Associations of Multidomain Interventions With Improvements in Cognition in Mild Cognitive Impairment

Salzman, Talia; Sarquis‐Adamson, Yanina; Son, Surim; Montero‐Odasso, Manuel; Fraser, Sarah

doi:10.1001/jamanetworkopen.2022.6744

Cited by 52 publications

(40 citation statements)

References 76 publications

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“…In line with this argumentation, multidomain interventions have already been shown to be effective in stimulating modifiable risk factors in parallel to delay the progression of dementia [ 314 , 379 , 382 ], even with existing structural changes in the brain [ 295 , 400 , 406 ]. To improve cognition, multidomain interventions should comprise at least three modalities, one of which is a cognitive approach [ 314 ].…”

Section: Discussionmentioning

confidence: 98%

“…Acting on several modifiable risk factors simultaneously seems to be particularly promising to influence the brain and cognitive reserve and maintain functioning [ 16 , 375 , 376 ]. Therefore, multidomain approaches, including psychosocial and educational support are of growing interest to delay the decline in dementia [ 16 , 314 , 377 , 378 , 379 , 380 ]. Figure 6 provides an overview of the interrelationships and interactions of individual interventions in AD.…”

Section: Multidomain Interventionsmentioning

confidence: 99%

“…The meta-analysis of Salzmann et al (2022) on 28 studies directly compared multi- and single-domain interventions in MCI. The authors found greater pooled effect sizes in multidomain intervention groups for MCI compared to single-domain intervention groups in global cognition (SMD, 0.41; 95% CI 0.23 to 0.59; p < 0.001), executive function (SMD, 0.20; 95% CI 0.04 to 0.36; p = 0.01), memory (SMD, 0.29; 95% CI 0.14 to 0.45; p < 0.001) and verbal fluency (SMD, 0.30; 95% CI 0.12 to 0.49; p = 0.001) [ 379 ]. The systematic review of Chalfont et al (2021) on multidomain interventions in dementia included 26 studies, of which 92% demonstrated improvement, maintenance, or delayed decline of cognitive functioning.…”

Section: Multidomain Interventionsmentioning

confidence: 99%

“…Both reviews comprised, among other modes, cognitive, physical, and nutritional interventions, and educational support. Therefore, it is reasonable to combine these approaches, whereby cognition and physical training is up to date the most common combination [ 314 , 379 , 381 , 382 ]. A review of 17 studies found greater improvement in older adults with MCI on global cognition (SMD = 0.83, 95% CI 0.41 to 1.25; p = 0.0001) for combined cognitive and physical intervention compared with intervention in a single domain [ 381 ].…”

Section: Multidomain Interventionsmentioning

confidence: 99%

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Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Ablinger¹,

Dressel

Rott³

et al. 2022

Biomedicines

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Alzheimer’s disease is one of the most common neurodegenerative diseases in the western population. The incidence of this disease increases with age. Rising life expectancy and the resulting increase in the ratio of elderly in the population are likely to exacerbate socioeconomic problems. Alzheimer’s disease is a multifactorial disease. In addition to amyloidogenic processing leading to plaques, and tau pathology, but also other molecular causes such as oxidative stress or inflammation play a crucial role. We summarize the molecular mechanisms leading to Alzheimer’s disease and which potential interventions are known to interfere with these mechanisms, focusing on nutritional approaches and physical activity but also the beneficial effects of cognition-oriented treatments with a focus on language and communication. Interestingly, recent findings also suggest a causal link between oral conditions, such as periodontitis or edentulism, and Alzheimer’s disease, raising the question of whether dental intervention in Alzheimer’s patients can be beneficial as well. Unfortunately, all previous single-domain interventions have been shown to have limited benefit to patients. However, the latest studies indicate that combining these efforts into multidomain approaches may have increased preventive or therapeutic potential. Therefore, as another emphasis in this review, we provide an overview of current literature dealing with studies combining the above-mentioned approaches and discuss potential advantages compared to monotherapies. Considering current literature and intervention options, we also propose a multidomain interdisciplinary approach for the treatment of Alzheimer’s disease patients that synergistically links the individual approaches. In conclusion, this review highlights the need to combine different approaches in an interdisciplinary manner, to address the future challenges of Alzheimer’s disease.

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Section: Discussionmentioning

confidence: 98%

Section: Multidomain Interventionsmentioning

confidence: 99%

Section: Multidomain Interventionsmentioning

confidence: 99%

Section: Multidomain Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Ablinger¹,

Dressel

Rott³

et al. 2022

Biomedicines

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“…This refers to an intermediate stage from normal aging to dementia (1). Older adults with MCI have the highest risk of progression to dementia (4). By 2050, it is estimated that there will be 2 billion people aged 60 years and over, and 131 million of whom are expected to be influenced by dementia (5).…”

Section: Introductionmentioning

confidence: 99%

The role of dietary patterns and erythrocyte membrane fatty acid patterns on mild cognitive impairment

Wang

Ding

et al. 2022

Front. Nutr.

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BackgroundDietary fatty acids have been shown to be associated with the development of cognition. However, research on the role of fatty acid intake in dietary patterns and fatty acid patterns (FAPs) in the development of cognitive function is limited. The aim of this study was to explore the correlation between dietary patterns and FAPs and to provide available evidence for preventing mild cognitive impairment (MCI) through these patterns.Materials and methodsThe 973 participants aged between 65 and 85 were recruited from 2020 to 2021 for this multicenter research in Beijing. Neuropsychological tests were used for cognitive evaluation, and data of dietary intake in the past 12 months were collected with semi-quantitative food frequency questionnaire. The erythrocyte membrane fatty acid profile was tested by chromatography and mass spectrometry lipid profiling. Factor analysis was used to derive the main dietary patterns and FAPs. Pearson’s correlation or Spearman’s correlation was used to explore the association between dietary patterns and FAPs. Binary logistic regression was applied to examine the relationship between patterns and cognitive function.ResultsSix dietary patterns and six FAPs were identified, explaining 53.4 and 80.9% of the total variance separately. After adjusting all potential confounders, T3 of the pattern 1 and FAP2 were the independent protect factors for MCI, respectively (OR 0.601, 95% CI [0.395, 0.914]; OR 0.108, 95% CI [0.019, 0.623]). Rich of SM (26:0), SM (24:1), and SM (26:1) is the characteristic of FAP2. A positive correlation was found between component scores of dietary pattern1 and FAP2 (r = 0.441, p = 0.001). People who adhered to a reasonable intake of animal flesh consumed more various long-chain fatty acids as well.ConclusionThe erythrocyte membrane metabolites, SM (26:0), SM (24:1), and SM (26:1), might function as early biomarkers for predicting or monitoring of cognitive aging in the elderly. The dietary pattern with recommended animal flesh consumption was significantly associated with FAP characterized by very long-chain SMs. This dietary pattern affected FAP, which might achieve the ultimate goal of neuroprotection through the very long-chain SMs. A rational intake of dietary fatty acids might be an effective way on preventing MCI in the elderly.

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Effects of Exercise Alone or Combined With Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild Cognitive Impairment

et al. 2023

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ImportanceExercise, cognitive training, and vitamin D may enhance cognition in older adults with mild cognitive impairment (MCI).ObjectiveTo determine whether aerobic-resistance exercises would improve cognition relative to an active control and if a multidomain intervention including exercises, computerized cognitive training, and vitamin D supplementation would show greater improvements than exercise alone.Design, Setting, and ParticipantsThis randomized clinical trial (the SYNERGIC Study) was a multisite, double-masked, fractional factorial trial that evaluated the effects of aerobic-resistance exercise, computerized cognitive training, and vitamin D on cognition. Eligible participants were between ages 65 and 84 years with MCI enrolled from September 19, 2016, to April 7, 2020. Data were analyzed from February 2021 to December 2022.InterventionsParticipants were randomized to 5 study arms and treated for 20 weeks: arm 1 (multidomain intervention with exercise, cognitive training, and vitamin D), arm 2 (exercise, cognitive training, and placebo vitamin D), arm 3 (exercise, sham cognitive training, and vitamin D), arm 4 (exercise, sham cognitive training, and placebo vitamin D), and arm 5 (control group with balance-toning exercise, sham cognitive training, and placebo vitamin D). The vitamin D regimen was a 10 000 IU dose 3 times weekly.Main Outcomes and MeasuresPrimary outcomes were changes in ADAS-Cog-13 and Plus variant at 6 months.ResultsAmong 175 randomized participants (mean [SD] age, 73.1 [6.6] years; 86 [49.1%] women), 144 (82%) completed the intervention and 133 (76%) completed the follow-up (month 12). At 6 months, all active arms (ie, arms 1 through 4) with aerobic-resistance exercise regardless of the addition of cognitive training or vitamin D, improved ADAS-Cog-13 when compared with control (mean difference, −1.79 points; 95% CI, −3.27 to −0.31 points; P = .02; d = 0.64). Compared with exercise alone (arms 3 and 4), exercise and cognitive training (arms 1 and 2) improved the ADAS-Cog-13 (mean difference, −1.45 points; 95% CI, −2.70 to −0.21 points; P = .02; d = 0.39). No significant improvement was found with vitamin D. Finally, the multidomain intervention (arm 1) improved the ADAS-Cog-13 score significantly compared with control (mean difference, −2.64 points; 95% CI, −4.42 to −0.80 points; P = .005; d = 0.71). Changes in ADAS-Cog-Plus were not significant.Conclusions and RelevanceIn this clinical trial, older adults with MCI receiving aerobic-resistance exercises with sequential computerized cognitive training significantly improved cognition, although some results were inconsistent. Vitamin D supplementation had no effect. Our findings suggest that this multidomain intervention may improve cognition and potentially delay dementia onset in MCI.Trial RegistrationClinicalTrials.gov Identifier: NCT02808676

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Associations of Multidomain Interventions With Improvements in Cognition in Mild Cognitive Impairment

Cited by 52 publications

References 76 publications

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

The role of dietary patterns and erythrocyte membrane fatty acid patterns on mild cognitive impairment

Effects of Exercise Alone or Combined With Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild Cognitive Impairment

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