COPENHAGEN—Older persons at risk for cognitive impairment improved in multiple areas of cognition in a two-year study that focused on lifestyle intervention, reported Miia Kivipelto, MD, PhD, at the 2014 Alzheimer’s Association International Conference.
“This is a proof-of-concept study giving the first evidence from a large, long-term, multidomain, randomized controlled trial showing that we can reduce the risk of cognitive impairment among older, at-risk individuals,” said Dr. Kivipelto, Professor of Clinical Geriatric Epidemiology at the Karolinska Institutet Center for Alzheimer Research in Stockholm and Professor at the National Institute for Health and Welfare in Helsinki.
“The effect is not only limited to some areas of cognition, but we see it for several cognitive domains. [The intervention is] feasible, people are able to follow it, and there were no side effects.”
Dr. Kivipelto presented results from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. The trial included 1,260 participants (ages 60 to 77) who had modifiable risk factors for cognitive impairment and Alzheimer’s disease. Dr. Kivipelto’s group sought to reduce cognitive impairment in an at-risk population through a two-year multidomain lifestyle intervention that included nutritional guidance, physical activity, cognitive and social activities, and monitoring and managing metabolic and vascular risk factors such as hypertension, dyslipidemia, obesity, and impaired glucose tolerance.
Subjects were categorized into two groups. One group received the intervention program, and the control group received regular health advice. After two years, the researchers found that the intervention group performed significantly better on a comprehensive cognitive examination, compared with the control group. In addition, the intervention group performed significantly better on specific tests of memory, executive function, and speed of cognitive processing, compared with controls. “Participants told us their experience was very positive, and the dropout rate was only 11% after two years,” said Dr. Kivipelto.
The researchers plan an extended, seven-year follow up study that will begin in 2015 and will include measures of dementia and Alzheimer’s incidence, as well as biomarkers, including brain imaging with MRI and PET. “The extended follow-up is important to really understand the effect on the incidence of dementia, effect on secondary outcomes, and the long-term adherence of this intervention,” said Dr. Kivipelto. “We have a long list of secondary outcomes that will be analyzed later, and that is very important to understand the total benefit.”
—Colby Stong