INVADE: a real-life primary care long-term intervention program for brain health - results from 2013 to 2020

Background The primary care prevention program INVADE (INtervention project on VAscular brain diseases and Dementia in the district of Ebersberg) is intended to prevent stroke and dementia through systematic detection and evidence-based treatment of modifiable vascular risk factors. The study reports on the results of an eight-year evaluation phase. Methods Longitudinal study with non-randomized control group. AOK-insured patients over the age of 50 from the Bavarian district of Ebersberg were invited to participate in the project. The control group consisted of AOK-insured individuals of the same age-group from the district of Dachau. Primary clinical endpoints (mortality and long-term care dependency) and secondary endpoints (inpatient treatment due to cerebrovascular diseases) were based on the administrative data from the AOK. Analyses were carried out according to the principle "intention to treat". Results The intervention group (n=10,663) included 39.7% of insured persons who had enrolled in the program. Significant advantages were observed in the intervention group compared to the control group (n=13,225). Mortality was reduced by 6%, the incidence of long-term care by 10% and the prevalence of long-term care by 18.6%. There were about 190 fewer deaths and 260 fewer new cases of long-term care dependency than expected over a period of eight years. The prevalence of care dependency decreased by 1,600 years. The frequency of hospital treatment for cerebrovascular diseases, however, did not differ between the groups. Conclusion Our results suggest that a real-life practice-based prevention program aimed at better control of vascular risk factors can possibly contribute to a reduction of care dependency and an increase in life expectancy.