Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer’s disease: the MIND-ADmini randomized controlled trial

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Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer’s disease: the MIND-ADmini randomized controlled trial

Thunborg, Charlotta, 1965- (författare): Högskolan i Gävle,Karolinska Institutet,Med-Vårdvetenskap,Karolinska institutet

Wang, Rui (författare): Gymnastik- och idrottshögskolan,Institutionen för fysisk aktivitet och hälsa,Karolinska Institute, Solna, Sweden; University of Wisconsin, USA

Rosenberg, Anna (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland

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Sindi, Shireen (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden; The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary’s Hospital, Norfolk Place, W2 1PG, London, UK

Andersen, Pia (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, 171 64, Solna, Stockholm, Sweden

Andrieu, Sandrine (författare): Department of Clinical Epidemiology and Public Health, CHU de Toulouse, and Aging Research Team, CERPOP Inserm UMR 1295, Jules Guesde, 31000, Toulouse, France; IHU HealthAge, 31059, Toulouse, France

Broersen, Laus M. (författare): Danone Nutricia Research, Utrecht, Netherlands

Coley, Nicola (författare): Department of Clinical Epidemiology and Public Health, CHU de Toulouse, and Aging Research Team, CERPOP Inserm UMR 1295, Jules Guesde, 31000, Toulouse, France; IHU HealthAge, 31059, Toulouse, France

Couderc, Celine (författare): Department of Clinical Epidemiology and Public Health, CHU de Toulouse, and Aging Research Team, CERPOP Inserm UMR 1295, Jules Guesde, 31000, Toulouse, France

Duval, Celine Z. (författare): German Institute for Dementia Prevention (DIDP), Saarland University, 66424, Homburg, Germany; Institute of General Practice, Goethe University Frankfurt a.M, 60590, Frankfurt, Germany

Faxen-Irving, Gerd (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden

Hagman, Göran (författare): Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, 171 64, Solna, Stockholm, Sweden

Hallikainen, Merja (författare): The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary’s Hospital, Norfolk Place, W2 1PG, London, UK

Håkansson, Krister (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, 171 64, Solna, Stockholm, Sweden; Stockholm Gerontology Research Center, Tomtebodavägen 18a, 171 65, Solna, Sweden

Kekkonen, Eija (författare): The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary’s Hospital, Norfolk Place, W2 1PG, London, UK

Lehtisalo, Jenni (författare): The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary’s Hospital, Norfolk Place, W2 1PG, London, UK; Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, Helsinki, Finland

Levak, Nicholas (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, 171 64, Solna, Stockholm, Sweden

Mangialasche, Francesca (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden

Pantel, Johannes (författare): German Institute for Dementia Prevention (DIDP), Saarland University, 66424, Homburg, Germany; Institute of General Practice, Goethe University Frankfurt a.M, 60590, Frankfurt, Germany

Rydström, Anders (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden

Stigsdotter Neely, Anna, 1961- (författare): Karlstads universitet,Luleå tekniska universitet,Hälsa, medicin och rehabilitering,Department of Social and Psychological Studies, Karlstad University, 651 88, Karlstad, Sweden,Institutionen för sociala och psykologiska studier (from 2013),Luleå University of Technology, Sweden

Wimo, Anders (författare): Karolinska Institutet

Ngandu, Tiia (författare): Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, Helsinki, Finland

Soininen, Hilkka (författare): The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary’s Hospital, Norfolk Place, W2 1PG, London, UK

Hartmann, Tobias (författare): German Institute for Dementia Prevention (DIDP), Saarland University, 66424, Homburg, Germany; Department of Experimental Neurology, Medical Faculty, Saarland University, 66424, Homburg, Germany

Solomon, Alina (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland; The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary’s Hospital, Norfolk Place, W2 1PG, London, UK

Kivipelto, Miia (författare): Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research QA32, Karolinska Institute, Karolinska Vägen 37 A, 171 64, Solna, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Karolinska Vägen 37 A, 171 64, Solna, Stockholm, Sweden; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland; The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary’s Hospital, Norfolk Place, W2 1PG, London, UK; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland

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Springer Nature, 2024
2024
Engelska.
Ingår i: Alzheimer's Research & Therapy. - : Springer Nature. - 1758-9193. ; 16

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://ltu.diva-por... (primary) (Raw object); https://kau.diva-por... (primary) (Raw object); https://gih.diva-por... (primary) (Raw object); https://hig.diva-por... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; https://urn.kb.se/re...; http://kipublication...; https://urn.kb.se/re...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed cognitive benefits from a multidomain lifestyle intervention in at-risk older people. The LipiDiDiet trial highlighted benefits of medical food in prodromal Alzheimer’s disease (AD). However, the feasibility and impact of multimodal interventions combining lifestyle with medical food in prodromal AD is unclear.Methods: MIND-ADmini was a 6-month multinational (Sweden, Finland, Germany, France) proof-of-concept randomized controlled trial (RCT). Participants were 60–85 years old, had prodromal AD (International Working Group-1 criteria), and vascular/lifestyle risk factors. The parallel-group RCT had three arms: multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); multimodal lifestyle intervention + medical food (Fortasyn Connect); and regular health advice/care (control). Participants were randomized 1:1:1 (computer-generated allocation at each site). Outcome evaluators were blinded to randomization. Primary outcome was feasibility of the multimodal intervention, evaluated by recruitment rate during a 6-month recruitment phase, overall adherence in each intervention arm, and 6-month retention rate. Successful adherence was pre-specified as attending ≥ 40% of sessions/domain in ≥ 2/4 domains (lifestyle intervention), and consuming ≥ 60% of the medical food (lifestyle intervention + medical food). The secondary outcomes included adherence/participation to each intervention component and overall adherence to healthy lifestyle changes, measured using a composite score for healthy lifestyle. Cognitive assessments were included as exploratory outcomes, e.g. Clinical Dementia Rating scale.Results: During September 2017-May 2019, 93 individuals were randomized (32 lifestyle intervention, 31 lifestyle + medical food, and 30 control group). Overall recruitment rate was 76.2% (64.8% during the first 6 months). Overall 6-month retention rate was 91.4% (lifestyle intervention 87.5%; lifestyle + medical food 90.3%; control 96.7%). Domain-specific adherence in the lifestyle intervention group was 71.9% to cognitive training, 78.1% exercise, 68.8% nutritional guidance, and 81.3% vascular risk management; and in the lifestyle + medical food group, 90.3% to cognitive training, 87.1% exercise, 80.7% nutritional guidance, 87.1% vascular risk management, and 87.1% medical food. Compared with control, both intervention arms showed healthy diet improvements (βLifestyle×Time = 1.11, P = 0.038; βLifestyle+medical food×Time = 1.43, P = 0.007); the lifestyle + medical food group also showed vascular risk reduction (P = 0.043) and less cognitive-functional decline (P < 0.05, exploratory analysis). There were 5 serious adverse events (control group: 1; lifestyle intervention: 3; lifestyle + medical food: 1) unrelated to interventions.Conclusions: The multidomain lifestyle intervention, alone or combined with medical food, had good feasibility and adherence in prodromal AD. Longer-term cognitive and other health benefits should be further investigated in a larger-scale trial.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)

Nyckelord

Adherence
Alzheimer’s disease
Lifestyle intervention
Medical food
Multimodal intervention
Prevention
Randomized controlled trial
Psychology
Psykologi
Psykologi
Medicin/Teknik

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