sites participate in qualitative process evaluation interviews, which will be analysed using thematic analytic methods.
Discussion: If effective, the intervention design, involving remote delivery and non-clinical facilitators, would facilitate intervention roll-out to older people with memory concerns.
Trial Registration: ISRCTN17325135 . Registration date 27 November 2019.
(© 2022. The Author(s).)
Databáze: MEDLINE
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