TY - JOUR
T1 - An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults
T2 - a randomized controlled trial
AU - Brodaty, Henry
AU - Chau, Tiffany
AU - Heffernan, Megan
AU - Ginige, Jeewani A.
AU - Andrews, Gavin
AU - Millard, Michael
AU - Sachdev, Perminder S.
AU - Anstey, Kaarin J.
AU - Lautenschlager, Nicola T.
AU - McNeil, John J.
AU - Jorm, Louisa
AU - Kochan, Nicole A.
AU - Maeder, Anthony
AU - Welberry, Heidi
AU - San Jose, Juan Carlo
AU - Briggs, Nancy E.
AU - Popovic, Gordana
AU - Mavros, Yorgi
AU - Almendrales Rangel, Carolina
AU - Noble, Yian
AU - Radd-Vagenas, Sue
AU - Flood, Victoria M.
AU - O’Leary, Fiona
AU - Lampit, Amit
AU - Walton, Courtney C.
AU - Barr, Polly
AU - Fiatarone Singh, Maria
AU - Valenzuela, Michael
PY - 2025/2
Y1 - 2025/2
N2 - Effective, scalable dementia prevention interventions are needed to address modifiable risk factors given global burden of dementia and challenges in developing disease-modifying treatments. A single-blind randomized controlled trial assessed an online multidomain lifestyle intervention to prevent cognitive decline over 3 years. Participants were dementia-free community-dwelling Australians aged 55–77 years with modifiable dementia risk factors. Eligible participants (n = 6,104, 64% female) were randomized 1:1 to a personalized schedule of online coaching in two to four modules (targeting physical activity, nutrition, cognitive activity and depression or anxiety) or a control group that received module-eligible information only. At 3 years, the mean change in a global cognitive composite, the primary outcome, was met. The mean changes in z scores were 0.28 (95% confidence interval (CI): 0.25–0.32) for intervention, 0.10 (95% CI: 0.07–0.13) for control and 0.18 (95% CI: 0.13–0.23, P < 0.001) for the between-group difference. Trial-related adverse events occurred in 19 (0.60%) intervention and 1 (0.03%) control participant. Randomization of this internet-delivered lifestyle intervention tailored to individual dementia risk factors resulted in significantly better cognition in older adults over 3 years. This intervention is scalable with the potential for population-level rollout that may delay cognitive decline in the general community.
AB - Effective, scalable dementia prevention interventions are needed to address modifiable risk factors given global burden of dementia and challenges in developing disease-modifying treatments. A single-blind randomized controlled trial assessed an online multidomain lifestyle intervention to prevent cognitive decline over 3 years. Participants were dementia-free community-dwelling Australians aged 55–77 years with modifiable dementia risk factors. Eligible participants (n = 6,104, 64% female) were randomized 1:1 to a personalized schedule of online coaching in two to four modules (targeting physical activity, nutrition, cognitive activity and depression or anxiety) or a control group that received module-eligible information only. At 3 years, the mean change in a global cognitive composite, the primary outcome, was met. The mean changes in z scores were 0.28 (95% confidence interval (CI): 0.25–0.32) for intervention, 0.10 (95% CI: 0.07–0.13) for control and 0.18 (95% CI: 0.13–0.23, P < 0.001) for the between-group difference. Trial-related adverse events occurred in 19 (0.60%) intervention and 1 (0.03%) control participant. Randomization of this internet-delivered lifestyle intervention tailored to individual dementia risk factors resulted in significantly better cognition in older adults over 3 years. This intervention is scalable with the potential for population-level rollout that may delay cognitive decline in the general community.
KW - cognitive decline
KW - dementia
KW - Prevention interventions
KW - at-risk older adults
KW - multidomain interventions
UR - https://www.scopus.com/pages/publications/85217222256
UR - http://purl.org/au-research/grants/NHMRC/1095097
U2 - 10.1038/s41591-024-03351-6
DO - 10.1038/s41591-024-03351-6
M3 - Article
C2 - 39875685
AN - SCOPUS:85217222256
SN - 1078-8956
VL - 31
SP - 565
EP - 573
JO - Nature Medicine
JF - Nature Medicine
IS - 2
ER -