The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People

Abstract

OBJECTIVE To investigate the effect of a 2‐year multidomain lifestyle intervention on daily functioning of older people. DESIGN A 2‐year randomized controlled trial (http://clinicaltrials.gov, NCT01041989). SETTING Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. PARTICIPANTS A total of 1260 older adults, with a mean age of 69 years at the baseline, who were at risk of cognitive decline. INTERVENTION A multidomain intervention, including simultaneous physical activity intervention, nutritional counseling, vascular risk monitoring and management, and cognitive training and social activity. MEASUREMENTS The ability to perform daily activities (activities of daily living [ADLs] and instrumental ADLs) and physical performance (Short Physical Performance Battery). RESULTS The mean baseline ADL score was 18.1 (SD = 2.6) points; the scale ranges from 17 (no difficulties) to 85 (total ADL dependence). During the 2‐year intervention, the ADL disability score slightly increased in the control group, while in the intervention group, it remained relatively stable. Based on the latent growth curve model, the difference in the change between the intervention and control groups was −0.95 (95% confidence interval [CI] = −1.61 to −0.28) after 1 year and −1.20 (95% CI = −2.02 to −0.38) after 2 years. In terms of physical performance, the intervention group had a slightly higher probability of improvement (from score 3 to score 4; P = .041) and a lower probability of decline (from score 3 to scores 0‐2; P = .043) for chair rise compared to the control group. CONCLUSION A 2‐year lifestyle intervention was able to maintain the daily functioning of the at‐risk older population. The clinical significance of these results in this fairly well‐functioning population remains uncertain, but the study results hold promise that healthy eating, exercise, and cognitive and social activity may have favorable effects on functional independence in older people.

Education and marriage synergistically protect oldest old against severe cognitive impairment

“…Results of a recent study show that cognitive decline is not inevitable among at-risk elderly persons if continuous lifestyle interventions can be adopted [30]. Compared with other high-age people, married high-age participants with high levels of education were identified as being protective against severe cognitive impairment; this finding was consistent with previous studies [31,32] There are some limitations to this study.…”

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

“…472 (72%) of participants adhered to all intervention domains, and 52 (4%) participants reported adverse effects from intervention (mostly musculoskeletal pain). In addition to the primary composite cognitive outcome, a number of secondary outcomes have been have been reported, including health-related quality of life [37], reduced risk of chronic disease [38], maintenance of functional abilities [39], and intervention efficacy among different subpopulations characteristics [40], including ApoE e4 carrier status [41].…”

“…Moreover, digital deployments of these programs are uniquely positioned to augment FTF programs as a means of reinforcing intervention components, maintain engagement, and support effective adherence for optimal dosing of unique lifestyle behaviors. Given the rise of digital therapeutics to address chronic disease, digital multidomain intervention programs to enhance cognitive reserve and reduce risk of ADRD are well-positioned to effect lifestyle change in at-risk individuals with both short- and longer-term health benefits [38,39,40].…”

“…Multidomain interventions targeting the enhancement of cognitive reserve and reduction of risk factors associated with ADRD enjoy a unique position due to the numerous non-dementia specific outcomes that these programs can effectively address in older adult populations. A “top-down” approach to lifestyle interventions, beginning with cognitive health, has demonstrated improvements in cognition [36], health-related quality of life [37], self-perceived physical function and general health [39], and chronic disease risk reduction [38].…”

Synergistic influence of education and marriage on the risk for cognition loss among the older people in China

“…Results of a recent study show that cognitive decline is not inevitable among at-risk older people persons if continuous lifestyle interventions can be adopted [30]. Compared to other high-aged people, married high-aged participants with high levels of education were identi ed as having a lower risk for severe cognitive impairment.…”