Multidomain Intervention Trial for Preventing Cognitive Decline among Older Adults with Type 2 Diabetes: J-MIND-Diabetes

IF 4.3 Q2 BUSINESS
T. Sugimoto, A. Araki, H. Fujita, K. Fujita, K. Honda, N. Inagaki, T. Ishida, J. Kato, M. Kishi, Y. Kishino, K. Kobayashi, K. Kouyama, Y. Kuroda, S. Kuwahata, N. Matsumoto, T. Murakami, H. Noma, J. Ogino, M. Ogura, M. Ohishi, H. Shimada, K. Sugimoto, T. Takenaka, Y. Tamura, H. Tokuda, K. Uchida, H. Umegaki, Takashi Sakurai
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Abstract

Background

No multidomain intervention trials have been designed for the prevention of cognitive decline in older adults with type 2 diabetes.

Objectives

To investigate the efficacy of a multidomain intervention in preventing cognitive decline in older adults with type 2 diabetes and cognitive impairment.

Design

Eighteen-month, multi-centered, randomized controlled trial.

Setting

Twelve hospitals in Japan.

Participants

Outpatients with type 2 diabetes aged 70–85 years with cognitive impairment.

Intervention

The multidomain intervention program includes management of metabolic and vascular risk factors, exercise, nutritional counseling, and promotion of social participation. Participants in the control group received usual care and treatment for type 2 diabetes.

Measurements

The primary outcome was the change in a composite score combining several neuropsychological tests from baseline to the 18-month follow-up. To assess the differences in cognitive changes between the intervention and control groups, a mixed-effects model for repeated measures was used.

Results

Between March 13, 2019, and May 8, 2020, 361 participants were screened, and 154 were randomly assigned to either the intervention group (n = 81) or the control group (n = 73). Finally, 110 participants completed the trial. The between-group difference in the composite score changes was 0.068 (95% confidence interval, −0.091 to 0.226). Analyses for secondary outcomes indicated a positive impact of the intervention on memory and indicated that the intervention led to changes in dietary habits with increased intakes of niacin and meat, along with weight reduction compared to the control group.

Conclusion

The multidomain intervention did not demonstrate efficacy in preventing cognitive decline. However, this trial provided proof-of-concept evidence that multidomain interventions may offer cognitive benefits and contribute to changes in dietary behavior and weight reduction in older adults with type 2 diabetes and cognitive impairment. These findings should be confirmed in future studies.

Abstract Image

预防 2 型糖尿病老年人认知能力下降的多领域干预试验:J-MIND-Diabetes
背景目前还没有针对预防老年 2 型糖尿病患者认知功能衰退的多领域干预试验。目的研究多领域干预对预防老年 2 型糖尿病患者认知功能衰退的疗效。干预措施多领域干预计划包括代谢和血管风险因素管理、运动、营养咨询和促进社会参与。测量主要结果是几项神经心理学测试的综合得分从基线到18个月随访期间的变化。为了评估干预组和对照组之间认知变化的差异,采用了重复测量的混合效应模型。结果在2019年3月13日至2020年5月8日期间,共筛选出361名参与者,其中154人被随机分配到干预组(n = 81)或对照组(n = 73)。最后,110 名参与者完成了试验。综合评分变化的组间差异为 0.068(95% 置信区间,-0.091 至 0.226)。对次要结果的分析表明,干预对记忆力有积极影响,并表明干预导致了饮食习惯的改变,增加了烟酸和肉类的摄入量,与对照组相比,体重有所减轻。不过,这项试验提供了概念验证证据,证明多领域干预措施可能对患有 2 型糖尿病和认知障碍的老年人的认知能力有益,并有助于改变他们的饮食行为和减轻体重。这些发现应在今后的研究中得到证实。
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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
自引率
0.00%
发文量
0
期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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