Feasibility and preliminary efficacy of the LEAD trial: a cluster randomized controlled lifestyle intervention to improve hippocampal volume in older adults at-risk for dementia

被引:4
作者
Koblinsky, N. D. [1 ]
Anderson, N. D. [1 ,2 ,3 ]
Ajwani, F. [1 ,4 ]
Parrott, M. D. [5 ]
Dawson, D. [1 ,6 ,7 ]
Marzolini, S. [4 ]
Oh, P. [4 ]
MacIntosh, B. [8 ]
Middleton, L. [9 ]
Ferland, G. [10 ,11 ]
Greenwood, C. E. [1 ,12 ]
机构
[1] Baycrest Hlth Sci, Rotman Res Inst, Toronto, ON, Canada
[2] Univ Toronto, Dept Psychol, Toronto, ON, Canada
[3] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
[4] Univ Hlth Network, Toronto Rehabil Inst, KITE, Toronto, ON, Canada
[5] Concordia Univ, PERFORM Ctr, Montreal, PQ, Canada
[6] Univ Toronto, Dept Occupat Sci, Toronto, ON, Canada
[7] Univ Toronto, Occupat Therapy & Rehabil Sci Inst, Toronto, ON, Canada
[8] Univ Toronto, Sunnybrook Res Inst, Hurvitz Brain Sci, Toronto, ON, Canada
[9] Univ Waterloo, Waterloo, ON, Canada
[10] Montreal Heart Inst, Res Ctr, Montreal, PQ, Canada
[11] Univ Montreal, Dept Nutr, Montreal, PQ, Canada
[12] Univ Toronto, Dept Nutr Sci, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
Exercise; Diet; Intervention; Feasibility; Subjective cognitive decline; Early MCI; Vascular risk factors; MILD COGNITIVE IMPAIRMENT; STOP HYPERTENSION DIET; ALZHEIMERS-DISEASE; MEDITERRANEAN DIET; PHYSICAL-ACTIVITY; EXERCISE; DECLINE; VALIDATION; INVENTORY; ADHERENCE;
D O I
10.1186/s40814-022-00977-6
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: Healthy diet and exercise are associated with reduced risk of dementia in older adults. The impact of diet and exercise interventions on brain health is less consistent, especially with dietary interventions which rely on varying approaches. Our objective was to evaluate the feasibility and preliminary efficacy of a 6-month intervention combining exercise with a novel dietary counseling approach to improve hippocampal volume among older adults at-risk for dementia. Methods: Participants with vascular risk factors and subjective cognitive decline or early mild cognitive impairment were cluster randomized in groups of 3-4 to the diet intervention (DIET) or control education (ED) group. All participants engaged in 1 h of supervised exercise per week and additional exercise at home. DIET involved 1 h per week of group-based dietary counseling comprising education, goal setting, and strategy training. ED involved 1 h per week of group-based brain health education classes. Our primary outcome was change in hippocampal volume from baseline to 6 months. Secondary outcomes included changes in cognitive function, blood biomarkers, diet, and fitness. Recruitment challenges and early discontinuation of the trial due to COVID-19 necessitated a revised focus on feasibility and preliminary efficacy. Results: Of 190 older adults contacted, 14 (7%) were eligible and enrolled, constituting 21% of our recruitment target. All participants completed the intervention and attended 90% of exercise and DIET/ED sessions on average. All 6-month assessments prior to COVID-19 were completed but disruptions to in-person testing resulted in incomplete data collection. No serious adverse events occurred and all participants expressed positive feedback about the study. Preliminary findings did not identify any significant changes in hippocampal volume; however, substantial improvements in diet and HbA1c were observed with DIET compared to ED (d = 1.75 and 1.07, respectively). Conclusions: High adherence and retention rates were observed among participants and preliminary findings illustrate improvements in diet quality and HbA1c. These results indicate that a larger trial is feasible if difficulties surrounding recruitment can be mitigated.
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页数:18
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