Table 1 Description of randomized controlled trials of multidomain interventions for prevention of cognitive impairment, dementia or AD

Study population

1260 community dwellers from previous population-based non-intervention studies

3526 community dwellers

1680 community dwellers

2600 community dwellers

Main inclusion criteria

CAIDE Dementia Risk Score ≥ i6 and cognitive performance at the mean level or slightly lower than expected for age assessed with the Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological battery

All community-dwelling older people without dementia registered with a participating general practice

Frail older people: spontaneous memory complaint, limitation in one instrumental activity of daily living and slow walking speed (i.e. lower than 0.8 m/s)

Older adults without dementia at increased risk of cardiovascular disease

Age at enrolment

60–77 years

70–78 years

≥70 years

≥65 years

Study design

Multicentre, randomized controlled trial

Multicentre, cluster randomized controlled trial

Multicentre, randomized controlled trial

Multicentre, randomized controlled trial

Intervention

Multidomain: (1) nutritional guidance; (2) physical exercise; (3) cognitive training and social activity; and (4) intensive monitoring and management of metabolic and vascular risk factors

Multidomain: (1) nutritional advice; (2) physical activity advice; and (3) vascular care including medical treatment of risk factors

Multidomain: (1) nutritional advice; (2) physical activity advice; (3) cognitive training; and (4) vascular care, and/or 800 mg docosahexaenoic acid per day

e-health: multidomain interactive Internet platform, stimulating self-management of vascular risk factors, with remote support

Control group

General health advice

Usual care

Placebo alone

Static Internet platform with basic health information

Duration

2 years plus 5-year follow-up

6 years

3 years plus 2-year follow-up

18 months

Outcomes

Primary: change in cognitive performance. Secondary: dementia; disability; depression; vascular risk factors and outcomes; quality of life; utilization of health resources; and neuroimaging biomarkers.

Primary: cumulative incidence of dementia and disability score (ALDS) at 6 years of follow-up. Secondary: incident cardiovascular disease and cardiovascular and all-cause mortality. Other secondary: cognitive decline, depression, blood pressure, body mass index, blood lipid concentrations, and glucose concentration.

Primary: change in memory function. Secondary: cognitive performance, functional status, depression, cost-effectiveness

Primary: outcome is a composite score based on the average z-score of the difference between baseline and 18-month follow-up values of systolic blood pressure, low-density-lipoprotein and body mass index. Secondary: include the effect on the individual components of the primary outcome, the effect on lifestyle-related risk factors, incident cardiovascular disease, mortality, cognitive functioning, mood and cost-effectiveness

Status

Completed in 2014

Completed in 2015

Completed in 2014

Due to finish in 2017

Findings (if available)

The multidomain intervention could improve or maintain cognitive functioning [24]

The intervention did not result in a reduced incidence of all-cause dementia and did not have an effect on mortality, cardiovascular disease or disability [26]

The multidomain intervention and polyunsaturated fatty acids, either alone or in combination, had no significant effects on cognitive decline. Post-hoc data showed that the combination of polyunsaturated fatty acids and multidomain intervention had potential beneficial effects in participants with CAIDE scores ≥ 6 or higher or evidence of brain amyloid pathology, suggesting that people with increased risk of dementia might benefit most from the intervention [28]

N/A

Reference

[23]

[25]

[27]

[29]