Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics: The FINGER trial

Abstract There is emerging evidence linking fruit and vegetable consumption and cognitive function. However, studies focusing on the nutrients underlying this relationship are lacking. We aim to examine the association between plasma nutrients and cognition in a population at risk for cognitive decline with a suboptimal diet. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) trial is a randomized controlled intervention that examines the effects of the MIND diet to prevent cognitive decline. The primary outcome is global cognition. A multivariate linear model was used to investigate the association between blood nutrients and global and/or domain-specific cognition. The model was adjusted for age, sex, education, study site, smoking status, cognitive activities and physical activities. High plasma α-carotene was associated with better global cognition. Participants in the highest tertile of plasma α-carotene had a higher global cognition z score of 0⋅17 when compared with individuals in the lowest tertile (P 0⋅002). Circulating α-carotene levels were also associated with higher semantic memory scores (P for trend 0⋅007). Lutein and zeaxanthin (combined) was positively associated with higher semantic memory scores (P for trend 0⋅009). Our study demonstrated that higher α-carotene levels in blood were associated with higher global cognition scores in a US population at risk for cognitive decline. The higher α-carotene levels in blood reflected greater intakes of fruits, other types of vegetables and lesser intakes of butter and margarine and meat. The higher circulating levels of lutein plus zeaxanthin reflected a dietary pattern with high intakes of fruits, green leafy, other vegetables and cheese, and low consumption of fried foods. Objective nutrient markers in the blood can better characterize dietary intake, which may facilitate the implementation of a tailored dietary intervention for the prevention of cognitive decline.

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Gene Variants of TCF7L2 Influence Weight Loss and Body Composition During Lifestyle Intervention in a Population at Risk for Type 2 Diabetes

Diabetes ◽

10.2337/db09-1050 ◽

2009 ◽

Vol 59 (3) ◽

pp. 747-750 ◽

Cited By ~ 52

Author(s):

A. Haupt ◽

C. Thamer ◽

M. Heni ◽

C. Ketterer ◽

J. Machann ◽

...

Keyword(s):

Type 2 Diabetes ◽

At Risk ◽

Weight Loss ◽

Body Composition ◽

Lifestyle Intervention ◽

Gene Variants ◽

Population At Risk

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Higher Plasma α-Carotene Was Associated With Better Cognitive Function: A Cross-Sectional Evaluation Among the MIND Trial Participants

Current Developments in Nutrition ◽

10.1093/cdn/nzab033_032 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 32-32

Author(s):

Xiaoran Liu ◽

Klodian Dhana ◽

Jeremy Furtado ◽

Puja Agarwal ◽

Neelum Aggarwal ◽

...

Keyword(s):

At Risk ◽

Cognitive Function ◽

Cognitive Decline ◽

Vegetable Consumption ◽

High Plasma ◽

Leafy Vegetables ◽

Population At Risk ◽

Domain Specific ◽

Global Cognition ◽

The Mind

Abstract Objectives There is emerging evidence linking fruit and vegetable consumption and cognitive function. However, mechanistic evidence underlying this relationship is lacking. We aim to examine the association between plasma carotenoids and cognition in a population at risk for cognitive decline. Methods The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) trial (R01 AG052583) is an ongoing randomized controlled intervention on the effects of the MIND diet in preventing cognitive decline. The primary outcome is global cognition assessed using a battery of 12 cognitive tests. Plasma carotenoid levels were measured in 295 participants. Multivariate linear regression models were used to examine the association between blood nutrients and global and domain-specific cognition. Model was adjusted for age, sex, education, study site, smoking status, and frequency of cognitive and physical activities. The Benjamini-Hochberg method with a false discovery rate of 0.25 was used for multiple testing. Results Participants are predominantly Caucasian females (68%) with obesity (BMI 33.6) and a mean age of 69.8 years. High plasma α-carotene was associated with higher average scores for a global measure of cognition. Individuals in the highest tertile of plasma α-carotene levels (tertile median: 155.8 mcg/L) had a higher average score of 0.17 for global cognition compared to those in the lowest tertile (tertile median: 34.9 mcg/L, P = 0.002). Individuals with high plasma α-carotene levels had a dietary pattern that featured high consumption of vegetables other than green leafy vegetables (i.e., carrots, corn, beets, green beans, and onions), and fruits, as well as, lower consumption of butter, margarine, and fried foods. Plasma levels of α-carotene (p for trend 0.007) and lutein plus zeaxanthin (p for trend 0.009) were also associated with higher mean scores for semantic memory. Conclusions Higher circulating levels of specific forms of carotenoids i.e., α-carotene, lutein plus zeaxanthin was associated with higher scores of global and domain-specific cognitive function in a US population at risk for cognitive decline. Funding Sources Funding: R01 AG052583

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Feasibility of a 12 Week Physical Intervention to Prevent Cognitive Decline and Disability in the At-Risk Elderly Population in Korea

Journal of Clinical Medicine ◽

10.3390/jcm9103135 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3135

Author(s):

Sun Min Lee ◽

Hong-sun Song ◽

Buong-O Chun ◽

Muncheong Choi ◽

Kyunghwa Sun ◽

...

Keyword(s):

At Risk ◽

Cognitive Function ◽

Physical Exercise ◽

Cognitive Decline ◽

Elderly Population ◽

Exercise Intervention ◽

Test Facility ◽

Disease Assessment ◽

Home Based ◽

Before And After

There is a need for measures that can prevent the onset of dementia in the rapidly aging population. Reportedly, sustained physical exercise can prevent cognitive decline and disability. This study aimed to assess the feasibility of a 12-week physical exercise intervention (PEI) for delay of cognitive decline and disability in the at-risk elderly population in Korea. Twenty-six participants (aged 67.9 ± 3.6 years, 84.6% female) at risk of dementia were assigned to facility-based PEI (n = 15) or home-based PEI (n = 11). The PEI program consisted of muscle strength training, aerobic exercise, balance, and stretching using portable aids. Feasibility was assessed by retention and adherence rates. Physical fitness/cognitive function were compared before and after the PEI. Retention and adherence rates were 86.7% and 88.3%, respectively, for facility-based PEI and 81.8% and 62.3% for home-based PEI. No intervention-related adverse events were reported. Leg strength/endurance and cardiopulmonary endurance were improved in both groups: 30 s sit-to-stand test (facility-based, p = 0.002; home-based, p = 0.002) and 2 -min stationary march (facility-based, p = 0.001; home-based, p = 0.022). Cognitive function was improved only after facility-based PEI (Alzheimer’s Disease Assessment Scale-cognitive total score, p = 0.009; story memory test on Literacy Independent Cognitive Assessment, p = 0.026). We found that, whereas our PEI is feasible, the home-based program needs supplementation to improve adherence.

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Aerobic Fitness Protects Against Age-Related Cognitive Decline In A Population At Risk For Alzheimer’S Disease

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000677432.36050.2b ◽

2020 ◽

Vol 52 (7S) ◽

pp. 339-339

Author(s):

Ryan J. Dougherty ◽

Clayton Vesperman ◽

Brandon Mergen ◽

Julian Gaitán ◽

Sarah Lose ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

At Risk ◽

Cognitive Decline ◽

Aerobic Fitness ◽

Population At Risk ◽

Age Related ◽

Age Related Cognitive Decline

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Recruitment and Baseline Characteristics of Participants in the AgeWell.de Study—A Pragmatic Cluster-Randomized Controlled Lifestyle Trial against Cognitive Decline

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020408 ◽

2021 ◽

Vol 18 (2) ◽

pp. 408

Author(s):

Susanne Röhr ◽

Andrea Zülke ◽

Melanie Luppa ◽

Christian Brettschneider ◽

Marina Weißenborn ◽

...

Keyword(s):

Risk Factors ◽

At Risk ◽

Cognitive Decline ◽

Large Scale ◽

Sociodemographic Factors ◽

Cognitive States ◽

Dementia Risk ◽

Study Population ◽

Baseline Characteristics ◽

Cluster Randomized

Targeting dementia prevention, first trials addressing multiple modifiable risk factors showed promising results in at-risk populations. In Germany, AgeWell.de is the first large-scale initiative investigating the effectiveness of a multi-component lifestyle intervention against cognitive decline. We aimed to investigate the recruitment process and baseline characteristics of the AgeWell.de participants to gain an understanding of the at-risk population and who engages in the intervention. General practitioners across five study sites recruited participants (aged 60–77 years, Cardiovascular Risk Factors, Aging, and Incidence of Dementia/CAIDE dementia risk score ≥ 9). Structured face-to-face interviews were conducted with eligible participants, including neuropsychological assessments. We analyzed group differences between (1) eligible vs. non-eligible participants, (2) participants vs. non-participants, and (3) between intervention groups. Of 1176 eligible participants, 146 (12.5%) dropped out before baseline; the study population was thus 1030 individuals. Non-participants did not differ from participants in key sociodemographic factors and dementia risk. Study participants were M = 69.0 (SD = 4.9) years old, and 52.1% were women. The average Montreal Cognitive Assessment/MoCA score was 24.5 (SD = 3.1), indicating a rather mildly cognitively impaired study population; however, 39.4% scored ≥ 26, thus being cognitively unimpaired. The bandwidth of cognitive states bears the interesting potential for differential trial outcome analyses. However, trial conduction is impacted by the COVID-19 pandemic, requiring adjustments to the study protocol with yet unclear methodological consequences.

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