Japan‐Multimodal Intervention Trial for the Prevention of Dementia: A randomized controlled trial

• Published in: Alzheimer's & dementia 2024-06, Vol.20 (6), p.3918-3930
• Main Authors: Sakurai, Takashi, Sugimoto, Taiki, Akatsu, Hiroyasu, Doi, Takehiko, Fujiwara, Yoshinori, Hirakawa, Akihiro, Kinoshita, Fumie, Kuzuya, Masafumi, Lee, Sangyoon, Matsumoto, Nanae, Matsuo, Koichiro, Michikawa, Makoto, Nakamura, Akinori, Ogawa, Susumu, Otsuka, Rei, Sato, Kenji, Shimada, Hiroyuki, Suzuki, Hiroko, Suzuki, Hiroyuki, Takechi, Hajime, Takeda, Shinya, Uchida, Kazuaki, Umegaki, Hiroyuki, Wakayama, Satomu, Arai, Hidenori
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Apolipoprotein E4 - genetics; Cognitive Behavioral Therapy - methods; cognitive decline; Cognitive Dysfunction - prevention & control; cognitive training; dementia; Dementia - prevention & control; diet; Exercise Therapy - methods; Female; Humans; Japan; Male; mild cognitive impairment; multidomain intervention; nutrition; physical exercise; randomized control trial; Risk Factors; Treatment Outcome
• ISSN: 1552-5260; 1552-5279; 1552-5279
• DOI: 10.1002/alz.13838

INTRODUCTION We examined the efficacy of a multidomain intervention in preventing cognitive decline among Japanese older adults with mild cognitive impairment (MCI). METHODS Participants aged 65‐85 years with MCI were randomized into intervention (management of vascular risk factors, exercise, nutritional counseling, and cognitive training) and control groups. The primary outcome was changes in the cognitive composite score over a period of 18 months. RESULTS Of 531 participants, 406 completed the trial. The between‐group difference in composite score changes was 0.047 (95% CI: −0.029 to 0.124). Secondary analyses indicated positive impacts of interventions on several secondary health outcomes. The interventions appeared to be particularly effective for individuals with high attendance during exercise sessions and those with the apolipoprotein E ε4 allele and elevated plasma glial fibrillary acidic protein levels. DISCUSSION The multidomain intervention showed no efficacy in preventing cognitive decline. Further research on more efficient strategies and suitable target populations is required. Highlights This trial evaluated the efficacy of multidomain intervention in individuals with MCI. The trial did not show a significant difference in preplanned cognitive outcomes. Interventions had positive effects on a wide range of secondary health outcomes. Those with adequate adherence or high risk of dementia benefited from interventions.