Face-to-Face and Digital Multidomain Lifestyle Interventions to Enhance Cognitive Reserve and Reduce Risk of Alzheimer’s Disease and Related Dementias: A Review of Completed and Prospective Studies

Abstract

Background: Currently, there is no pharmaceutical intervention to treat or delay pathological cognitive decline or Alzheimer’s disease and related dementias (ADRD). Multidomain lifestyle interventions are increasingly being studied as a non-pharmacological solution to enhance cognitive reserve, maintain cognition, and reduce the risk of or delay ADRD. Review of completed and prospective face-to-face (FTF) and digital multidomain interventions provides an opportunity to compare studies and informs future interventions and study design. Methods: Electronic databases (PubMed, PsycINFO, and NIH RePORTER) were searched for multidomain lifestyle programs. Studies were included if the program (1) included a control group, (2) included at least 3 interventions, (3) were at least 6 months in duration, and (4) included measurement of cognitive performance as an outcome. Results: In total, 17 multidomain lifestyle programs aimed at enhancing cognitive reserve and reducing risk of ADRD were found. Thirteen programs are FTF in intervention delivery, with 3 FTF programs replicating the FINGER protocol as part of the World Wide Fingers Consortium. Four programs are delivered digitally (website, Web application, or mobile app). Program characteristics (e.g., target population, duration, frequency, outcomes, and availability) and results of completed and prospective studies are reviewed and discussed. Conclusion: This review updates and discusses completed and current multidomain lifestyle interventions aimed at enhancing cognitive reserve and reducing risk of ADRD. A growing number of international studies are investigating the efficacy and utility of these programs in both FTF and digital contexts. While a diversity of study designs and interventions exist, FTF and digital programs that build upon the foundational work of the FINGER protocol have significant potential to enhance cognitive reserve and reduce risk of ADRD.

Associations of Lifestyle Factors With Cognition in Community-Dwelling Adults Aged 50 and Older: A Longitudinal Cohort Study

“…Our results seem to be consistent with previous research which has shown that the adherence to overall healthier lifestyles are associated with better cognitive function in adulthood ( Lövdén et al, 2013 ; Klimova et al, 2017 ; Kivipelto et al, 2018 ; Bott et al, 2019 ; Mintzer et al, 2019 ). The mechanisms that underlie the relationship between lifestyle factors and cognition are not yet fully understood.…”

<p>Healthy Eating, Physical Activity, and Sleep Hygiene (HEPAS) as the Winning Triad for Sustaining Physical and Mental Health in Patients at Risk for or with Neuropsychiatric Disorders: Considerations for Clinical Practice</p>

“…167 In the same field, other trials targeted disease onset reduction through support in chronic disease management, smoking cessation, and health coaching. 168…”

Engaging Patients to Design the Systematic Multi-Domain Alzheimer’s Risk Reduction Trial (SMARRT) Intervention: Findings from a Web-Based Survey

“…Multi-domain intervention studies are now being tested around the world. A recent review of completed and prospective multi-domain lifestyle programs aimed at enhancing cognitive reserve and reducing risk of ADRD reported 17 studies, 13 of which are face-to-face and 4 delivered digitally [3]. One of the main barriers to multi-domain intervention studies is adherence to the intervention.…”

“…Primary prevention of Alzheimer's disease and related dementias (ADRD) is increasingly studied as a risk reduction strategy in the absence of any currently available disease-modifying treatments [1,2]. Several interventions studied to-date have had mixed results, and a frequent barrier to these programs has been adherence [3]. One way to potentially improve adherence to risk reduction interventions is to engage patients in the design of the trial, especially when designing a personalized, multi-domain intervention.…”