A multidomain lifestyle intervention to maintain optimal cognitive functioning in older adults

Evidence on the effectiveness of multidomain lifestyle interventions in preventing cognitive decline in older adults without dementia has been mixed. The goal of FINGER-NL––part of the World-Wide FINGERS initiative--was to investigate the effectiveness of a 2-year multidomain lifestyle intervention on the cognitive functioning of older at-risk Dutch individuals.

This multi-center, randomized, controlled trial spanned 24 months and involved 1,210 adults aged 60-79 years – with at least two modifiable risk factors and one non-modifiable risk factor for cognitive decline. Participants were recruited between January 2022 and May 2023 through the Dutch Brain Research Registry and five study sites in Netherlands. Participants were assigned to either a high-intensity or low-intensity intervention group. The intervention included lifestyle components––physical activity, cardiovascular risk factor management, cognitive training, nutritional counseling, stress management, sleep counseling, and social activities, and one nutritional product––developed with the aim of preventing Alzheimer's disease and containing docosahexaenoic acid, eicosapentaenoic acid, phospholipids, choline, uridine monophosphate, vitamin E (alpha-tocopherol equivalents), selenium, vitamin B12, vitamin B6, and folic acid, for maintaining cognitive function. 

The high-intensity group received a personalized, supervised intervention with group meetings (both on-site and online), individual sessions led by a trained lifestyle coach, and access to a digital platform with tailored training materials and lifestyle apps. The low-intensity group received bi-monthly online lifestyle-related health advice via the digital platform. The primary outcome was the 2-year change in a cognitive composite score that included processing speed, executive function, and memory.

Participants were recruited over 17 months (mean age - 67.7 years; 64% female). Common modifiable risk factors at baseline included – physical inactivity - 89%; low social engagement - 39%; low mental/cognitive activity - 50%; hypertension - 39%; and high alcohol consumption - 39%. The mean body mass index was 28.3 and total serum cholesterol was 5.4 mmol/L.

Baseline measurements indicate successful recruitment of participants with substantial potential for prevention. The results of this study provided valuable insights into the efficacy of a multidomain lifestyle intervention combined with a nutritional product in preventing cognitive decline in older adults. These findings may guide and inspire the development of new-generation combination therapies involving lifestyle interventions and pharmacological treatments.

Source: Deckers K, Zwan MD, Soons LM, et al. Alzheimers Res Ther. 2024;16(1):126.