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多维生活方式干预以维持荷兰老年人的最佳认知功能:FINGER-NL 随机对照试验的研究设计和基线特征。

A multidomain lifestyle intervention to maintain optimal cognitive functioning in Dutch older adults-study design and baseline characteristics of the FINGER-NL randomized controlled trial.

机构信息

Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute (MHeNs), Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.

Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.

出版信息

Alzheimers Res Ther. 2024 Jun 13;16(1):126. doi: 10.1186/s13195-024-01495-8.

Abstract

BACKGROUND

Evidence on the effectiveness of multidomain lifestyle interventions to prevent cognitive decline in older people without dementia is mixed. Embedded in the World-Wide FINGERS initiative, FINGER-NL aims to investigate the effectiveness of a 2-year multidomain lifestyle intervention on cognitive functioning in older Dutch at risk individuals.

METHODS

Multi-center, randomized, controlled, multidomain lifestyle intervention trial with a duration of 24 months. 1210 adults between 60-79 years old with presence of ≥ 2 modifiable risk factors and ≥ 1 non-modifiable risk factor for cognitive decline were recruited between January 2022 and May 2023 via the Dutch Brain Research Registry and across five study sites in the Netherlands. Participants were randomized to either a high-intensity or a low-intensity intervention group. The multidomain intervention comprises a combination of 7 lifestyle components (physical activity, cognitive training, cardiovascular risk factor management, nutritional counseling, sleep counseling, stress management, and social activities) and 1 nutritional product (Souvenaid®) that could help maintain cognitive functioning. The high-intensity intervention group receives a personalized, supervised and hybrid intervention consisting of group meetings (on-site and online) and individual sessions guided by a trained lifestyle coach, and access to a digital intervention platform that provides custom-made training materials and selected lifestyle apps. The low-intensity intervention group receives bi-monthly online lifestyle-related health advice via the digital intervention platform. Primary outcome is 2-year change on a cognitive composite score covering processing speed, executive function, and memory.

RESULTS

Within 17 months, participant recruitment has been successfully completed (N = 1210; mean age: 67.7 years (SD: 4.6); 64% female). Modifiable risk factors commonly present at baseline were physical inactivity (89%), low mental/cognitive activity (50%), low social engagement (39%), hypertension (39%) and high alcohol consumption (39%). The mean body mass index of participants was 28.3 (SD: 4.2) and the total serum cholesterol was 5.4 mmol/L (SD: 1.2).

CONCLUSIONS

Baseline lifestyle and clinical measurements showed successful recruitment of participants with sufficient potential for prevention. Results of FINGER-NL will provide further insight into the efficacy of a multidomain lifestyle intervention to prevent cognitive decline in older adults.

TRIAL REGISTRATION

ClinicalTrials.gov (ID: NCT05256199)/2022-01-11.

摘要

背景

关于多领域生活方式干预在预防无痴呆症的老年人认知能力下降方面的有效性的证据参差不齐。作为世界范围内 FINGERS 倡议的一部分,FINGER-NL 旨在研究为期 2 年的多领域生活方式干预对荷兰有认知风险的老年人认知功能的影响。

方法

这是一项多中心、随机、对照、多领域生活方式干预试验,持续 24 个月。2022 年 1 月至 2023 年 5 月期间,通过荷兰大脑研究登记处和荷兰的五个研究点,招募了 1210 名年龄在 60-79 岁之间、存在≥2 个可改变的认知能力下降风险因素和≥1 个不可改变的认知能力下降风险因素的成年人。参与者被随机分配到高强度或低强度干预组。多领域干预包括 7 个生活方式组成部分(身体活动、认知训练、心血管风险因素管理、营养咨询、睡眠咨询、压力管理和社交活动)和 1 种营养产品(Souvenaid®)的组合,有助于维持认知功能。高强度干预组接受个性化、监督和混合干预,包括小组会议(现场和在线)和由训练有素的生活方式教练指导的个人会议,以及访问数字干预平台,该平台提供定制的培训材料和选定的生活方式应用程序。低强度干预组通过数字干预平台每月收到两次关于生活方式的在线健康建议。主要结局是认知综合评分(涵盖处理速度、执行功能和记忆)的 2 年变化。

结果

在 17 个月内,成功完成了参与者的招募(N=1210;平均年龄:67.7 岁(SD:4.6);64%为女性)。基线时常见的可改变风险因素包括身体不活动(89%)、低精神/认知活动(50%)、低社交参与(39%)、高血压(39%)和高酒精摄入(39%)。参与者的平均体重指数为 28.3(SD:4.2),总血清胆固醇为 5.4mmol/L(SD:1.2)。

结论

基线生活方式和临床测量显示成功招募了有足够预防潜力的参与者。FINGER-NL 的结果将进一步深入了解多领域生活方式干预预防老年人认知能力下降的效果。

试验注册

ClinicalTrials.gov(编号:NCT05256199)/2022-01-11。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0895/11170777/5cf53f86f368/13195_2024_1495_Fig1_HTML.jpg

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