2021222324252623 of 79
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer’s disease: the MIND-ADmini randomized controlled trial
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 Caring Sciences, Faculty of Health and Occupational Studies, 801 76, Gävle, Sweden.
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 Physical Activity and Health, the Swedish School of Sport and Health Sciences, SE-114 86, Stockholm, Sweden; Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave J5/1 Mezzanine, 53792, Madison, WI, USA.
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.
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.
Show others and affiliations
2024 (English)In: Alzheimer's Research & Therapy, E-ISSN 1758-9193, Vol. 16, article id 118Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 16, article id 118
Keywords [en]
Adherence, Alzheimer’s disease, Lifestyle intervention, Medical food, Multimodal intervention, Prevention, Randomized controlled trial
National Category
Geriatrics Nutrition and Dietetics
Research subject
Psychology
Identifiers
URN: urn:nbn:se:ltu:diva-106132DOI: 10.1186/s13195-024-01468-xPubMedID: 38812047Scopus ID: 2-s2.0-85194873714OAI: oai:DiVA.org:ltu-106132DiVA, id: diva2:1867982
Funder
AlzheimerfondenThe Swedish Brain FoundationRegion StockholmStiftelsen Stockholms SjukhemForte, Swedish Research Council for Health, Working Life and WelfareEU, European Research Council, 804371NordForskKarolinska InstituteSwedish Research Council
Note

Validerad;2024;Nivå 2;2024-06-11 (hanlid);

Funder: Joint Program of Neurodegenerative Disorders; Demensfonden;

Full text license: CC BY

Available from: 2024-06-11 Created: 2024-06-11 Last updated: 2024-06-11Bibliographically approved

Open Access in DiVA

fulltext(1569 kB)19 downloads
File information
File name FULLTEXT01.pdfFile size 1569 kBChecksum SHA-512
1c3f97be541872ef53fdd733424c16191a9cfe2a902df7334556c1196fd99449154fa09fd599ae5d7cd5558ce5bd18ec62761f9d38e5288e1d19a1ecca77f5a6
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Stigsdotter Neely, Anna

Search in DiVA

By author/editor
Stigsdotter Neely, Anna
By organisation
Health, Medicine and Rehabilitation
In the same journal
Alzheimer's Research & Therapy
GeriatricsNutrition and Dietetics

Search outside of DiVA

GoogleGoogle Scholar
Total: 19 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 96 hits
2021222324252623 of 79
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf