A multidomain intervention against cognitive decline in an at-risk-population in Germany: Results from the cluster-randomized AgeWell.de trial.

Autor:	Zülke AE; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany., Pabst A; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany., Luppa M; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany., Roehr S; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.; School of Psychology, Massey University, Manawatū Campus, Palmerston North, New Zealand.; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland., Seidling H; Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany., Oey A; Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany., Cardona MI; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany., Blotenberg I; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany., Bauer A; Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Weise S; Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Zöllinger I; Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany., Sanftenberg L; Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany., Brettschneider C; University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Service Research, Hamburg, Germany., Döhring J; Institute of General Practice, University of Kiel, Kiel, Germany., Lunden L; Institute of General Practice, University of Kiel, Kiel, Germany., Czock D; Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany., Haefeli WE; Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany., Wiese B; Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany., Hoffmann W; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.; Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany., Frese T; Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany., Gensichen J; Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany., König HH; University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Service Research, Hamburg, Germany., Kaduszkiewicz H; Institute of General Practice, University of Kiel, Kiel, Germany., Thyrian JR; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.; Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.; Faculty V-Faculty of Life Sciences, University of Siegen, Siegen, Germany., Riedel-Heller SG; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
Jazyk:	angličtina
Zdroj:	Alzheimer's & dementia : the journal of the Alzheimer's Association [Alzheimers Dement] 2024 Jan; Vol. 20 (1), pp. 615-628. Date of Electronic Publication: 2023 Sep 28.
DOI:	10.1002/alz.13486
Abstrakt:	Introduction: We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia in Germany in a cluster-randomized trial. Methods: Individuals with a Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score ≥ 9 aged 60 to 77 years were recruited. After randomization of their general practitioner (GP), patients received a multidomain intervention (including optimization of nutrition and medication, and physical, social, and cognitive activity) or general health advice and GP treatment as usual over 24 months. Primary outcome was global cognitive performance (composite z score, based on domain-specific neuropsychological tests). Results: Of 1030 participants at baseline, n = 819 completed the 24-month follow-up assessment. No differences regarding global cognitive performance (average marginal effect = 0.010, 95% confidence interval: -0.113, 0.133) were found between groups at follow-up. Perceived restrictions in intervention conduct by the COVID-19 pandemic did not impact intervention effectiveness. Discussion: The intervention did not improve global cognitive performance. Highlights: Overall, no intervention effects on global cognitive performance were detected. The multidomain intervention improved health-related quality of life in the total sample. In women, the multidomain intervention reduced depressive symptoms. The intervention was completed during the COVID-19 pandemic. (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
Databáze:	MEDLINE
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