دورية أكاديمية
Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer’s disease: the MIND-ADmini randomized controlled trial
العنوان: | Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer’s disease: the MIND-ADmini randomized controlled trial |
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المؤلفون: | Charlotta Thunborg, Rui Wang, Anna Rosenberg, Shireen Sindi, Pia Andersen, Sandrine Andrieu, Laus M. Broersen, Nicola Coley, Celine Couderc, Celine Z. Duval, Gerd Faxen-Irving, Göran Hagman, Merja Hallikainen, Krister Håkansson, Eija Kekkonen, Jenni Lehtisalo, Nicholas Levak, Francesca Mangialasche, Johannes Pantel, Anders Rydström, Anna Stigsdotter-Neely, Anders Wimo, Tiia Ngandu, Hilkka Soininen, Tobias Hartmann, Alina Solomon, Miia Kivipelto |
المصدر: | Alzheimer’s Research & Therapy, Vol 16, Iss 1, Pp 1-12 (2024) |
بيانات النشر: | BMC, 2024. |
سنة النشر: | 2024 |
المجموعة: | LCC:Neurosciences. Biological psychiatry. Neuropsychiatry LCC:Neurology. Diseases of the nervous system |
مصطلحات موضوعية: | Alzheimer’s disease, Lifestyle intervention, Multimodal intervention, Adherence, Medical food, Prevention, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429 |
الوصف: | Abstract Background The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed cognitive benefits from a multidomain lifestyle intervention in at-risk older people. The LipiDiDiet trial highlighted benefits of medical food in prodromal Alzheimer’s disease (AD). However, the feasibility and impact of multimodal interventions combining lifestyle with medical food in prodromal AD is unclear. Methods MIND-ADmini was a 6-month multinational (Sweden, Finland, Germany, France) proof-of-concept randomized controlled trial (RCT). Participants were 60–85 years old, had prodromal AD (International Working Group-1 criteria), and vascular/lifestyle risk factors. The parallel-group RCT had three arms: multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); multimodal lifestyle intervention + medical food (Fortasyn Connect); and regular health advice/care (control). Participants were randomized 1:1:1 (computer-generated allocation at each site). Outcome evaluators were blinded to randomization. Primary outcome was feasibility of the multimodal intervention, evaluated by recruitment rate during a 6-month recruitment phase, overall adherence in each intervention arm, and 6-month retention rate. Successful adherence was pre-specified as attending ≥ 40% of sessions/domain in ≥ 2/4 domains (lifestyle intervention), and consuming ≥ 60% of the medical food (lifestyle intervention + medical food). The secondary outcomes included adherence/participation to each intervention component and overall adherence to healthy lifestyle changes, measured using a composite score for healthy lifestyle. Cognitive assessments were included as exploratory outcomes, e.g. Clinical Dementia Rating scale. Results During September 2017-May 2019, 93 individuals were randomized (32 lifestyle intervention, 31 lifestyle + medical food, and 30 control group). Overall recruitment rate was 76.2% (64.8% during the first 6 months). Overall 6-month retention rate was 91.4% (lifestyle intervention 87.5%; lifestyle + medical food 90.3%; control 96.7%). Domain-specific adherence in the lifestyle intervention group was 71.9% to cognitive training, 78.1% exercise, 68.8% nutritional guidance, and 81.3% vascular risk management; and in the lifestyle + medical food group, 90.3% to cognitive training, 87.1% exercise, 80.7% nutritional guidance, 87.1% vascular risk management, and 87.1% medical food. Compared with control, both intervention arms showed healthy diet improvements (βLifestyle×Time = 1.11, P = 0.038; βLifestyle+medical food×Time = 1.43, P = 0.007); the lifestyle + medical food group also showed vascular risk reduction (P = 0.043) and less cognitive-functional decline (P |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 1758-9193 |
Relation: | https://doaj.org/toc/1758-9193 |
DOI: | 10.1186/s13195-024-01468-x |
URL الوصول: | https://doaj.org/article/989086a951054f3195f215b6ea45f7d8 |
رقم الأكسشن: | edsdoj.989086a951054f3195f215b6ea45f7d8 |
قاعدة البيانات: | Directory of Open Access Journals |
تدمد: | 17589193 |
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DOI: | 10.1186/s13195-024-01468-x |