An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial

被引：8

作者：

Brodaty, Henry ^{[1
]}

Chau, Tiffany ^{[1
]}

Heffernan, Megan ^{[1
]}

Ginige, Jeewani A. ^{[2
]}

Andrews, Gavin ^{[3
]}

Millard, Michael ^{[3
]}

Sachdev, Perminder S. ^{[1
]}

Anstey, Kaarin J. ^{[4
,5
,6
]}

Lautenschlager, Nicola T. ^{[7
,8
]}

Mcneil, John J. ^{[9
]}

Jorm, Louisa ^{[10
]}

Kochan, Nicole A. ^{[1
]}

Maeder, Anthony ^{[11
]}

Welberry, Heidi ^{[10
]}

San Jose, Juan Carlo ^{[1
,12
]}

Briggs, Nancy E. ^{[13
]}

Popovic, Gordana ^{[13
]}

Mavros, Yorgi ^{[14
,15
]}

Almendrales Rangel, Carolina ^{[14
]}

Noble, Yian ^{[14
]}

Radd-Vagenas, Sue ^{[14
]}

Flood, Victoria M. ^{[14
,16
]}

O'Leary, Fiona ^{[17
,18
]}

Lampit, Amit ^{[7
]}

Walton, Courtney C. ^{[19
]}

Barr, Polly ^{[20
]}

Fiatarone Singh, Maria ^{[14
,21
,22
]}

Valenzuela, Michael ^{[1
]}

机构：

[1] UNSW Sydney, Ctr Hlth Brain Ageing CHeBA, Sch Clin Med, Sydney, NSW, Australia

[2] Western Sydney Univ, Sch Comp Data & Math Sci, Sydney, NSW, Australia

[3] UNSW Sydney, Sch Psychiat, Clin Res Unit Anxiety & Depress, Sydney, NSW, Australia

[4] UNSW Sydney, Sch Psychol, Sydney, NSW, Australia

[5] UNSW Sydney, UNSW Ageing Futures Inst, Sydney, NSW, Australia

[6] Neurosci Res Australia, Sydney, NSW, Australia

[7] Univ Melbourne, Dept Psychiat, Melbourne, Vic, Australia

[8] Royal Melbourne Hosp, Mental Hlth Serv, Parkville, Vic, Australia

[9] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia

[10] UNSW Sydney, Ctr Big Data Res Hlth, Sydney, NSW, Australia

[11] Flinders Univ S Australia, Coll Nursing & Hlth Sci, Adelaide, SA, Australia

[12] UNSW Sydney, Res Technol Serv ResTech, Sydney, NSW, Australia

[13] UNSW Sydney, Stats Cent Mark Wainwright Analyt Ctr, Sydney, NSW, Australia

[14] Univ Sydney, Fac Med & Hlth, Sch Hlth Sci, Sydney, NSW, Australia

[15] Univ Sydney, Fac Med & Hlth, Heat & Hlth Res Ctr, Sydney, NSW, Australia

[16] Univ Sydney, Univ Ctr Rural Hlth, Fac Med & Hlth, Northern Rivers, Sydney, NSW, Australia

[17] Univ Sydney, Fac Med & Hlth, Susan Wakil Sch Nursing & Midwifery, Sydney, NSW, Australia

[18] Univ Sydney, Charles Perkins Ctr, Sydney, NSW, Australia

[19] Univ Melbourne, Melbourne Sch Psychol Sci, Melbourne, Vic, Australia

[20] Univ Bristol, Sch Psychol Sci, Bristol, England

[21] Hinda & Arthur Marcus Inst Aging Res, Hebrew SeniorLife, Boston, MA USA

[22] Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW, Australia

来源：

NATURE MEDICINE | 2025年 / 31卷 / 02期

基金：

英国医学研究理事会; 澳大利亚国家健康与医学研究理事会;

关键词：

DEMENTIA PREVENTION; ALZHEIMERS-DISEASE; RELIABILITY; PERFORMANCE; DEPRESSION; IMPAIRMENT; VALIDITY; BATTERY;

D O I：

10.1038/s41591-024-03351-6

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

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. Australian New Zealand ClinicalTrials.gov registration: ACTRN12618000851268.

引用

页码：565 / 573

页数：18

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