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

From: Alzheimer’s disease prevention: from risk factors to early intervention

  FINGER PreDIVA MAPT HATICE
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]
  1. AD Alzheimer’s disease, ALDS Academic Medical Center Linear Disability Score, CAIDE Cardiovascular Risk Factors, Aging, and Incidence of Dementia, FINGER Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, HATICE Healthy Ageing Through Internet Counselling in the Elderly, MAPT Multidomain Alzheimer Preventive Trial, PreDIVA Prevention of Vascular Dementia by Intensive Care